Reimbursement and Reporting Requirements 650-25-65-10
(NEW 7/1/19 ML #3552)
Request for Reimbursement Form
The contract entity must submit the Request for Reimbursement–Direct Services form (SFN 1763) to Aging Services Division no later than 30 days after the end of the monthly service period (with exception of the June reimbursement which is due July 10).
The Request for Reimbursement–Direct Services form is available as a fillable PDF form on-line at www.nd.gov/eforms. State will make payment within 30 days after receipt of the Request for Reimbursement–Direct Services and other required reporting. No payment will be made until the reimbursement request and required reporting have been approved by the State.
Monthly Expenditures and Service Report
The contract entity must submit the Monthly Expenditures and Service Report, generated by the contract entity, to Aging Services Division with the reimbursement request.
Monthly Volunteer Service Report
The contract entity must submit the Monthly Volunteer Service Report, generated by the contract entity, to Aging Services Division with the reimbursement request.
