The Homeless Housing Grant Program and the Affordable Housing Grant Program share a single reimbursement request form:
*This link takes you to our electronic submission system, powered by DocuSign. This form includes a Reimbursement Request Form and a Summary Statement of Expenses.
Important Note: Before you click the link, you must have all the information you will need to submit the reimbursement request assembled. Unfortunately, you cannot save your work once you've started.
You can look at a example blank Reimbursement Request Form and Summary Statement of Expenses Form.
Example Reimbursement Form
Example Summary Statement Form
Electronic Reimbursement Request Form
*For Reimbursement Request Summaryof Expense that include more than 14 seperate line items, please use the following form;
Electronic Reimbursement Request (Extended) Form
We have designed the system with your ease and efficiency in mind; please don't hesitate to call with any questions. Staff will be happy to walk you through the process if you need assistance.
Kirsten Jewell, Program Coordinator 360-337-7286 or firstname.lastname@example.org
Corey Derenburger, Program Specialist 360-337-7287 or email@example.com
Doug Washburn, Director Department of Human Services firstname.lastname@example.org
Quarterly Reports; Affordable Housing Grant Program
Example:AHGP -Q-ReportsAHGP-Final Progress
To Submit:AHGP-Q-ReportsAHGP-Final Progress
Quarterly Reports; Homeless Housing Grant Program
To Submit:HHGP-Q-ReportsHHGP-Final Progress
Affordable Housing Grant Program
Homeless Housing Grant Program