This is the place to check whenever you receive a new or amended contract. We will post the revised claim form as soon as we send the contracts out.
1. Use the latest claim form available.
2. Please check your year-to-date totals. Be sure to carry over the non-calendar
contract year-to-date to the new forms.
3. For amended reports:
a. Please use "Amended" in file name.
b. Only enter the numbers that changed in the monthly column and update
c. Leave off numbers previously reported in monthly column and
4. Elder Abuse - only report expenses to contract amount.
5. Elder Abuse - please "X" the box if you have overspent your contract.
6. Do not report pennies - please round up or down.
7. Manually enter I&A Replacement numbers. Divide monthly expenses and
year-to- date expenses by 2. Enter 1/2 in the I&A Replacement line and the other
half down below on the federal match line. NOTE: These 2 numbers should be the same.
8. Clear prior months numbers in the monthly column if you are not reporting expense
for these funds.
9. Please check your monthly totals on the Certificate of Claim totals. This should
agree with the expense reimbursement you are expecting.
2013 County Claim Form Revised 5/7/13
2013 Tribal Claim Form Revised 5/7/13