Highway Safety Office
NHTSA FORMS
Equipment Forms:
Equipment acquisitions must be documented on the Equipment Report Form. The form must be submitted to the Highway Safety Office (HSO) and a copy remains with the grantee. The form includes: description, serial number or identification number, date equipment was received, cost, percentage of federal participation in the cost, location of the equipment, date of disposition, sale price, and condition of equipment.
Grant Application Forms:
Once a project proposal is approved for funding by the HSO, prospective grantees must complete the Highway Safety Project Application. This form is required by all federally-funded programs and, when signed by all concerned parties, shall constitute a contractual agreement between the applicant and the HSO to perform in accordance with the terms of the application and attachments.
Grant Proposal Forms:
A project proposal can be submitted by any political sub-division (municipality, county, state agency), school districts, other local agencies or non-profit corporations. When completing the proposal, agencies are asked to review, analyze, and evaluate their community’s specific highway safety problem, which is referred to as problem identification. Prospective grantees should then develop innovative approaches designed to combat local traffic safety problems.
Monitoring and Review Forms:
The Project Monitoring Form is used by HSO program managers who will perform grant reviews during the year to make certain compliance with the applicable federal requirements, and objectives and requirements of the agreement are being met.
Monthly Expenditure Report Forms:
Monthly Expenditure Report Sample
The federal grant program operates on a reimbursement basis. The grantee must first incur the costs for approved expenditures and then apply for the reimbursement. This process utilizes the Expenditure Reimbursement Form, which must be completed and submitted to the HSO.
Monthly/Quarterly Report Forms:
Monthly program activity reports are required each month of the grant period, unless quarterly reports have been agreed upon. The report provides the grantee with the opportunity to report successes and describe problems. It also allows for the grantee to evaluate the program and identify if any modifications need to be made in order to successfully accomplish the objectives.
Project Adjustment Forms:
Program revisions that change the intent of the project, or alters the funding allotment by more than 10% of the total federal budget, must first be approved by the HSO. The HSO will evaluate the proposed revision/adjustment and if approved, incorporate it into the Highway Safety Plan.