TX HHS Form 3470. Request for Advance or Reimbursement (RAR) Centers for Independent Living Base/Operation Grant

The TX HHS Form 3470, Request for Advance or Reimbursement (RAR) Centers for Independent Living Base/Operation Grant, is a crucial document that helps solve the problem of managing funds and tracking expenditures for centers providing independent living services. This form is typically used by service providers to request advances or reimbursements from the Texas Health and Human Services (HHS) for their programs.

The form requires essential information such as payee ID number, service provider name, contract number, address, and phone number. It also includes sections for budget periods, report periods, and cumulative expenditures. The form emphasizes the importance of accurate reporting, stating that any false or fraudulent information may subject the submitter to criminal, civil, or administrative penalties.

The key features of this form include the requirement to provide a total amount requested, which must be supported by the previous month's receipts. The form also specifies that advances over 30 days are not allowed. By signing the report, the submitter certifies that the information is true, complete, and accurate. The form is designed for financial officers and other authorized personnel who need to track and manage funds for independent living services programs.

• The form is used by service providers to request advances or reimbursements from HHS for their independent living services programs.
• The form requires essential information such as payee ID number, service provider name, contract number, address, and phone number.
• The form emphasizes the importance of accurate reporting and specifies penalties for false or fraudulent information.