State Homeland Security Grants Program (SHSGP) Forms

  • A-19 INVOICE VOUCHER (Word) (PDF)
    • Use this when a local jurisdiction is submitting expenditures for reimbursement.
    • EFT payments can include LOCAL determined email text, limited to thirty (30) characters, to assist with tracking payments when they arrive into their electronic accounts. See A19 Sample (PDF) for instructions.
  • REIMBURSEMENT WORKSHEET (Excel)
    • Attach this form to the A-19 Invoice Voucher.
  • MATCH DOCUMENTATION FORM (Excel)
    • Attach this form to the A-19 Invoice Voucher to document any match requirement.
  • CONTRACT AMENDMENT REQUEST FORM (Word) (PDF) & BUDGET WORKSHEET (Excel)
    • Use these two forms together when a local jurisdiction needs to amend an open contract.
  • BI-ANNUAL PROGRESS and CLOSEOUT REPORT (Word) (PDF)
    • Local jurisdictions file this report at predetermined intervals through FFY07. Contact your program coordinator / manager for the FY08+ progress report templates.
  • EQUIPMENT APPROVAL REQUEST FORM (Office 2007 Excel) or (Office 2003 Excel)
    • Use this form when a local jurisdiction requests pre-approval for equipment purchases from the Committee on Homeland Security Equipment Subcommittee, which meets the first Wednesdays of the month.
  • FEMA EHP SCREENING MEMO (Word) and Picture Documentation Instructions (Word)
    • Use this form when a local jurisdiction requests pre-approval from FEMA & DHS for projects that may have potential effects related to human and environment impacts to historical buildings and nature.
  • TRAINING COURSE REQUEST FOR APPROVAL AND AUTHORIZATION (Word)
    • Use this form when a local jurisdictions wants to attend training courses that are not on the federal-sponsored, state-sponsored or TEI-sponsored course catalogs.
  • HSGP CONFERENCE ALLOWABILITY DETERMINATION WORKSHEET (PDF)
    • Use this checklist when a local jurisdiction wants to self-determine if a conference attendance is allowable.
  • HSGP REQUEST FOR CATASTROPHIC INCIDENT REIMBURSEMENT (PDF) (Word)
    • Use this form when a local jurisdiction requests approval for non-terrorism related grant expenditure

Download Adobe Acrobat Reader Adobe Acrobat Reader

Download Microsoft Excel Reader Microsoft Excel Reader

Download Microsoft Word Reader Microsoft Word Reader