Downloading a Form to Your Computer

Fillable forms cannot be viewed on mobile or tablet devices. Follow the steps below to download and view the form on a desktop PC or Mac.

  1. Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
  2. Select the folder you want to save the file in and then click "Save."
  3. Navigate to the folder you saved the file in and Right Click for PC or Ctrl + Click for Mac, then select "Open With" from the menu and select Adobe Acrobat Reader DC.

    Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC. Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message.

    If still having trouble viewing or downloading a form, click here.

Effective Date: 




Updated 9/2018



After the accounting records ("books") are closed for a given month of the budget period and actual expenditures for that month are known, the Quarterly Financial Report (QFR) may be completed for that month. These numbers must be taken directly from the grantee's accounting records. More than likely, these numbers will not be the same as those from Form  3153, Request for Advance or Reimbursement.


Copies and Distribution

2 copies

Submit a signed original of this report to the grant manager and a copy to the Central Office program specialist.



Grantee records and accounts must be retained for at least three years after:

  • HHSC Independent Living Services has made final payments, and
  • all other pending matters are closed.


Detailed Instructions

The form must reflect expenditures and projections of both Independent Living Services funds and program income or matching funds. The numbers reflected as program income must reconcile with Form 3156, Quarterly Program Income Report, which must be submitted with the QFR.

  1. Complete the grant identifying information (grantee organization, grant number, and budget period).
  2. Indicate the reporting period (for example, 1st quarter, 2nd quarter, etc.).
  3. Enter the approved budget category amounts (from the Statement of Grant Award) in the column titled "Budget Period Totals—Approved" (far right).
  4. Enter actual expenditures from those months that have passed. Unliquidated obligations must be shown in the month where you anticipate that liquidation will occur.

Exception: Show the audit cost obligation in Month 12 of the budget year when you anticipate that this obligation will be liquidated after the end of the budget period.

  1. Enter projected expenditures for every month remaining in the budget period. These projections should be based on the best information available on anticipated expenditure patterns.

Do not prorate remaining balance of funds in any category.

  1. Total the columns and rows to reflect monthly totals and category totals. This will result in a "Total Projected Cost" for the budget period. The PDF version of the form calculates these totals automatically.
  2. Enter the difference between the "Approved" columns and the "Projected" columns in the space that reads "Delta =    ". The PDF version of the form calculates the difference automatically.

For the next section, Sources and Amounts of Funds and Resources, the information will be identical to the information used to prepare the RSA 704 annual report, with the exception that it is reported quarterly. See section 725(c)(8)(d) of the Act; 34 CFR 366.50(i)(4) (This is the same financial information as the RSA instructions but by quarter.)

Sources and Amounts of Funds and Resources

List the amounts of all resources received each quarter by the center for independent living from items (A) through (M) during each quarter. Round off to the nearest dollar any amounts ending with cents.  Example: $4,240,010.87 ® $4,240,011)

  • Rows (A) through (L) will reflect categories shown on the RSA 704.
  • Amounts in rows (A) through (L) are added (A)+(B)+(C)+(D)+(E)+(F)+(G) +(H)+(I)+(J)+(K)+(L) to give the Total income (M).
  • Row (K) should reflect information reported on Form 3156, Quarterly Program Income Report.
  • Row (N) will reflect Pass-through funds. (Pass-through funds include funds received for a consumer that are subsequently released to the consumer or for his or her benefit. This includes personal assistance services, representative payee funds, or Medicaid funds.)
  • Subtract Pass-through funds (N) from Total income (M) to obtain Net operating resources (O). The PDF version of the form calculates the difference automatically.


  1. The financial administration authority must sign and date the QFR, certifying his or her review and understanding of the information presented.
  2. Complete and submit a signed original of this report to the grant manager and a copy to the Central Office program specialist.
  3. Submit at the same time as the:
  • Form 3156, Quarterly Program Income Report,
  • Form 3158, Quarterly Financial Report and Analysis, and, if appropriate,
  • Form 3159, Final Report of Expenditures.
  1. This report is due 30 days after the close of the reporting period, except the final quarterly report for the year is due 45 days after the end of the year.

Report Analysis

  1. Ratio A: Enter the percentage from totals on page 1: budget period totals projected divided by budget period totals approved.
  2. If the percentage is less than 90 percent, indicate whether there is a need to revise the grant award amount.
  3. If the percentage is less than 100 percent, explain your plans to reduce expenses.
  4. Ratio B: Enter the percentage of the number of months passed divided by 12.
  5. Ratio C: Enter the percentage of the amount expended/obligated to date divided by the total award amount.
  6. Indicate whether there is more than a 5 percent different between Ration B and Ratio C.
  7. If you answered yes, indicate your plans to get back on schedule.
  8. To calculate the percentages under “2. Projected Variance by Category” divide the difference of the approved category budget minus the projected category expense by the approved category budget. The PDF version of the form calculates the percentages automatically.
  9. To calculate the percentage under “3. Cumulative Projected Variance” divide the difference of the total approved budget minus the total projected budget by the total approved budget. The PDF version of the form calculates the percentage automatically.
  10. Indicate yes or no to the three questions.
  11. Sign and date.

Acronyms and Definitions

The Act—Title VII, Chapter 1, Part C of the Rehabilitation Act of 1973, as amended.

RSA—Rehabilitation Services Administration