Reporting Schedule / Forms
 

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Nevada Aging and Disability Services Division (ADSD)

Grantee Reporting Schedule
Fiscal and Programmatic Reports
Revised July 2013
 

REPORT/DOCUMENT

DUE DATE

SEND TO

# OF COPIES

Notification of Grant Award (NGA)

Ten (10) days after receipt of grant award.

See name/address in
NGA E-mail Notification

Signed Original

Confidentiality Addendum (CA)
-SAMS Users

Ten (10) days after receipt of grant award.

See name/address in
NGA E-mail Notification

Signed original for each grant award

FISCAL REPORTS
Request for Funds (RFF)

Form is available online!
Click on the link below.


Request for Funds
(Revised 7/13) -
Use only if you have not yet received a FY14 NGA and RFF


Instructions

(Revised 6/13)

Request for Funds for
Discretionary Grant Programs

(Revised 10/13)

To receive timely payments, Request for Funds should be received by the 10th calendar day of the month preceding the quarter requested.

Las Vegas ADSD

- ADSD Policy (PDF)

Titles III-B, III-D, and III-E, ILG, State Transportation and State Volunteer Grantees: A RFF form was emailed to you with your program's FY14 NGA. Complete the form, sign and email it to adsdgrants@adsd.nv.gov.

All Other Grantees: Use the RFF dated 7/2013 until you receive your FY14 grant documents. Complete the form, sign and email it to adsdgrants@adsd.nv.gov.

 
Quarterly Financial

Form is available online!
Click on the link below
that is applicable to your grant.

Adult Day Care Grants

Nutrition Fixed-Fee Grants

All Other Categorical Grants

All Other Fixed-Fee Grants
 

10th calendar day of the month following the end of a reporting quarter.

(You must submit a report for each grant you receive from ADSD, even if you did not spend any of the funding during the reporting period.)

Las Vegas ADSD  - ADSD Policy (PDF)

 E-mailed to:

     adsdgrants@adsd.nv.gov

October 10  
April 10 

January 10
July 10

PROGRAMMATIC REPORTS
Social Assistance Management System (SAMS)

Client Registration Forms

Program Narrative Report

Input monthly data by the 10th calendar day of the following month.

There is no hard copy report to send in. ADSD will pull information directly from SAMS.

Example: Input January's data by February 10th.

Monthly Meal Count
-Nutrition Programs

Monthly Meal Count Form

Due by the 10th calendar day of each month following the month of service.

Lisa Williams
Las Vegas ADSD

One (1) copy

E-mailed to:    
     lawilliams@adsd.nv.gov

Transportation Report

Reporting Form
(Grantees who report ride information to NDOT may alternatively submit the quarterly NDOT report)

10th calendar day of the month following the end of a reporting quarter.

Lisa Williams
Las Vegas ADSD and

Your RD Specialist

One (1) copy

E-mail the spreadsheet to:     
     lawilliams@adsd.nv.gov and
     your assigned RD Specialist

October 10
April 10

January 10
July 10

State Transportation

Reporting Form

10th calendar day of the month following the end of a reporting quarter.

Shirley Chantrill
Elko ADSD

One (1) copy

Mailed or e-mailed to:    
    schantrill@adsd.nv.gov

October 10
April 10

January 10
July 10


State Volunteer

Instructions

Expense and Service Report

Narrative Report
 

10th calendar day of the month following the end of a reporting quarter.

Shirley Alloway
Las Vegas ADSD

One (1) copy

Mailed or e-mailed to:    
    sjalloway@adsd.nv.gov

October 10
April 10

January 10
July 10

MIPPA Reporting Template

Due by the 10th calendar day of each month following the month of service. 

Report covers 1st day of the month to the last day of the month.

Jeff Doucet
Las Vegas ADSD

 One (1) copy 

 E-mailed monthly to:
    jsdoucet@adsd.nv.gov

Aging and Disability Resource Center (ADRC)

Monthly Data Tracking Tool (DTT)

Form available at
http://www.nevadaadrc.com

Due by the 15th calendar day of each month following the month of service.

Teresa Sacks,
Sanford Center for Aging
Program Evaluator

 Online submission at
    http://www.nevadaadrc.com 

 Must register for a login.

Aging and Disability Resource Center (ADRC)

Semi-Annual Reporting Tool (SART) - federal report

Six (6) month report due for review by each ADRC site one week prior to final submission date.

Final submission dates by ADSD:
April 30         October 31

Cheyenne Pasquale,
ADRC Project Manager/
State Lead
Las Vegas ADSD

 Online tool located at
    
http://www.adrc-tae.org

 Must be authorized by State
 Lead to submit SART. 

 SART is available the first week
 in April and October.

State Health Insurance Assistance Program (SHIP)
Volunteer Coordinator's Monthly Activity Report due by the 5th of each calendar month following the month of service.

Annual Resource Report for Sub-state Areas due by May 1 for prior grant year (April 1 - March 31).

Annual Strategic Plan for new grant year (April 1 - March 31) due by January 15th.

Year End Progress Report for grant year (April 1 - March 31) due by January 15th of that grant year.

Mid-Term Progress Report due September 15 for period April 1 - August 30.
 

Wanda Brown,
SHIP Director and


Kathryn Lopan
Las Vegas SHIP

E-mailed to:
    wbrown@adsd.nv.gov

    kalopan@adsd.nv.gov

Carson City Regional Office
3416 Goni Road #D132
Carson City, NV 89706
(775) 687-4210
Fax (775) 687-4264
Elko Regional Office
1010 Ruby Vista Drive #104
Elko, NV 89803
(775) 738-1966
Fax (775) 753-8543
Las Vegas Regional Office
1860 E. Sahara Avenue
Las Vegas, NV 89104
(702) 486-3545
Fax (702) 486-3236
Reno Regional Office
445 Apple Street #104
Reno, NV 89502
(775) 688-2964
Fax (775) 688-2969

  Last Updated: 11/19/2013

Looking for resources? Visit Nevada's Aging and Disability Resource Center website at www.nevadaadrc.com.

Questions or Comments for the Aging and Disability Services Division?
Please contact a Regional Office.
We look forward to speaking with you!

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