Reimbursement and Reporting Requirements 650-25-70-10
(Revised 7/1/19 ML #3552)
Monthly Data & Payment Report
The contract entity must submit the Monthly Data & Payment Report (SFN 269) 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 Monthly Data & Payment Report is available in the web-based data collection system and as a fillable PDF form on-line at www.nd.gov/eforms. State will make payment within 30 days after receipt of the Monthly Data & Payment Report and other required reporting. No payment will be made until the reimbursement request and required reporting have been approved by the State.
Agency Summary Report
An Agency Summary Report must be generated from the web-based data collection system and must be attached to the Monthly Data & Payment Report when submitted.
