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Service Providers
General
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Newsletter
Applicants:
Form
Purpose
470
Description of Services Requested and Certification Form
471
Description of Services Ordered and Certification Form
471ws
Worksheet: Optional Pre-Discount Cost Calculation Grid
472
Billed Entity Applicant Reimbursement ("BEAR") Form
479
Certification of CIPA Compliance for Consortium Members
486
Receipt of Service Confirmation
500
Adjustment to Funding Commitment and Modification to Receipt of Service Confirmation
Service Providers:
Form
Purpose
473
Service Provider Annual Certification ("SPAC") Form
474
Service Provider Invoice ("SPI") Form
498
Service Provider Information Form (apply for a SPIN)
499
Telecommunications Reporting Worksheet
General:
Letter of Agency (LOA) Exemplary
SPIN Correction and
Service Provider Changes
Sample Survey FY 2013
Sample Survey FY 2013 - Spanish version