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.
