Follow the steps to successfully complete your disbursement request form.

1. Click the ‘Get Form’ button to obtain the form and open it in your editing tool.
2. Begin by identifying the grantee's information. In this instance, fill in 'Allegheny County' in the Grantee field.
3. Enter the ME number assigned to your request, which is '350220'.
4. Indicate the disbursement request number in the appropriate field.
5. Specify whether this is a final request by selecting 'Yes' or 'No'.
6. In the 'Approved Costs' section, categorize your budget items such as Project Development, Public Education, and Collection Equipment and input the respective approved costs.
7. Next, input your current expenditures, previous expenditures, and total expenditures to date for each category.
8. Calculate and enter the DEP share, balance, and percentage to be paid for each category.
9. There is a section for the matching funds. Fill in the total DEP share to date, balance, total match, current match, previous match, and total match to date.
10. Review all entries for accuracy, ensuring that they reflect the financial details related to your recycling program.
11. At the bottom of the form, certify the accuracy of the information provided by signing your name in the designated signature field.
12. Enter the date of the certification and type or print your name and title.
13. Lastly, include a contact telephone number for any follow-up.
14. Once all sections are completed and verified, save your changes, and you may choose to download, print, or share the completed form as necessary.

Complete your disbursement request form online today to facilitate your funding process!