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: 21.13
For the Periods:
January 1, 2010 to December 31, 2010
July 1, 2010 to June 30, 2011
Issued: February 15, 2010
Number. This number must match the Federal Tax Identification
Number included in the service provider’s fully executed direct
contract.
Zip Code (Box 3)
Municipalities:
Not-for Profits:
Enter the 12 digit Municipality Code assigned to the LGU by the
Office of the State Comptroller. Enter the first nine (9) digits of the
code in the Payee ID box and the remaining three (3) digits in the
Additional box.
Make no entry.
Route
Make no entry.
Payee Name, Address, City, State & Zip Code (Box 4)
If a Municipality or Not for Profit has signed up with the Office of the State
Comptroller (OSC) for Electronic Funds Transfer (EFT) payments, all
information must be consistent with that provided to OSC or payment will not be
paid via EFT.
Municipalities:
Not-for Profits:
Enter the title of the municipal fiscal officer and the street address,
city, state and zip code for the municipal fiscal officer. Do not enter
the name of the municipal fiscal officer.
Enter the corporate name, street address, city, state and zip code
of the service provider’s corporate headquarters.
Payee Amount
Make no entry.
MIR Date (MM) (DD) (YY)
Make no entry.
IRS Code
Make no entry.