Compliance | CDBG Financial Monitoring Form

Rural Economic Development Division (REDD)
Community Development Block Grant (CDBG) Program
Rev. September 22, 2025

FINANCIAL MONITORING FORM

All financial activities must comply with the Uniform Administrative Requirements for Federal Grants: 2 CFR, Part 200, which replaces the Circular OMB A-87

Grantee Information

Field	Value	Field	Value
Grantee:		Grant Number:
Prepared By:		Date Prepared:

Authorization to Incur Costs

Authorization Questionnaire

Question	Response
1. Has the governing body adopted a project or budget ordinance? If yes, complete the section below.	Yes / No

Type of Ordinance

List Type of Ordinance	Date Adopted

Budget Revision Questionnaire

Question	Response
Has a budget revision and/or project amendment (with changes to the budget) been approved by REDD?	Yes / No
If yes, is there an amended ordinance in the file?	Yes / No
2. What date were the funding approval and grant agreement signed by REDD?
What date were the funding approval and grant agreement signed by the grantee?
What is the date for the release of funds?

Release of Funds Activity

Type of Activity	Release Date	Date of Obligation	Source Documentation
Exempt (Administration & Planning)
Non-Exempt (hard costs)

Obligated Funds Questionnaire

Question	Response
3. Has the grantee obligated funds before the allowable dates? If yes, list items below:	Yes / No

Vendor or Contractor Items

Vendor or Contractor	Date	Amount	Activity

Grantee Financial System

Perform a spot check on back up documentation for disbursements. Front and back of cashed checks, list of disbursements examined, amount, payee, check number and authorization. If the check reveals any instances of unnecessary, unreasonable, or unallowable costs, make a copy of the documentation and attach to the monitoring sheet.

Grantee Financial System Questionnaire

Question	Response
4. Is the depository for CDBG funds interest-bearing?	Yes / No
If yes, has the grantee earned more than $100 during the most recent fiscal year?	Yes / No / N/A
If yes, has the amount over $100 been returned to REDD?	Yes / No / N/A

Requisition Review

Requisition 4a

Requisition 4a Details

Requisition Information	Payment Type
4a. Requisition Number:	Do the requisitions represent advance payments or reimbursements? If the grantee is on advance payments, complete the chart below
Total Amount:	Advance / Reimbursements / Mix of Both
Date of EFT:

Requisition 4a Chart

Date	Check #	Amount	Vendor	Days Between Deposit and Disbursement

Requisition 4a Summary

Field	Value
Total Amount:
Was there a violation of the 3-day rule?	Yes / No / N/A

Requisition Review

Requisition 4b

Requisition 4b Details

Requisition Information	Payment Type
4b. Requisition Number:	Do the requisitions represent advance payments or reimbursements? If the grantee is on advance payments, complete the chart below
Total Amount:	Advance / Reimbursements / Mix of Both
Date of EFT:

Requisition 4b Chart

Date	Check #	Amount	Vendor	Days Between Deposit and Disbursement

Requisition 4b Summary

Field	Value
Total Amount:
Was there a violation of the 3-day rule?	Yes / No / N/A

Requisition 4c

Requisition 4c Details

Requisition Information	Payment Type
4c. Requisition Number:	Do the requisitions represent advance payments or reimbursements? If the grantee is on advance payments, complete the chart below
Total Amount:	Advance / Reimbursements / Mix of Both
Date of EFT:

Requisition 4c Chart

Date	Check #	Amount	Vendor	Days Between Deposit and Disbursement

Requisition 4c Summary

Field	Value
Total Amount:
Was there a violation of the 3-day rule?	Yes / No / N/A

Requisition Review

Requisition 4d

Requisition 4d Details

Requisition Information	Payment Type
4d. Requisition Number:	Do the requisitions represent advance payments or reimbursements? If the grantee is on advance payments, complete the chart below
Total Amount:	Advance / Reimbursements / Mix of Both
Date of EFT:

Requisition 4d Chart

Date	Check #	Amount	Vendor	Days Between Deposit and Disbursement

Requisition 4d Summary

Field	Value
Total Amount:
Was there a violation of the 3-day rule?	Yes / No / N/A

Grantee Personnel and Administrative Charges

Personnel Questionnaire

Question	Response
5. Are any local staff persons (full or part-time) paid from CDBG funds? If no, proceed to number 10	Yes / No

Personnel Charges

Name	Full-Time employee	Job Title	Duties	Salary

Personnel Reasonableness

Question	Response
6. Are the amounts charged reasonable when compared to the time worked, the responsibilities of the workers, and the needs of the grant?	Yes / No / N/A

Purchase of Equipment and/or Real Property

Equipment Purchase Questionnaire

Question	Response
10. Does the grantee intend to purchase equipment or real property with CDBG funds? If no, proceed to number 20	Yes / No / N/A Purchase Date:
11. Has the grantee purchased equipment or real property with CDBG funds?	Yes / No / N/A
12. Describe the equipment (make, model, etc.) or provide a description of the real property purchased.	Yes / No / N/A
13. What procurement method was used?
14. What is the purchase price of the equipment or real property?
15. List the check number, date, and amount of the check issued for the purchase.
16. Does the purchase price meet the grantee’s threshold for depreciation?
17. Is the equipment or real property listed on the grantee’s inventory record?
18. Is the purchase allowable under current guidelines?	Yes / No / N/A If not, what is the suggested remedy?
19. Is the grantee reminded to reflect the purchase on the property disposition form at closeout?	Yes / No

Grantee Allowable Costs, Indirect Costs, Cost Allocation

Allowable Costs Questionnaire

Question	Response
20. Are the allowable cost guidelines, pursuant to Uniform Administrative Requirements for Federal Grants 2 CFR, Part 200, which replaces the Circular OMB A-87, being followed?	Yes / No If yes, what documents support compliance or non-compliance?
21. Are there any indirect costs being charged to the grant? (i.e. electricity, rent, phones, postage, copies, etc.)	Yes / No / N/A
If yes, has the plan been approved by REDD? If no, skip to # 24	Yes / No / N/A

Indirect Costs Questionnaire Continued

Question	Response
22. What is the basis for the allocation costs? (i.e. square footage, hours, FTEs etc.)
23. Review the Indirect Cost Allocation Plan with the actual expenses charged to the grant. Are the amounts charged reasonable when compared with time worked, responsibilities, and the needs of the grant?	Yes / No / N/A If no, list problems or concerns.

Grantee Program Income

Program Income Questionnaire 1

Question	Response
24. Are revenue-generating activities being undertaken? If yes, complete the table below:	Yes / No / N/A

Revenue Activities

Date of Receipt	Source	Amount	Use	REDD Approval
				Yes / No
				Yes / No
				Yes / No
				Yes / No
				Yes / No
				Yes / No
Total:

Program Income Questionnaire 2

Question	Response
25. Has the grantee established a revenue account to record the receipt of program income?	Yes / No / N/A If yes, describe the adequacy of the process:
26. Did the grantee expend program income before requesting additional drawdowns of CDBG funds?	Yes (Checked) / No / N/A If no, explain:
27. Were all expenditures of program income for CDBG eligible activities?	Yes / No / N/A

_____________________________________________ ________________
Grantee Representative Date

_____________________________________________ ________________
Grant Management Representative Date

Non-CDBG Funds

Non-CDBG Questionnaire

Question	Response
28. Are there any local or non-local funds committed to the grant? If yes, complete the chart below:	Yes / No / N/A

Non-CDBG Funds Committed

Source of Funds	Amount Committed	Expended to Date
Total:

Final Expenditure

Question	Response
29. If non-CDBG funds are not fully expended, indicate the anticipated date of final expenditure. Note any problems or noncompliance.

Comments: