Fiscal Return to the Oregon Department of Education

By completing this form, you are authorizing the Oregon Department of Education to issue an invoice to your institution to collect payment for the amount being returned. Warrant information should be available on the check or ACH documentation for the original payment, or you can log into EGMS and look under Web - Sub Grant in the Financial Details section. If you need additional assistance, you may email egms.refund@ode.oregon.gov.


Please only enter refund(s) for ONE subgrant per request. We will need to know how much to apply toward which claim(s).

What entity is sending back funding?

Who should we contact with questions?

Select or enter value
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Subgrant number in EGMS (i.e. 5xxxx). Please only submit ONE subgrant number per request. If you are returning funds for multiple claims within that single subgrant, please specify in the Grantee Comment field how much each original claim was for, and how much of each claim you are returning.

Which grant does this pertain to?

(If known)

(If known)

Amount of payment received via check or ACH

How much of the original amount is being sent back?

Backup documents supporting this refund

Drag and drop files here or