Form CDA240 "Adrc Infrastructure Grants Program Expenditure Report & Request for Reimbursement" - California

What Is Form CDA240?

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

Form Details:

  • Released on March 1, 2021;
  • The latest edition provided by the California Department of Aging;
  • 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 fillable version of Form CDA240 by clicking the link below or browse more documents and templates provided by the California Department of Aging.

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Download Form CDA240 "Adrc Infrastructure Grants Program Expenditure Report & Request for Reimbursement" - California

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STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF AGING
ADRC INFRASTRUCTURE GRANTS PROGRAM EXPENDITURE REPORT &
REQUEST FOR REIMBURSEMENT
CDA 240 (REV 03/2021)
Invoice #:
FI$Cal PO#:
Contract No:
Invoice Date:
Contract Term: Fiscal Years 19/20 through 21/22
ADRC Name:
Remit to Name:
Remit to Address:
PART I: EXPENDITURE REPORT
Expenditure Month:
Year:
ADMINISTRATION COSTS
Personnel
Operating Expenses
Indirect Costs
Total Administration Costs
$ 0
PROGRAM COSTS
Personnel
Operating Expenses
Indirect Costs
Total Program Costs
$ 0
SUBCONTRACTED SERVICE COSTS
Subcontractor Costs
Vendor Costs
Total Subcontracted Service Costs
$ 0
Total Costs
$ 0
PART II: REQUEST FOR REIMBURSEMENT
Request Month:
Year:
TOTAL
Total Amount to be Reimbursed
$ 0
FOR STATE USE ONLY
Program Analyst Approval
Program Manager Approval
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF AGING
ADRC INFRASTRUCTURE GRANTS PROGRAM EXPENDITURE REPORT &
REQUEST FOR REIMBURSEMENT
CDA 240 (REV 03/2021)
Invoice #:
FI$Cal PO#:
Contract No:
Invoice Date:
Contract Term: Fiscal Years 19/20 through 21/22
ADRC Name:
Remit to Name:
Remit to Address:
PART I: EXPENDITURE REPORT
Expenditure Month:
Year:
ADMINISTRATION COSTS
Personnel
Operating Expenses
Indirect Costs
Total Administration Costs
$ 0
PROGRAM COSTS
Personnel
Operating Expenses
Indirect Costs
Total Program Costs
$ 0
SUBCONTRACTED SERVICE COSTS
Subcontractor Costs
Vendor Costs
Total Subcontracted Service Costs
$ 0
Total Costs
$ 0
PART II: REQUEST FOR REIMBURSEMENT
Request Month:
Year:
TOTAL
Total Amount to be Reimbursed
$ 0
FOR STATE USE ONLY
Program Analyst Approval
Program Manager Approval