CDBG_Reimbursement_Form.pdf

This document is a Lake County Housing and Community Services Reimbursement Request form for Community Development Block Grant (CDBG) funds. The form is designed to capture detailed financial information for project reimbursement, with sections for payroll, invoices, equipment, and other contracts. The form requires comprehensive documentation, including authorized timesheets, copies of disbursed checks, procurement information, and contract copies.

The reimbursement request form is structured to track and validate expenses across multiple categories, with designated spaces for specific dollar amounts for each expense type. The document includes multiple review stages, with signature lines for Housing & Community Services Staff, CDBG Program Supervisor, and the Housing & Community Services Director. There is also a section to indicate whether the account is subject to program income, providing additional financial oversight and transparency for the CDBG fund reimbursement process.