SafeNY   Highway Safety Forms

Grants application information.

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


2015 GTSC Chair Award Nomination Form
Nomination Form

The GTSC Chair Awards are presented each year at the Highway Safety Symposium consist of two categories: one for individuals and a second for organizations. Individuals and organizations to be considered will have made efficient use of public resources and will have produced programs that are innovative, superior and highly successful in promoting traffic safety. State agencies, however, are not eligible for this award. Recipients must be grantees of the Governor's Traffic Safety Committee (GTSC). Nominations are due by September 14, 2015.

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
Word form
(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 Classes are entered here.)
PLEASE UPDATE THE CLASS ROSTER ON THIS REPORT (when appropriate)
Do not fax or e-mail 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-eventsForm.doc
Word form
(1 page / 46k)
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 that establish the STOP-DWI program operating guidelines pdf document
(7 pages / 34k)
2016 County STOP-DWI Plans
Use both this Word form template and the instruction document below to prepare your 2016 plan in MS Word®.
STOP-DWI Plan 2016
Instructions for the 2016 STOP-DWI Plan in MS Word® Instructions
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

(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
(pdf document)
Guide
(31 pages / 1,516K)
PS-1 — Itemized Listing of Personal Services for Enforcement ps-1.doc
(1 page / 37K)
PS-1NE — Itemized Listing of Personal Services for Non-Enforcement ps-1ne.doc
(1 page / 77K)
Personal Activity Report Time Record in Excel
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
(1 page / 25K)
Certifications for Full-Time Staff on GTSC Grants in MS Word
Time keeping certification form for full time employees who are 100% funded by a GTSC grant. Complete semi-annually.
certifications
(1 page)
GTSC Mileage Log in MS Word
Mileage Log for GTSC grant related travel.
mileage
(1 page)