Governor's Traffic Safety Committee

Highway Safety Grant Forms
2017 Federal Fiscal Year

Grants application information.

HELP with downloading and using the GTSC MS Word® forms. What to do if you do not have MS Word®.


 

MADD STOP-DWI Recognition Award Forms

MADD STOP-DWI Recognition Awards for 2016

Nominations are requested, to recognize a dedicated officer, a unique enforcement strategy, an outstanding program or person that has had success in reducing drunk or impaired driving.
Nominations are due by March 15, 2017. For details, see the announcement.

MADD STOP-DWI Recognition Award Nomination Form Award Nomination Form (pdf)

Grant Reporting — Forms & Instructions:
Type of Grant Type of
report link:
Highway Safety (HS) Grant Reports
Progress Report - Use eGrants to file your semi-annual and annual progress reports for all highway safety (HS) grants beginning with 2010 grants.
Use eGrants
Police Traffic Services (PTS) Grant Reports
Progress Report - Use eGrants to file your semi-annual and annual progress reports for all PTS grants.
Use eGrants
Buckle Up New York, Click it or Ticket
Buckle Up New York Observation Seatbelt Compliance Survey
Use this form to create a tally sheet for conducting a seat belt use survey. Report the results of your survey(s) as an email attachment to: dmv.sm.SafeNY@dmv.ny.gov.
bunysurvey (MS Word)
(2 pages / 74K)
Child Passenger Safety Report Forms
Fitting Station Annual/Semi-Annual Progress Report - Schedule A Use eGrants
Child Passenger Safety Awareness Training Report - Schedule B
Complete report after EACH training you hold.

On the report you must check the appropriate box for which type of awareness class was given:
  1. Community Awareness
  2. Agency Awareness
  3. Technical Update Class
  4. Special Needs Training
  5. School Bus Training
  6. Other - (Renewal Testing is entered here.)
PLEASE UPDATE THE CLASS ROSTER ON THIS REPORT (when appropriate)
Do not fax or email the roster
Use eGrants
Child Passenger Seat Check Progress Report - Schedule C
Complete report after EACH seat check event.

The host of the event MUST list any other agencies that participated in this event (in the box that allows comments, at the end of the report) so participants get credit.
Use eGrants
Notification of Upcoming Child Passenger Seat Check Events
Complete this form and email it to the CPS Coordinator BEFORE your check event.
CPS Event Web Posting Form (pdf)
fill-in format using Adobe Acrobat® Reader
(1 page)
Child Safety Seat Distribution Program Annual/Semi-Annual Progress Report - Schedule D Use eGrants

 

STOP-DWI Forms
New York State STOP-DWI Vehicle and Traffic Law and Commissioner Regulations (pdf) that establish the STOP-DWI program operating guidelines
2017 County STOP-DWI Plans
Use both this Word form template and the instruction document below to prepare your 2017 plan in MS Word®.
STOP-DWI Plan 2017 (MS Word)
Instructions for the 2017 STOP-DWI Plan in MS Word® Instructions (MS Word)
STOP-DWI Fiscal Report Forms
Use this form to submit your quarterly and final fiscal reports. Enter the year of the report, the financial information and sign where indicated.
Quarterly and Year End
STOP-DWI Reports (MS Word)

(4 pages)

 

Fiscal / Accounting and Time Keeping — Forms & Instructions:
Form # / Title of Form MS Word®
Use eGrants to submit payment request for reimbursement. You may continue to use the PS-1 or PS-1NE to track your personal services hours.
Claim for Payment - Instruction Guide Guide (pdf)
(31 pages / 1,516K)
Equipment Acquisition Form
Equipment Acquisition Form (MS Word)
(1 page / 16K)
PS-1 — Itemized Listing of Personal Services for Enforcement ps-1.doc (MS Word)
(1 page / 37K)
PS-1NE — Itemized Listing of Personal Services for Non-Enforcement ps-1ne.doc (MS Word)
(1 page / 77K)
Personal Activity Report Time Record
Time keeping form for full time employees who are partially funded by a GTSC grant, to account for grant-funded activities vs. non-grant funded.
time-record.xls (MS Excel)
(1 page / 25K)
Certifications for Full-Time Staff on GTSC Grants
Time keeping certification form for full time employees who are 100% funded by a GTSC grant. Complete semi-annually.
certifications (MS Word)
(1 page)
GTSC Mileage Log
Mileage Log for GTSC grant related travel.
mileage (MS Word)
(1 page)