Instructions for Form FS-57 "Budget Revision Request" - New Jersey

This document contains official instructions for Form FS-57, Budget Revision Request - a form released and collected by the New Jersey Department of Health. An up-to-date fillable Form FS-57 is available for download through this link.

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Download Instructions for Form FS-57 "Budget Revision Request" - New Jersey

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New Jersey Department of Health
BUDGET REVISION REQUEST (FS-57)
Instructions
Please refer to Subpart M of the Terms and Conditions for Administration of Grants for additional instructions for the use of this form.
Reporting Agency and Address
Budget Categories and Approved Budget
Enter the name and complete mailing address, including the zip
Enter the amounts by budget category as approved in the Notice of
code.
Grant Award, Attachment B or the amounts in the most recent
budget request approved by the Department of Health.
Grant Title
Requested Changes
Enter the title of the grant award as it appears on the Notice of
Grant Award.
Enter the amounts, plus or minus, of the requested changes. On a
separate sheet provide complete justifications for all the requested
changes. Decreases should be explained in the same detail as
Budget Period
increases.
Refer to the Notice of Grant Award or the latest Approved Grant
Modification for this information; the Budget Period is the period of
Revised Budget
time for which a project is funded.
The Approved Budget column plus or minus the Requested
Changes equals the Revised Budget.
Grant Number
Enter the Grant Number as shown on the signed Notice of Grant
Signatures
Award.
The budget revision must be signed by the Chief Financial Officer of
the agency receiving this grant.
Account Number(s)
Enter the account number or numbers which appear in the Notice of
Approval
Grant Award.
A Budget Revision Request shall require the approval of the
Granting Agency’s Program Management Officer and Grant
Revision Number
Management Officer. A budget revision will not be considered as
Requests should be numbered consecutively for each grant.
valid unless both signatures are on the copy returned to your
agency.
FS-57
AUG 12
New Jersey Department of Health
BUDGET REVISION REQUEST (FS-57)
Instructions
Please refer to Subpart M of the Terms and Conditions for Administration of Grants for additional instructions for the use of this form.
Reporting Agency and Address
Budget Categories and Approved Budget
Enter the name and complete mailing address, including the zip
Enter the amounts by budget category as approved in the Notice of
code.
Grant Award, Attachment B or the amounts in the most recent
budget request approved by the Department of Health.
Grant Title
Requested Changes
Enter the title of the grant award as it appears on the Notice of
Grant Award.
Enter the amounts, plus or minus, of the requested changes. On a
separate sheet provide complete justifications for all the requested
changes. Decreases should be explained in the same detail as
Budget Period
increases.
Refer to the Notice of Grant Award or the latest Approved Grant
Modification for this information; the Budget Period is the period of
Revised Budget
time for which a project is funded.
The Approved Budget column plus or minus the Requested
Changes equals the Revised Budget.
Grant Number
Enter the Grant Number as shown on the signed Notice of Grant
Signatures
Award.
The budget revision must be signed by the Chief Financial Officer of
the agency receiving this grant.
Account Number(s)
Enter the account number or numbers which appear in the Notice of
Approval
Grant Award.
A Budget Revision Request shall require the approval of the
Granting Agency’s Program Management Officer and Grant
Revision Number
Management Officer. A budget revision will not be considered as
Requests should be numbered consecutively for each grant.
valid unless both signatures are on the copy returned to your
agency.
FS-57
AUG 12