Community Service Block Grant Program — 2020


CSBG Contract Documents for Off-Reservation Subcontractors

Agreement Proposal Documents:



Certification LobbyingSTD FORM LLLCertification Regarding Lobbying/Disclosure of Lobbying Activities

Module 2 CSBG Eligible Entity Expenditures, Capacity, and Resources

Module 3 Community Level

Module 4 Individual and Family Level


Module 2

Module 3

Module 4
Instructions V2
Additional NPIs


Federal Funding Accountability and Transparency Act (FFATA)CSD 279\
Contractors Certification ClausesCCC-04/2017Contractors Certification Clauses Form
Contract Budget Forms

425 Budget Forms

425.S Contract Budget Summary Form and instructions

425.1.1 Budget Support—Personnel Costs and instructions

425.1.2 Budget Support—Non Personnel Costs and instructions

425.1.3 Other Agency Operating Funds and instructions

425.1.4 Budget Narrative and example

NCIDC 425 Budget Series
Justification for Contract Amendment/Modification FormNCIDC 425-B
Justification for Subcontract Amendment/Modification
Request for Pre-Approval Purchase/LeaseCSD 558 
CSBG Closeout PackageNCIDC 715 SeriesCloseout Interest Earned/Program Income and Equipment Inventory
Closeout/Equipment InventoryCSD 715 DClose-Out Equipment Inventory Schedule
Agency Staff and Board RosterCSD 188 
CSBG Monthly Expenditure ReportNCIDC 425.ER 
CSBG Final Expenditure ReportNCIDC 425.FER 
NCIDC Information Request FormIR-1 
NCIDC Advance RequestAdvance Request 
NCIDC CSBG Client Intake and RegistrationClient Intake and Registration 
CSD Self Assessment ToolSelf Assessment Tool 
Sample ResolutionSample Resolution 


Federal Regulations Incorporated into this Agreement here

• Federal Regulation, 45 CFR Part 16 – Procedures of the Departmental Grant Appeals Board
• Federal Regulation, 45 CFR Part 30 – Claims Collection
• Federal Regulation, 45 CFR, Part 74 codification of OMB Circular A-11
• Federal Regulation, 45 CFR Part 76 – Debarment and Suspension from Eligibility for Financial Assistance (Nonprocurement)
• Federal Regulation, 45 CFR Part 80 - Nondiscrimination Under Programs Receiving Federal Assistance through the Department of Health and Human Services, Effectuation of Title VI of the Civil Rights Act of 1964
• Federal Regulation, 45 CFR Part 81 - Practice and Procedure for Hearings Under Part 80 of this Title
• Federal Regulation, 45 CFR Part 84 - Nondiscrimination on the Basis of Handicap in Programs and Activities Receiving Federal Financial Assistance
• Federal Regulation, 45 CFR Part 86 – Nondiscrimination on the Basis of Sex in Education Programs and Activities Receiving or Benefiting from Federal Financial Assistance
• Federal Regulation, 45 CFR Part 87 – Equal Treatment for Faith-Based Organizations
• Federal Regulation, 45 CFR Part 91 – Nondiscrimination on the Basis of Age in HHS Programs or Activities Receiving Federal Financial Assistance
• Federal Regulation, 45 CFR Part 93   – New Restrictions on Lobbying
• Federal Regulation, 45 CFR Part 96 – Block Grants
• Federal Regulation, 45 CFR Part 97 – Consolidation of Grants to the Insular Areas
• Federal Regulation, 45 CFR Part 100 – Intergovernmental Review of Department of Health and Human Services Programs and Activities