Included in CFR Manual Only - New York State Office of Mental Health

New York State
Consolidated
Budget and Claiming
Manual
Subject: AC-1171 State Aid Voucher Section/Page: 21.6
For the Periods:
January 1, 2010 to December 31, 2010
July 1, 2010 to June 30, 2011
Issued: February 15, 2010
Rubber stamp signatures are not allowed.
Date:
Title:
Name of Municipality:
Enter the date the State Aid Voucher was signed by the
LGU Chief Fiscal Officer or duly authorized representative.
Enter the title of the county fiscal officer or duly authorized
representative (Treasurer, Controller, etc.).
Enter the county name of the LGU.
For State Use Only Section
Make no entry.
State Comptroller’s Pre-Audit Section
Make no entry.
Expenditure Section
Make no entry.
Liquidation Section
Make no entry.
Direct Contract Funded Service Provider Instructions
Direct contract funded service providers are required to complete and submit State Aid
Vouchers to OPWDD in order to receive advance payments and as part of their mid-year
and final year-end State Aid claim packages. The instructions that follow are broken into
two (2) sections, one for advance payment voucher completion and one for State Aid
claim voucher completion.
Direct Contract Advance Payment Voucher
Voucher Number
Make no entry.
Originating Agency (Box 1)
Enter the acronym for OPWDD as follows: