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

New York State
Consolidated
Budget and Claiming
Manual
Subject: CBR-i – Agency Identification and
Certification Statement
For the Periods:
January 1, 2010 to December 31, 2010
July 1, 2010 to June 30, 2011
Section/Page: 11.2
Issued: February 15, 2010
Not-for-Profit:
Proprietary:
Governmental:
A group, institution, or corporation formed for the purpose of providing
goods and services under a policy where no individual (e.g.,
stockholder, trustee) will share in any profits or losses of the
organization. Profit is not the primary goal of not-for-profit entities. All
income and earnings will be used exclusively for the purpose of the
corporation and no part shall inure to the benefit of any private
individual, firm or corporation.
A privately or publicly owned entity operated for profit.
An entity operated by a State, County or Municipality.
Person to Contact
Enter the name, title, email address phone number and fax number of the person that can
answer questions about the information contained in the document.
Note:
Please check the box if the person to contact has changed since the last
reporting period.
State Agency(ies)
Indicate the NYS Department of Mental Hygiene (DMH) State Agency(ies) that
fund(s)/Certify(ies) the reported program(s). The DMH State Agencies are the Office of
Alcoholism and Substance Abuse Services (OASAS), Office of Mental Health (OMH) and
the Office for People with Developmental Disabilities (OPWDD).
Date Prepared
Enter date this document was completed.
Number of Pages
Enter the total number of pages submitted including attachments to the Consolidated
Budget Report (CBR).