Outdoor Recreation Grants Program

Reimbursement Request Forms

Reimbursement Forms are avaiable in two formats:  Blank Forms and Fillable Forms.  Blank Forms can be viewed and printed using the most recent version of Adobe Acrobat Reader.  You will not be able to complete these forms electronically, but can print them out and complete them manually.  Fillable Forms can be completed electronically and then printed.  However, you will not be able to save your completed form.   You will need Adobe Acrobat Reader to view these forms.  A free version of this software can be downloaded by clicking the link at the bottom of this page.  Click on the link below to be taken to the appropriate form:                                              Blank Forms     :     Fillable Forms

Blank Forms:

Reimbursement Summary Sheet This form includes line items related to the project. The line items reflected on the summary sheet should be the same as the approved elements of the final budget.

Value of Donated Labor This form is used when the sponsor is requesting reimbursement for donated labor directly related to the project. All donated labor is reimbured at current minimum wage except when a licensed professional is preforming the job they are licensed to perform, they then are reimbursed at a rate determined by the Arkansas Employment Security Division.

City Employees' Time Record Use this form if you want to be reimbursed for city or county employee time on the project. The employee and their supervisors must sign and date the form and a copy of the employees offical pay record from the city/county must accompany the request.

Park Inventory Form This form should be completed and returned with your reimbursement request. We use this form to keep an up to date and accurate inventory on the available recreation facilities in the state.


Fillable Forms:

Reimbursement Summary Sheet This form includes line items related to the project. The line items reflected on the summary sheet should be the same as the approved elements of the final budget.

Value of Donated Labor This form is used when the sponsor is requesting reimbursement for donated labor directly related to the project. All donated labor is reimbured at current minimum wage except when a licensed professional is preforming the job they are licensed to perform, they then are reimbursed at a rate determined by the Arkansas Employment Security Division.

Value of Donated Material This form is straight forward. You will receive credit for materials as documented by invoices and letters by the donor establishing the mateial cost.

Value of Donated/City Equipment This form is straight forward. The rate allowed is the rate it would cost you to rent that particular piece from an "Equipment Rental Facility".

City Employees' Time Record Use this form if you want to be reimbursed for city or county employee time on the project. The employee and their supervisors must sign and date the form and a copy of the employees offical pay record from the city/county must accompany the request.

Park Inventory Form This form should be completed and returned with your reimbursement request. We use this form to keep an up to date and accurate inventory on the available recreation facilities in the state.




You will need Adobe Acrobat Reader to view these forms.
You can download it for free from Adobe by clicking on the logo below.