Request for Establishment or Adjustment of Receivables
Exhibit 8-2

TO: Office of Policy and Management, Budget and Financial
Management Division - Telephone # (860) 418-6418
FROM:
DATE:
SUBJECT: Grant Award Report (Page 1 of 2)
CT#
TITLE:
CFDA #

PART I (Summary of Award):
Has your grant application been selected for an award? Yes box2.gif (823 bytes) No box2.gif (823 bytes) (check one)
If Yes, approved: $__________ Grant Award
Federal Award box2.gif (823 bytes) Private Awardbox2.gif (823 bytes) (Check one)
Amount of Variance from Original Application: $___________________________
Grant Duration: __/__/__ -__/__/__
Sub-grantees:
State Agencies ____________ $____________
____________ $____________
____________ $____________
Non-State Entities ____________ $____________
____________ $____________
____________ $____________
Final Approved Budget: Number of positions:
Personnel $____________ Federal __________
Fringe Benefits $____________ State __________
Travel $____________ Private __________
Equipment $____________
Supplies $____________
Contractual $____________
Other $____________
Indirect $____________
Total $____________
This award requires (Check one)
box2.gif (823 bytes)The use of advance funding
box2.gif (823 bytes)The establishment (or adjustment) of Receivables in anticipation of funds.
box2.gif (823 bytes)Receivable or Letter of Credit
If No, Application Rejected- Reason(s) Why?







(Rev. 9/97)
ACCOUNTING MANUAL 8-16 APRIL 2000
Grant Award Report (Page 2 of 2)
CT #
PART II (Request to Assign SID if not Currently in Existence)-
FISCAL YEAR FUND CODE AGENCY CODE SID ACCOUNT TITLE/PROJECT NUMBER

















































































PART III (Request to Establish or Adjust Receivables and Control Accounts
Public Works Project No. ___________________________ Federal Project No. ______________________________
Type of Receivable _____________
Receivable Appropriation $____________ Debit  box2.gif (823 bytes) Credit box2.gif (823 bytes) (Check one.)
For Bond Fund items, authorizing statute is S.A. ______________ Section _________ 19__ Session.
Reconciliation of Receivable (If Applicable):
-Allotments to be Financed $_______________
-Bond Fund Sec. Project Receivables $_______________
-Receivable Per Previous Request $_______________
-Receivable as Adjusted by this Request $_______________
-Adjustment $_______________
Approval of Part III by Office of Policy and Management, Budget and Financial Management Division:
_________________________________________ __________________ _______________
Signature of Assigned Budget Analyst Title Date
PART IV (Acknowledgement/Authorization by Grantee Agency):
_________________________________________ __________________ _______________
Signature of Chief Fiscal Officer or Authorized Representative Title Date
INSTRUCTIONS:
1. If award is not made (application is not approved), complete Parts I and IV of this form
2. If project will be financed through a receivable in anticipation of funding or a Letter of Credit, complete all four Paris of this form.
3. If project will be advance funded (not a receivable), complete Paris 1, 11, and IV of this form.
4. Submit two copies of this form and two copies of grant award letter. (Submit three copies of this form and two copies of grant award letter for Public Works projects.)
5. Always submit this form to the Office of Policy and Management, Budget and Financial Management.
ACCOUNTING MANUAL 8-17 APRIL 2000

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