Grant Reallocation Request Form

Grant Reallocation Request Form

This is a post award grant budget amendment form. Grantees are required to submit this form in order to reallocate grant funds to address unexpected program changes. Note: While programmatic changes or budget revisions costing less than $1,000 do not require a budget amendment, MCSS reserves the right to request that this form is filled out to document any change that impacts the initial approved budget or program/project. All budget amendments must be approved by MCSS prior to commencement of work.

Organization Name*

Head of Organization*

Type of Grant*

Select

Grant Number*

Grant/Program Manager (Requestor)*

First Name, Last Name

Grant/Program Manager (Requestor's) Email*

Grant/Program Manager (Requestor's) Phone #*

Phone

Fiscal Year*

Select

Is this your first time submitting a grant change request?*

Select

Choose Amendment Number.*

Select

Purpose of Grant Change Request*

Select

Current Approved Grant Budget*

Performance Period (Extension):*

Enter the new proposed end-date.

You indicated that the purpose of your grant change request is to "Increase/Decrease the amount of the grant". Choose which option applies below.*

Select

Increase(+)*

Amount ($)

Decrease(-)*

Amount($)

New Project Request*

What is the new project that is being considered to justify increasing/decreasing the previously approved award amount? Provide a brief description of the new project.

New Program Budget (Total)*

If increasing/decreasing the previously approved award amount, what is the TOTAL newly proposed grant budget?

Previously Approved Project*

What was the project that was previously approved?

New POC*

Provide the First and Last Name of the new primary point of contact

New POC Phone #:*

New POC Email:*

You selected "Other" above. In a few words, describe the purpose of your grant change request. Include as much detail as possible.*

Provide a detailed narrative to support the need for this amendment.*

The narrative must tie directly to the Purpose of Grant Change Request selected above. A separate attachment with the detailed narrative may be attached to the form prior to submitting.

Budget Amendment ($ Requested)*

How much of the current approved budget are you requesting to realign?

Additional Request(s)*

Do you have additional realignment request(s)?

Select

Additional Request Detail*

Requested Realignment Amount*

Acknowledgement By signing this form, I acknowledge that all of the information provided above is accurate*

First Name, Last Name:

Title of person filling out form:*

File Upload

Attach any supporting file that is relevant to your request. Examples include estimates/quotes/contracts/etc.

Drag and drop files here or

Send me a copy of my responses

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