Group Reporting

For Specific ADSD Subrecipients Only 
At the direction of ADSD, certain subrecipients are required to submit group client and service data outside of the regular SAMS reporting system. These subrecipients must use the following form to submit data on a monthly basis. The due date is the 10th day following the end of month, per the Grantee Reporting Schedule. Please contact your Grants and Projects Specialist (GPS) if you have questions.

Organization/Agency:  
Grant Number:  
Service:  
Representative Name:  
Representative Email:  
   
   Group Client and Service Data
Month and Year:  
Number of Clients Served:  
Number of Units of Service:  
Comments: