Print a copy of the forms, save them as a PDF and upload them to the DC Commission on the Arts and Humanities application portal with the required supporting materials. For additional instructions on how to save in PDF, please proceed to the following link on Microsoft.com

Individuals:

• Certificate of Clean Hands [PDF] - This document describes the necessary steps to obtain a Certificate of Clean Hands from the DC Office of the Chief Financial Officer - Office of Tax and Revenue.
• W-9 [PDF] - Attach a W-9 to the payment request forms. Grants cannot be processed without a W-9.
• Automated Clearing House (ACH) Vendor Payment Enrollment Form [PDF] - Grantees may complete this form to register for direct deposit.
• Arrest and Conviction Statement [DOCX] - To affirm statement of any applicable indictions, charges and/or convictions arising directly or indirectly from the conduct of the applicant's organization.
• Notarized Letter for Self Payment Template [DOC] - If applicable, use  this form to report artistic fees paid directly to you.
• Notarized Letter for Self Payment Template [PDF] - See description above.
• Sample Completed Fellowship Grant Agreement with Required Documents [PDF]
• Statement of Certification [DOCX] - To ensure applicant has met and will maintain all qualifying criteria for certification throughout entire duration of award.
• List of Insurance Carriers and Policies - [DOCX] - To certify an applicant's current insurance carrier and coverage status.

Organizations:

• Certificate of Clean Hands [PDF] - This document describes the necessary steps to obtain a Certificate of Clean Hands from the DC Office of the Chief Financial Officer - Office of Tax and Revenue.
• W-9 [PDF] - Attach a W-9 to the payment request forms. Grants cannot be processed without a W-9.
• Automated Clearing House (ACH) Vendor Payment Enrollment Form [PDF] - Grantees may complete this form to register for direct deposit.
• Arrest and Conviction Statement [DOCX] - To affirm statement of any applicable indictions, charges and/or convictions arising directly or indirectly from the conduct of the applicant's organization.
• List of Insurance Carriers and Policies - [DOCX] - To certify an applicant's current insurance carrier and coverage status.
• Statement of Certification [DOCX] - To ensure applicant has met and will maintain all qualifying criteria for certification throughout entire duration of award.
• Affirmative Action Equal Employment Policy Statement - [DOCX] - Assurance of Compliance with EEO Requirements.
• First Source Employment Agreement [PDF] - For recruitment, retrieval and placement of District of Columbia residents.

Other:

• Budget Revision Form [PDF] - The purpose of this form is to show DCCAH that grant recipients have reconciled the difference between their original grant request and the awarded grant amount within their project.
• CAH Logos - [ZIP] Downloadable Zip folder of DCCAH logos for grantees and partners to use.
• FY17 Invoice - Request full amount of your award if $10,000 or less. Request 1/2 of your award if the award is over $10,000.
• Interim and Final Report Narrative Questions [PDF] - Prior to receiving the second payment of grant funds and on completion of the grant period, grantees are required to submit narrative answers to these questions.
• Interim and Final Financial Report Form [PDF]  - Prior to receiving the second payment of grant funds and on completion of the grant period, grantees are required to submit the Financial Report Form (805), accompanied by the appropriate supporting documentation.
• Master Supplier Information Collection Template [PDF] - For collection and identification of relevant master supplier information.
• Tax Certification Affidavit [PDF] - To be completed only by those who are registered to conduct business in the District of Columbia.