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Grant Reporting Forms

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Common Reporting Forms

Civil Rights Certification of Compliance (DCJ Form 30)

Certification of Compliance with Regulations - Office of Civil Rights, Department of Justice (DCJ Form 30) 

Grant Funds Source: Federal

Due Dates: Due to DCJ with signed Grant Agreement

Required Signatures: Project Director, Signature Authority

Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements

Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements

Grant Funds Source: Federal (Recipient receiving > $100,000 in federal funds)

Due Dates: Due with Grant Application or Upon Request

Required Signatures: Signature Authority

Certification of Match (DCJ Form 32)

Certification of Match (DCJ Form 32) 

Grant Funds Source: Federal

Due Dates: Due to DCJ with signed Grant Agreement.

Required Signatures: Signature Authority or Controller

Conference Policy and Certification (DCJ Form 31) - COMING SOON!

Conference Policy and Certification (DCJ Form 31) 

Grant Funds Source: Federal

Due Dates: Due no later than 120 days prior to the conference

Required Signatures: Project Director

Consultants/Contracts Certification (DCJ Form 16)

Consultants/Contracts Certification (DCJ Form 16) 

Grant Funds Source: State, Federal

Due Dates: Prior to contract execution with the contractor [Prior Approval Required];  After contract execution and prior to the disbursement of monies to Consultant/Contractor

Required Signatures: Project Director

Contract Debarment Certification (DCJ Form 17)

Contract Debarment Certification (DCJ Form 17) 

Grant Funds Source: State, Federal

Due Dates: Prior to contract execution with the contractor

Required Signatures: Project Director and Contractor

Equipment Inventory/Retention Certification (DCJ Form 5)

Equipment Inventory/Retention Certification (DCJ Form 5) 

Grant Funds Source: Federal

Due Dates: Equipment Acquired: due 30 days upon receipt of equipment; Grant Award Period End: due 45 days after the end of the Grant Award Period; Final Disposition: due 45 days after the equipment has reached final disposition.

Required Signatures: Project Director

Equipment Procurement Certification (DCJ Form 13)

Equipment Procurement Certification (DCJ Form 13) 

Grant Funds Source: Federal

Due Dates: Prior to any purchase of equipment [Prior Approval Required]

Required Signatures: Project Director

Financial Report (DCJ Form 1-A)

Financial Report (DCJ Form 1-A) 

Grant Funds Source: State, Federal

Due Dates: Quarterly due 15 days after the end of each calendar quarter; Final due 45 days after the end of the Grant Award Period.

Required Signatures: Financial Officer, Project Director

Payment Request (DCJ Form 3)

Payment Request (DCJ Form 3) 

Grant Funds Source: State, Federal

Due Dates: Quarterly due 15 days after the end of each calendar quarter; Final due 45 days after the end of the Grant Award Period; Payment Request frequency other than Quarterly requires Prior Approval.

Required Signatures: Project Director

Project/Program Income Report (DCJ Form 1-B)

Project/Program Income Report (DCJ Form 1-B) 

Grant Funds Source: Federal

Due Dates: Quarterly due 15 days after the end of each calendar quarter; Final due 45 days after the end of the Grant Award Period or the required percentage of earned project income is expended, whichever is later.

Required Signatures: Financial Officer, Project Director

Common Modification Forms

Budget Revision (DCJ Form 4-A)

Budget Revision (DCJ Form 4-A) 

Grant Funds Source: State, Federal

Due Dates: Due 30 days prior to deviating from the current approved budget [Prior Approval Required]

Required Signatures: Financial Officer, Project Director

Change in Grant Award Period (DCJ Form 4-C)

Change in Grant Award Period (DCJ Form 4-C) 

Grant Funds Source: State, Federal

Due Dates: Due No Later than 60 days Prior to the end of the Grant Award Period [Prior Approval Required]

Required Signatures: Project Director

Change in Project Officials (DCJ Form 4-B)

Change in Project Officials (DCJ Form 4-B) 

Grant Funds Source: State, Federal

Due Dates: Due 15 days following a change in Project Director, Financial Officer, or Signature Authority

Required Signatures: Project Director or Signature Authority

Modification of Other Grant Agreement Terms (DCJ Form 4-D)

Modification of Other Grant Agreement Terms (DCJ Form 4-D) 

Grant Funds Source: State, Federal

Due Dates: Due 30 days prior to deviating from the current approved Grant Agreement [Prior Approval Required]

Required Signatures: Project Director

Budget Revision Worksheet

Budget Revision Worksheet (xlsx) - Note: This worksheet is not a reporting form. It is a tool to assist in developing budget details. Your DCJ grant manager may require this document as a supplement to another form, but the worksheet by itself is not sufficient to request a budget change.

Grant Funds Source: State, Federal

Due Dates: NA

Required Signatures: NA

Program-Specific Reporting Forms

Narrative Report - Quarterly (JAG, DV, MJ, JABG, Formula)

OAJJA Narrative Report - Quarterly (JAG, DV, MJ, JABG, Formula) (DCJ Form 2Q) 

Grant Funds Source: State (DV & MJ), Federal (JAG, JABG, Formula)

Due Dates: Quarterly due 15 days after the end of each calendar quarter

Required Signatures: Project Director

Narrative Report - Final (JAG, DV, MJ, JABG, Formula)

OAJJA Narrative Report - Final (JAG, DV, MJ, JABG, Formula) (DCJ Form 2F) 

Grant Funds Source: (DV & MJ), Federal (JAG, JABG, Formula)

Due Dates: Final due 45 days after the end of the Grant Award Period

Required Signatures: Project Director

Narrative Report - Quarterly (NCHIP & COV)

OAJJA Narrative Report - Quarterly (NCHIP & COV) (DCJ Form 2Q) 

Grant Funds Source: Federal (NCHIP & COV)

Due Dates: Quarterly due 15 days after the end of each calendar quarter

Required Signatures: Project Director

Narrative Report - Final (NCHIP & COV)

OAJJA Narrative Report - Final (NCHIP & COV) (DCJ Form 2F) 

Grant Funds Source: Federal (NCHIP & COV)

Due Dates: Final due 45 days after the end of the Grant Award Period

Required Signatures: Project Director

Coverdell Quarterly Data Report - Quarterly (COV)

OAJJA Coverdell Quarterly Data Report - Quarterly (COV) 

Grant Funds Source: Federal (COV)

Due Dates: Quarterly due 15 days after the end of each calendar quarter

Required Signatures: Project Director

Narrative Report - Quarterly (VOCA, VAWA, SASP, State VALE)

Crime Victims Services Fund (CVS) Narrative Report - Quarterly (VOCA, VAWA, SASP, State VALE) (DCJ Form CVS-2) 

Grant Funds Source: State, Federal

Due Dates: Quarterly due 15 days after the end of each calendar quarter

Required Signatures: Project Director