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

New York State
Consolidated
Budget and Claiming
Manual
Subject: CQR-1 Agency Quarterly Fiscal
Summary
For the Periods:
January 1, 2010 to December 31, 2010
July 1, 2010 to June 30, 2011
Section/Page: 22.2
Issued: February 15, 2010
Heading Instructions – CQR-1.1 and CQR-1.2
State Agency *
Indicate the reported programs for OASAS services.
Fiscal Period *
Enter the beginning and ending dates of the complete 12 month fiscal reporting period
(01/01/XX to 12/31/XX, 07/01/XX to 06/31/XY, etc.). Do not enter the dates of the quarter or
mid-year period for which expenses and revenues are being reported.
Quarter Reported *
Indicate the specific intra-year claim period the CQR-1 covers (i.e. 1 st quarter, 2 nd quarter,
mid-year, etc.).
Agency Name *
Enter the name of the organization (service provider) operating the reported program(s).
Prepared by *
Enter name of person that prepared the CQR-1 and can answer questions about the
information contained in the document.
Telephone *
Enter the preparer's telephone number.
Agency Code *
Enter the five (5) digit code assigned to the organization operating the reported program(s).
County Name and Code *
LGU *
Enter the name and associated two (2) digit code for the county where the reported
programs operated and/or were funded through a local county contract. Please see
Appendix C of this manual and the Consolidated Fiscal Reporting and Claiming Manual
(CFR Manual) for a list of New York State counties and their associated county codes.
Local contract funded service providers:
Enter the name of the Local Governmental Unit
(LGU) that contracted for the reported