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How to use or fill out 5199, Financially Distressed Cities, Villages, and Townships (FDCVT) Reimbursement Request with our platform
- Click ‘Get Form’ to open the 5199 reimbursement request in the editor.
- In Part 1, enter the Grant Number, Project Title, Request Number, Period Start Date, and Period End Date. Select whether this is a partial or final reimbursement request.
- Fill in the SIGMA Vendor Number and Grantee Name. Provide your telephone number and complete the Payment Mailing Address section.
- Move to Part 2: Expenditure Detail. For each budget category listed from lines 11-22, input the Grant Award Amount, Previous Reimbursements, and Current Request Amount. The Remaining Balance will auto-calculate based on your entries.
- In Part 3: Certification, ensure you certify that all information is accurate by entering your printed name, title, signature, and date.
- Review all sections for completeness before submitting your request via email or fax as indicated in the instructions.
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