Form SF-260-R "Grant Reimbursement Request and Fiscal Report" - Rhode Island

What Is Form SF-260-R?

This is a legal form that was released by the Rhode Island Department of Public Safety - a government authority operating within Rhode Island. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 16, 2012;
  • The latest edition provided by the Rhode Island Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form SF-260-R by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Public Safety.

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Download Form SF-260-R "Grant Reimbursement Request and Fiscal Report" - Rhode Island

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RI Public Safety Grant Administration Office
PSGAO Use Only
Grant Reimbursement Request
and Fiscal Report (SF-260-R)
Requesting Agency:
Address:
State Agency Account #:
Grant Program Period:
Current Reporting Period:
:
Federal Employer ID# (FEIN)
From:
From:
Subgrant Award #:
To:
To:
Date Prepared:
PSGO
Federal Grant #:
Use Only
PO Release #:
BUDGET SUMMARY for Project Name:
Current Reporting
Total Federal
Original Budget
Total Federal
Total Match
Period Expenditures
Projected Program
Previously
Expenditures
Expenditures
Expenditures
Submitted for
Federal
Match
Federal
Local
to Date
to Date
Reimbursement
Amount
Amount
(RIJC)
(Match)
A. Personnel
B. Consult./Contracts
C. Travel Expenses
D. Supplies/Expenses
E. Equipment
F. Other Costs
Totals
Payment Request Amount
(Should equal Current Federal Expenditures)
Authorized Agent
(Please Print)
Signature
(Please Sign in Blue)
PSGAO
Final Payment
Use Only
Partial Payment
I, the above-signed, have reviewed this fiscal report and certify that the information contained herein is true and
correct to the best of my knowledge. I hereby certify that this request for grant reimbursement is in full
accordance with the approved project budget, as approved by the RI Public Safety Grant Administration Office.
PSGAO/CBO Use Only
Grant Manager Approval
Executive Approval
Progress reports are up to date
Fiscal Report is accurate
Routed to CBO:
Expenditures detailed satisfactorily
Grant Program
* Note:
Byrne/JAG
VOCA
RSAT
JJDPA Formula
JJ Block
Other __________________
VAWA
GTEAP
NCHIP
PSN
Coverdell
Revised – February 16, 2012 – G:/Shared/Forms/SF-260-R.DOC
RI Public Safety Grant Administration Office
PSGAO Use Only
Grant Reimbursement Request
and Fiscal Report (SF-260-R)
Requesting Agency:
Address:
State Agency Account #:
Grant Program Period:
Current Reporting Period:
:
Federal Employer ID# (FEIN)
From:
From:
Subgrant Award #:
To:
To:
Date Prepared:
PSGO
Federal Grant #:
Use Only
PO Release #:
BUDGET SUMMARY for Project Name:
Current Reporting
Total Federal
Original Budget
Total Federal
Total Match
Period Expenditures
Projected Program
Previously
Expenditures
Expenditures
Expenditures
Submitted for
Federal
Match
Federal
Local
to Date
to Date
Reimbursement
Amount
Amount
(RIJC)
(Match)
A. Personnel
B. Consult./Contracts
C. Travel Expenses
D. Supplies/Expenses
E. Equipment
F. Other Costs
Totals
Payment Request Amount
(Should equal Current Federal Expenditures)
Authorized Agent
(Please Print)
Signature
(Please Sign in Blue)
PSGAO
Final Payment
Use Only
Partial Payment
I, the above-signed, have reviewed this fiscal report and certify that the information contained herein is true and
correct to the best of my knowledge. I hereby certify that this request for grant reimbursement is in full
accordance with the approved project budget, as approved by the RI Public Safety Grant Administration Office.
PSGAO/CBO Use Only
Grant Manager Approval
Executive Approval
Progress reports are up to date
Fiscal Report is accurate
Routed to CBO:
Expenditures detailed satisfactorily
Grant Program
* Note:
Byrne/JAG
VOCA
RSAT
JJDPA Formula
JJ Block
Other __________________
VAWA
GTEAP
NCHIP
PSN
Coverdell
Revised – February 16, 2012 – G:/Shared/Forms/SF-260-R.DOC