Grant Forms

De Minimis Certification Form
Detailed Budget Narrative Form
NC Human Trafficking Commission Acknowledgement Letter/Form (HT Projects Only)
Participant Support Costs
Staffing Allocation Form
Sample Memorandum of Understanding
Sample Contract Template
Sample Detailed Supply List
Culturally Specific Organization Verification Letter
Legal Services Certification Letter
Assurance Concerning Polygraph Testing Prohibition
Summary of Direct and Contracted GCC Funds Form
Sample Template for Data Breach or Imminent Breach Procedures
Budget Clarification Worksheet
CVS FAQ

Single Audit Certification
No Overdue Taxes Certification
Certifications Regarding Lobbying; Debarment; Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements
Employment Eligibility Verification Form
Advance Determination of Suitability for Interacting with Minors Certification
NCID Acceptable Use Policy
Confidentiality Certification
Policy for Reporting Workplace Incidents

Civil Rights Compliance Forms

• Civil Rights Compliance Checklist
• Civil Rights Compliance Self-Certification Form
• Civil Rights Responsibilities and Requirements For Grantees
• Civil Rights Discrimination Consent Form 

Expense Reimbursement Cover Pages

• Contractual
• Equipment
• Operating Expenses
• Personnel
• Supplies
• Travel

Time and Activity Forms

• Multiple Funding Sources (4)
• Multiple Funding Sources (6)
• Multiple Funding Sources (14)
• Match or Single Funding Source

State Grant Compliance Reporting Forms

Level 1: Between $1 and $999,999 in state and federal pass-through funds

• Certification Form
• Schedule of Receipts and Expenditures
• Program Activities and Accomplishments
• Send reports to: DPS_GrantComplianceReports@ncdps.gov

Level 2: $1,000,000 or more in state and federal pass-through funds

• Certification Form
• Schedule of Receipts and Expenditures
• Program Activities and Accomplishments
• Submission of required single (or program-specific) audit in accordance with Generally Accepted Government Auditing Standards (gao.gov/yellowbook)
• Send reports to DPS_GrantComplianceReports@ncdps.gov

Addition if $1,000,000 or more in federal expenditures (see also 2 CFR 200.501)

• Submit federally required audit to: harvester.census.gov/facweb/
• Make copies of audit available to public.