1 Disaster Supplement Payment Management Reconciliation Ex

Generic for ACF Program Monitoring Activities

Attachment A Disaster Supplement Payment Management Reconciliation Example.xlsx

OMB: 0970-0558

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OMB Control Number: 0970-0558, Expiration Date: 11/30/2023
Period Under Review (PUR) 09/01/2018 thru 12/31/2018






PMS Disbursement Amount for PUR $















Grant Number Grantee Name Payment Date Check Number/EFT Payment Amount Payee Name Account Type Description Comments
02TD00000#





































































































































PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering information to help the Office of Head Start (OHS) examine grantee use of federal funds related to disaster relief in accordance with the Improper Payments Information Act 2002. Public reporting burden for this collection of information is estimated to average 1 hour per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information (Title 2, Code of Federal Regulations (CFR), Part 200, Subsection 300, "Statutory and National Policy Requirements" [also codified at Title 45, CFR, Part 75, Subsection 300]). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0558 and the expiration date is 11/30/2023. If you have any comments on this collection of information, please contact Stefanie Gordon at [email protected] or (646) 905-8061.

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