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Indicate the SNAP E&T funding source to be used. 100% Admin Funds 50/50 Admin Funds Will the WBL program cover other costs associated with wages, such as Workers Compensation or Payroll Taxes? Yes No What is the total amount of Workers Compensation or Payroll Taxes that is covered or reimbursed by SNAP E&T? $1,000.00 What is the total amount of other administrative costs associated with the activity that is covered or reimbursed by SNAP E&T, such as additional case management hours? $500.00 Total Projected Wages to be Paid to Participants Total Projected Subsidized Wages Total Projected Wages Covered/Reimbursed by SNAP E&T Total Cost of WBL Activity to be Covered/Reimbursed by SNAP E&T $131,820.48 $131,820.48 $65,910.24 $67,410.24 275