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VA Grant and Per Diem Program Special Need (SN) Payment Voucher 2026
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How to use or fill out VA Grant and Per Diem Program Special Need (SN) Payment Voucher with DocHub
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- Click ‘Get Form’ to open the VA Grant and Per Diem Program Special Need (SN) Payment Voucher in our editor.
- Begin by entering the PROGRAM NAME AND ADDRESS at the top of the form, followed by the DATE, FAIN/PROJECT NUMBER, EIN, and BILLING PERIOD. Ensure all dates are formatted correctly (mm/dd/yy).
- In the BILLING AMOUNTS section, calculate the TOTAL BED DAYS OF CARE PROVIDED. Multiply this number by the PER DIEM RATE to determine the TOTAL AMOUNT REQUESTED.
- Fill in the AMOUNT VAMC APPROVES FOR PAYMENT based on your calculations. Make sure these figures align with your records for accuracy.
- For VALIDATION, have the GPD GRANTEE AUTHORIZED AGENT sign and date the form, certifying that all billing is accurate. Include their NAME and TITLE.
- Next, obtain a signature from the VA GPD LIAISON VALIDATION SIGNATURE section to confirm that billing is accurate for bed days provided.
- Once completed, email your voucher to GPDVouchers@va.gov as instructed at the bottom of the form.
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