Get Sr 9 Federal Revenue Certification Form

The Sr 9 Federal Revenue Certification Form is essential for confirming that a corporation's total federal revenue remains below the $500,000 threshold in order to maintain submission guidelines for financial audit reports. This guide provides step-by-step instructions on how to fill out this form online.

Follow the steps to complete the Sr 9 Federal Revenue Certification Form online.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Begin by filling out the corporate name of the group home or foster family agency at the top of the form.
3. Provide the name of the executive director or authorized board officer in the designated field.
4. Enter the federal employer identification number (FEIN) to identify the corporation's tax status.
5. Fill in the corporate number for your organization as per your official documentation.
6. Input the street address, provider phone number, mailing address, and provider fax number for communication purposes.
7. Record the city, state, and ZIP code corresponding to the corporate address.
8. Indicate the corporation's fiscal year clearly, ensuring it aligns with your financial records.
9. List the individual program numbers that receive AFDC-FC Title IV-E funds in the provided fields.
10. Document the federal revenue for the fiscal year ending (month/day/year) in the appropriate section.
11. Complete the revenue sections for Group Home AFDC-FC Title IV-E Funds and Foster Family Agency AFDC-FC Title IV-E Funds.
12. Report any federal revenue from other sources, such as education or mental health.
13. Calculate the total federal revenue and ensure it is clearly marked.
14. If the total federal revenue is $500,000 or more, note the requirement to notify the California Department of Social Services within three months.
15. Certify that all information provided is true and correct by printing the name of the executive director or authorized board officer.
16. Sign and date the form, ensuring all fields are filled out accurately.
17. Once completed, save your changes, and prepare to download, print, or share the form as needed.

Complete your Sr 9 Federal Revenue Certification Form online today to ensure compliance and maintain funding eligibility.