Get Nd Sfn 1763 2005

This guide provides step-by-step instructions on how to accurately complete the ND SFN 1763 form, also known as the request for reimbursement for direct service. Users will find clear guidance tailored to help navigate each section of the form effectively, even with minimal legal experience.

Follow the steps to complete the ND SFN 1763 form online.

1. Click the ‘Get Form’ button to obtain the ND SFN 1763 form and open it in your selected editor.
2. In the general information boxes, enter a brief description of the services provided by your organization under the contract.
3. Fill in the 8-digit DHS contract number assigned to your contract on the provided line.
4. Specify the start and end dates of the contract, including all extension periods.
5. Enter the billing period dates for the expenditures you are claiming.
6. Provide the name of your organization as it should appear on the reimbursement check.
7. Include the full mailing address for your organization, including address lines, city, state, and zip code.
8. For Column A, input the total previously claimed amounts by expenditure classification.
9. In Column B, enter the expenditures claimed during the current billing period.
10. Calculate the cumulative expenditures to date and enter this in Column C.
11. For Column D, input the total contract award, including any amendments.
12. Complete Column E with total matching expenditures previously reported.
13. In Column F, indicate matching expenditures for the current billing period.
14. For Column G, total the cumulative matching expenditures.
15. Enter sub-totals for each column (A through C) in the sub-total section.
16. Deduct any advances or program income received during this billing period from the totals.
17. Complete the totals section by summing the sub-totals and less advances.
18. Indicate if this is the final reimbursement request by marking the appropriate box.
19. Sign and date the form, providing the payee's telephone number.
20. Once completed, save changes to the document, and you may download, print, or share the form as needed.

Start filling out the ND SFN 1763 online today to streamline your reimbursement process.