Human Services Department
Provide coordinated and holistic services to the human service providers within the County.
 
Department > Services > Provider Forms
 
Provider Forms
 
The following forms must be used by all Providers receiving funds from:
 
A.  Human Services Development Fund (HSDF)
PDF Document Form M-1-A: Unit Cost Invoice Report
This form is used for invoicing on a cost-per-unit basis
 
PDF Document Form M-1-B: Budget Summary Invoice Report
This form is used for invoicing for salary & fringe reimbursement
 
PDF Document Form M-2: Budget Summary of Service Areas
This is "Page 2" of the invoice form and must be used in conjunction with Form M-1-A & Form M-1-B
 
PDF Document Form Q: Quarterly Form for State Reporting
This form is used for reporting quarterly information to the Department of Public Welfare and must be used by all providers and submitted to the County by 20 days after the end of the quarter.
B.  Homeless Assistance Program (HAP)
Quarterly State Reporting Form
C.  Temporary Assistance To Needy Families (TANF)
Quarterly State Reporting Form