ANNUAL REPORT OF NON-PRIORITY CASES

Pursuant to 45 C.F.R. 1620.7(b)(2)

 

 

____________________________
Recipient Name

 

 

____________________________
Recipient Number

 

 

Total Number of emergency non-priority cases opened: _____________

 

 

Total Number of emergency non-priority matters opened: ___________

 

 

 

________________________                                    _______________________
Executive Director Date                                               Date

 

 

___________________
        2         Report due on January 31, for the prior year.

 

 


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