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The New York State Aid Voucher form, known as AC 1171, serves as a crucial document for municipalities and agencies seeking reimbursement for state-funded projects. This form facilitates the reporting of eligible expenses, ensuring that funds are distributed accurately and efficiently. Key elements of the voucher include the payee's identification, payment details, and a certification section where the payee affirms that the expenditures align with applicable statutes. The form also includes fields for various identifiers, such as the originating agency code and reference numbers, which help streamline the processing of claims. Additionally, the form requires detailed information about the nature of the charges and the amounts paid, allowing for transparency and accountability in the disbursement of state aid. Proper completion of the voucher is essential, as it not only impacts the timely processing of payments but also ensures compliance with state regulations. By understanding the components and requirements of the New York State Aid Voucher form, municipalities can navigate the reimbursement process more effectively, ultimately supporting their financial operations and community projects.

Similar forms

  • Invoice: An invoice is a document issued by a seller to a buyer, detailing the goods or services provided and the amount due. Like the NYS State Aid Voucher, it requires specific information about the payee and the payment amount.
  • Expense Report: An expense report is used to itemize expenses incurred by an employee or contractor. Similar to the voucher, it includes details about the expenses, the payee, and the justification for reimbursement.
  • Purchase Order: A purchase order is a document sent from a buyer to a seller, indicating types, quantities, and agreed prices for products or services. It shares similarities with the voucher in terms of specifying payment details and vendor information.
  • Grant Application: A grant application outlines a request for funding and often includes a budget. Like the voucher, it requires detailed information about the intended use of funds and compliance with specific regulations.

Form Preview

AC 1171 (Rev 10/96)

STATE

OF STATE AID VOUCHER

NEW YORK

Voucher No.

1

Originating Agency

 

 

 

 

 

 

Orig. Agency Code

Interest Eligible (Y/N)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Payment Date

(MM)

(DD) (YY)

OSC Use Only

 

 

 

 

Liability Date

 

(MM) (DD)

 

(YY)

 

 

 

/

/

 

 

 

 

 

 

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Payee ID

 

 

Additional

3 Zip Code

 

Route

Payee Amount

 

 

 

 

 

MIR Date (MM) (DD) (YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Payee Name (Limit to 30 spaces)

 

 

 

 

 

IRS Code

IRS Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Payee Name (Limit to 30 spaces)

 

 

 

 

 

Stat. Type

Statistic

 

Indicator-Dept.

 

 

Indicator-Statewide

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address (Limit to 30 spaces)

 

 

 

 

 

 

 

 

5

Ref/Inv. No. (Limit to 20 spaces)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address (Limit to 30 spaces)

 

 

 

 

 

 

 

 

Ref/Inv. Date

(MM)

(DD) (YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Limit to 20 spaces)

(Limit to 2 spaces) à

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

Date

Check or

 

 

 

 

 

 

Description of Charges

 

 

 

 

 

 

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Paid

Voucher No.

 

(If Personal Service, show name, title, period covered)

 

 

 

Dollars

Cents

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7State Aid Program or Applicable Statute:

TOTAL

8

Payee Certiication:

 

 

 

 

I certify that the above expenditures have been made in accordance with the provisions of the Applicable Statute; that the

 

Less Receipts

 

claim is just and correct; that no part thereof has been paid except as stated; that the balance is actually due and owing,

 

 

 

and that taxes from which the State is exempt are excluded.

 

 

 

è_________________________________________________________

_______________________________

 

NET

 

Signature in Ink

Date

 

 

 

Title____________________________________________________________________________________________

 

State Aid

 

 

 

 

 

Name of Municipality ______________________________________________________________________________

 

_____% Claimed

 

 

 

 

 

 

 

 

FOR STATE AGENCY USE ONLY

 

STATE COMPTROLLER’S PRE-AUDIT

Merchandise Received

Date

Page No.

By

I certify that this claim is correct and just, and payment is approved.

__________________________________________________________________________________

By

__________________________________________________________________________________

Date

Veriied

Audited

State

Aid

Certiied For Payment

of

State AId Amount

By ______________________________

 

 

 

 

 

Expenditure

 

 

Liquidation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cost Center Code

 

 

Object

Accum

Amount

Orig. Agency

 

PO/Contract

Line

F/P

Dept.

Cost Center Unit

Var.

Yr.

Dept.

Statewide

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distribution: Original to OSC with Copy to Agency and Municipality

Check if Continuation form is attached

Common mistakes

Filling out the NYS State Aid Voucher form can be straightforward, but many people stumble on some common mistakes. Understanding these pitfalls can help ensure that your submission is accurate and complete. Here are seven mistakes to watch out for when completing the form.

First, leaving fields blank is a frequent error. Each section of the form requires specific information. Omitting details such as the Payee ID or the Payment Date can delay processing. Always double-check that every required field is filled in before submitting.

Another common mistake is exceeding character limits. Each line has a specified number of characters allowed, such as the Payee Name, which is limited to 30 spaces. If you try to include more than this, your submission may be rejected. Keep your entries concise and within the limits.

Third, many people forget to sign the certification section. The certification signature is crucial as it confirms the accuracy of the information provided. Without this signature, the form cannot be processed, leading to unnecessary delays.

Additionally, failing to double-check the dates can lead to complications. Ensure that all dates, such as the Payment Date and Ref/Inv Date, are accurate and formatted correctly. Incorrect dates can create confusion and may require you to resubmit the form.

Another issue arises from using incorrect codes. Whether it’s the IRS Code or the Statute Type, using the wrong code can lead to processing errors. Always verify that you are using the correct codes that correspond to your specific situation.

Moreover, many people overlook the importance of the total amount. Ensure that the total amount claimed is accurately calculated and matches the detailed breakdown provided on the form. Inconsistencies in the amount can raise red flags and delay approval.

Finally, not keeping a copy of the submitted form is a mistake that can come back to haunt you. Always make a copy of your completed voucher for your records. This way, if any issues arise, you will have the necessary information on hand to resolve them quickly.

By avoiding these common mistakes, you can streamline the process of submitting your NYS State Aid Voucher form. Taking the time to review your work can save you from unnecessary setbacks and ensure that your funding is processed without delay.

More About Nys State Aid Voucher

  1. What is the NYS State Aid Voucher form?

    The NYS State Aid Voucher form, also known as AC 1171, is a document used by municipalities and other agencies in New York State to request reimbursement for eligible expenditures. This form ensures that the claims for state aid are processed accurately and in compliance with state regulations.

  2. Who should use the State Aid Voucher form?

    This form should be used by authorized representatives of municipalities or agencies that have incurred expenses eligible for state aid. It is essential for those responsible for financial management within these entities to be familiar with the form and its requirements.

  3. What information is required on the form?

    The form requires several pieces of information, including:

    • Voucher number
    • Originating agency details
    • Payee information, including name and address
    • Details of the expenditures, such as amounts and dates
    • Certification by the payee confirming the accuracy of the claim
  4. How do I complete the certification section?

    The certification section must be signed in ink by the payee. This signature confirms that the expenditures were made according to the applicable statutes and that the claim is accurate. It is crucial to ensure that all details are correct before signing.

  5. What happens after I submit the form?

    Once submitted, the form will undergo a pre-audit by the State Comptroller’s office. They will review the claim for accuracy and compliance. If approved, the payment will be processed and sent to the payee.

  6. Is there a deadline for submitting the State Aid Voucher?

    Yes, there are specific deadlines for submitting the State Aid Voucher form, which can vary based on the type of aid being requested. It is important to check with the relevant state agency to ensure timely submission.

  7. Can I attach additional documentation?

    Yes, you may attach additional documentation to support your claim. If necessary, indicate on the form that a continuation form is attached, especially if there are multiple pages of expenditures.

  8. What should I do if I make a mistake on the form?

    If a mistake is made, it is advisable to correct it before submission. You can cross out the error and write the correct information next to it. However, significant errors may require you to fill out a new form.

  9. Where can I find the NYS State Aid Voucher form?

    The NYS State Aid Voucher form can be obtained from the New York State Office of the State Comptroller's website or through your agency's financial department. It is essential to use the most current version of the form.

  10. Who can I contact for assistance with the form?

    If you need assistance with the NYS State Aid Voucher form, you can reach out to your agency's finance department or contact the New York State Office of the State Comptroller directly for guidance.

Misconceptions

Here are seven common misconceptions about the NYS State Aid Voucher form:

  1. Only certain agencies can use the form. Many believe that only specific agencies are allowed to submit this form. In reality, any qualifying agency that receives state aid can use it.
  2. The form must be submitted in person. Some think that the form must be physically delivered to the appropriate office. However, electronic submissions are often accepted, depending on the agency's procedures.
  3. All information on the form is optional. It is a misconception that all fields are optional. Certain fields, such as the payee name and amount, are mandatory for processing.
  4. Payment is guaranteed upon submission. Many assume that submitting the form guarantees payment. Payment is subject to review and approval by the state comptroller.
  5. The form can be submitted at any time. Some believe there are no deadlines for submission. In fact, there are specific timelines that must be followed to ensure timely processing.
  6. Only one form can be submitted per payment. It is often thought that only one voucher can be submitted for each payment. However, multiple vouchers can be submitted if they pertain to different expenses.
  7. All expenses must be pre-approved. Some individuals think that every expense listed on the form must be pre-approved. While some expenses may require prior approval, others can be submitted for reimbursement after the fact.

Key takeaways

Filling out and using the New York State Aid Voucher form (AC 1171) requires careful attention to detail. Here are some key takeaways to ensure a smooth process:

  • Accurate Information is Crucial: Make sure to provide correct details such as the originating agency, payee information, and payment dates. Errors can lead to delays in processing.
  • Limitations on Fields: Be aware of character limits for various fields. For example, the payee name is restricted to 30 spaces, while the reference/invoice number can only be 20 spaces. Adhering to these limits is essential.
  • Certification Requirement: The form requires a certification statement, affirming that all expenditures comply with applicable statutes. This certification must be signed in ink, ensuring accountability.
  • Include All Necessary Documentation: Attach any relevant documents that support your claim. This may include invoices or receipts, which can help verify the expenses listed on the voucher.
  • Understanding Payment Procedures: Familiarize yourself with the payment process after submission. Knowing how and when payments are processed can help manage expectations and planning.

By following these guidelines, you can effectively navigate the process of filling out and using the New York State Aid Voucher form. This attention to detail will contribute to a more efficient experience.

Nys State Aid Voucher: Usage Guide

Completing the NYS State Aid Voucher form is essential for processing payments accurately. After filling out the form, it should be submitted to the appropriate agency for review and approval. Follow these steps to ensure the form is completed correctly.

  1. Locate the voucher number section at the top of the form and enter the number.
  2. Fill in the originating agency and its corresponding code.
  3. Indicate if the payment is interest eligible by marking 'Y' for yes or 'N' for no.
  4. Provide the payment date in the format MM/DD/YY.
  5. Leave the OSC use only section blank; this will be filled out later by the appropriate personnel.
  6. Enter the liability date in the format MM/DD/YY.
  7. Complete the payee ID and additional information as required.
  8. Fill in the zip code and route for the payee.
  9. Input the payee amount and MIR date in the format MM/DD/YY.
  10. Write the payee name, ensuring it does not exceed 30 characters.
  11. Provide the IRS code and amount related to the payee.
  12. Include the statutory type and statistic indicator, as well as the department indicator for statewide tracking.
  13. Fill in the payee address, making sure to limit it to 30 characters.
  14. Record the reference or invoice number, limited to 20 characters.
  15. Enter the reference or invoice date in the format MM/DD/YY.
  16. Complete the city and state fields, adhering to the character limits.
  17. Document the date check or description of charges, along with the amount paid.
  18. If applicable, indicate the voucher number for personal service, along with the name, title, and period covered.
  19. Specify the state aid program or applicable statute.
  20. Calculate the total amount and enter it in the designated area.
  21. Sign the payee certification section in ink, providing your name, title, and date.
  22. Complete the name of the municipality and the percentage claimed.
  23. Leave the state agency use only section blank for agency personnel to fill out.
  24. If using a continuation form, check the box provided.