EFAP Report Please fill out the form below. A copy of the completed PDF will be emailed to you. Emergency Food Assistance Program (EFAPz) Subcontractor's Monthly Expenditure Request for Reimbursement and Demographics Report Reporting Month* Food Pantry Name* Contact Person* Contact Phone Number Contact Email* Group Served New Unduplicated Returning Duplicate Full Service Client Data 0-2 Years Old 0-2 Years Old - New 0-2 Years Old - Returning 3-18 Years Old 3-18 Years Old - New 3-18 Years Old - Returning 19-54 Years Old 19-54 Years Old - New 19-54 Years Old - Returning 55+ Years Old 55+ Years Old - New 55+ Years Old - Returning Total Clients Served Total Clients Served - New Total Clients Served - Returning Total Households served Total Households served - New Total Households served - Returning Optional Data Special Dietary Needs Clients Special Dietary Needs Clients - New Special Dietary Needs Clients - Returning Supplemental Clients Supplemental Clients - New Supplemental Clients - Returning Kids Weekend Bag Clients Kids Weekend Bag Clients - New Kids Weekend Bag Clients - Returning Monthly Match Match Description Match Amounts Total Cash Total Cash In-Kind Labor In-Kind Labor In-Kind Food In-Kind Food In-Kind Other In-Kind Other Total In-Kind In-Kind Total In-Kind Total Total Monthly Match Total Monthly Match Pounds of Food Distributed Food Description Food Amounts By Food Pantry Full Service Supplemental Food Distributed - Supplemental Δ
