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: 21.16
For the Periods:
January 1, 2010 to December 31, 2010
July 1, 2010 to June 30, 2011
Issued: February 15, 2010
Payee Certification (Box 8)
Municipalities: Signature in Ink: The State Aid Voucher must be signed by
the municipal fiscal officer (Treasurer,
Controller, etc.) or duly authorized
representative. The signature must be in
blue or black ink. Rubber stamp signatures
are not allowed.
Date:
Title:
Name of Municipality:
Enter the date the State Aid Voucher was
signed by the municipal fiscal officer or
duly authorized representative.
Enter the title of the municipal fiscal officer
or duly authorized representative
(Treasurer, Controller, etc.).
Enter the county name of the LGU.
Not-for-Profits: Signature in Ink: The State Aid Voucher must be signed by
the chief executive officer or duly
authorized representative. The signature
must be in blue or black ink. Rubber stamp
signatures are not allowed.
Date:
Title:
Name of Municipality:
Enter the date the State Aid Voucher was
signed by the chief executive officer or duly
authorized representative.
Enter the title of the chief executive officer
or duly authorized representative.
Make no entry.
For State Use Only Section
Make no entry.
State Comptroller’s Pre-Audit Section
Make no entry.