Community Service Block Grant Program — 2021


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, including 45 CFR Part 96, Administration of certain Block Grants to states, including LIHEAP and CSBG, can be found here




CSBG Eligibility Guidelines


2020 Community Service Block Grant Program