Rfa Approval Form - Department Of Health And Human Services

ADVERTISEMENT

DEPARTMENT OF HEALTH AND HUMAN SERVICES
DIVISION OF ________________________
RFA APPROVAL FORM
RFA # ___________________
RFA TITLE: _________________________________________________________________________________
BRIEF PURPOSE:
____________________________________________________________________________________________
____________________________________________________________________________________________
RFA submitted to:
PUBLIC _____ PRIVATE NON-PROFIT _____ PRIVATE FOR-PROFIT
_____
FUNDING SOURCE:
FEDERAL _______ STATE _______ BOTH FEDERAL & STATE _______
FUND TYPE: ______ CO # ________ ACCT # ___________ CENTER # ____________ AMOUNT __________
FUND TYPE: ______ CO # ________ ACCT # ___________ CENTER # ____________ AMOUNT __________
DIRECT SERVICES: ____________
INDIRECT SERVICES: __________
BOTH: __________
1.
INITIATOR: ______________________ DATE SUBMITTED: ____________________
2.
__________________________________ _______ APPROVAL
DATE: __________
SECTION/PROGRAM CHIEF
_______ DISAPPROVAL
COMMENTS: _________________________________________________________________________
_____________________________________________________________________________________
3.
__________________________________ _______ APPROVAL
DATE: __________
CONTRACT OFFICE
_______ DISAPPROVAL
COMMENTS: _________________________________________________________________________
_____________________________________________________________________________________
4.
__________________________________ _______ APPROVAL
DATE: __________
BUDGET OFFICE
_______ DISAPPROVAL
COMMENTS: _________________________________________________________________________
_____________________________________________________________________________________
5.
__________________________________ _______ APPROVAL
DATE: __________
DIRECTOR/DESIGNEE
_______ DISAPPROVAL
COMMENTS: _________________________________________________________________________
_____________________________________________________________________________________
RFA Check List:
_______________ RFA and Attachments
D-2

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Dmh 5-72-01 - Examination And Recommendation For Ivc Form - Department Of Health And Human Services - North Carolina Form Dmh 5-72-01 - Examination And Recommendation For Ivc Form - Department Of Health And Human Services - North Carolina Legal
Bse/ Feed Establishment Audit Form - Department Of Health And Human Services Bse/ Feed Establishment Audit Form - Department Of Health And Human Services
Form Nih 2762-3 - Undergraduate Scholarship Program (ugsp) - Academic Enrollment Certification And Service Obligation Deferment Request - U.s. Department Of Health And Human Services Form Nih 2762-3 - Undergraduate Scholarship Program (ugsp) - Academic Enrollment Certification And Service Obligation Deferment Request - U.s. Department Of Health And Human Services Legal
Form Dma 3051 - Request For Independent Assessment For Personal Care Services (pcs) Attestation Of Medical Need - North Carolina Department Of Health And Human Services Form Dma 3051 - Request For Independent Assessment For Personal Care Services (pcs) Attestation Of Medical Need - North Carolina Department Of Health And Human Services Legal
Form Dma-3065 - Personal Care Services (pcs) Medical Attestation For Licensed Care Home Residents - N.c. Department Of Health And Human Services Form Dma-3065 - Personal Care Services (pcs) Medical Attestation For Licensed Care Home Residents - N.c. Department Of Health And Human Services Legal
Form Dma 3137 - Personal Care Services (pcs) Icd-10 Transition Form - North Carolina Department Of Health And Human Services Form Dma 3137 - Personal Care Services (pcs) Icd-10 Transition Form - North Carolina Department Of Health And Human Services Legal
Form Dhhs 1662 - Nursing Record Of Tuberculosis Contacts Form - U.c. Department Of Health And Human Services Form Dhhs 1662 - Nursing Record Of Tuberculosis Contacts Form - U.c. Department Of Health And Human Services Legal
Form Dss-1688 - Designation Of Authorized Representative - North Carolina Department Of Health And Human Services Form Dss-1688 - Designation Of Authorized Representative - North Carolina Department Of Health And Human Services Legal
Form Dss-8594 - Notice Of Expiration - North Carolina Department Of Health And Human Services Form Dss-8594 - Notice Of Expiration - North Carolina Department Of Health And Human Services Legal
Form Dhhs 5010 - Bt And Emerging Pathogens - N.c. Department Of Health And Human Services Form Dhhs 5010 - Bt And Emerging Pathogens - N.c. Department Of Health And Human Services Legal

Related Categories

Parent category: Legal
Download
Go
Page of 2