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How to fill out the Self Direction Budget Template Excel online
Filling out the Self Direction Budget Template Excel is an essential step for individuals seeking personalized services through the New York State Office for People With Developmental Disabilities. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.
Follow the steps to accurately complete your Self Direction Budget Template Excel.
- Click ‘Get Form’ button to obtain the Self Direction Budget Template Excel and open it in your preferred online editor.
- Begin by entering your personal information in the first section. Fill in your name, street address, city, state, zip code, date of birth, TABS ID number, telephone number, gender, Medicaid ID number, and email address.
- If another person is filling out the form on your behalf, provide their name and relationship in the specified fields alongside their contact information.
- In the Medicaid Service Coordination Information section, include the name of the agency, your service coordinator's name, and their contact details.
- Select the CSS funding category you are requesting by checking the appropriate option: Residential funding (RES), Other-Than-Residential funding (OTR), or Both.
- Provide the name and contact information of the proposed Start-Up Broker or Broker Agency, including their mailing address.
- Identify the services or products the Start-Up Broker will provide by checking all applicable options listed in the form.
- Fill in the projected start date for services and provide the requested SUB reimbursement hourly fee, total estimated hours, and the total anticipated cost, ensuring it does not exceed $2400.
- Complete the FMS information section with the name, address, telephone number, and email of the Financial Management Services agency.
- Sign and date the authorization section to allow the service coordinator to discuss your application with relevant parties.
- Review the payment section and ensure you understand the billing process for services rendered by the Start-Up Broker.
- Both the Start-Up Broker and the applicant or their designee should sign and date the agreement for services to finalize the document.
- In the DDSO Statement of Support section, the DDSO liaison should complete their signature and date of signature for approval.
- Finally, save your changes and ensure that you have a copy for your records. You may also download or print the completed form for submission.
Complete your Self Direction Budget Template Excel online today to ensure you receive the services you need!
To create a new file based on a template in Excel, open the template you wish to use. Then, go to the File menu and choose 'Save As' to create a new document without altering the original. This feature is particularly useful when you work with a Self Direction Budget Template Excel, as it allows you to retain the original format while customizing your budget to fit your unique needs.