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Application Forms and Resources

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Use these forms and resources to help you prepare your application.

If you are applying for a SAMHSA grant, you must download the application forms found on Grants.gov. This website is the source for finding federal grant opportunities, downloading forms, and submitting an application. Additional forms available only on SAMHSA’s website also may be required. Read the Notice of Funding Opportunity (NOFO) carefully to determine which forms you must include in your application. Applications that do not include all required forms will be screened out and will not be eligible for review.

Additional Forms for Submission

HHS 690 Form

Every grant applicant must have a completed HHS 690 form (PDF | 324 KB) on file with the Department of Health and Human Services. Your signature acknowledges that you agree to comply with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, and the Age Discrimination Act of 1975.

Charitable Choice Form – SMA 170

You may be required to submit an Assurance of Compliance with SAMHSA Charitable Choice Statutes and Regulations form SMA 170 (PDF | 23 KB). Check the NOFO to determine if this form is required for the grant program for which you are applying.

Other Application Materials

Assurances and Certifications

When the Authorized Organization Representative (AOR) signs the Application for Federal Assistance SF-424 form, they certify that the statements contained in the SAMHSA List of Certifications (PDF | 11 KB) are true. Their signature also certifies that they agree to comply with the SF-424B (Assurances for Non-construction) Form (PDF | 115 KB).

Sample SF-424 and SF-424A Forms

The following PDFs are samples of the SF-424 and SF-424A forms:

SAMHSA Budget Template

To expedite review of your application, it is highly recommended you use the SAMHSA budget template below to complete the Detailed Budget and Narrative Justification for submission with your application. For SAMHSA to view all of your budget data, you must convert the PDF to a non-editable format by PRINTING TO PDF before submission:

Note: To download the SAMHSA Budget Template (PDF)":

  • Right-click the link "SAMHSA Budget Template (PDF)"
  • Select "save link as" and save to a location on your computer
  • Go to the saved location and open the "SAMHSA Budget Template (PDF)"

IMPORTANT: For the PDF template to function as designed, it must be opened directly in Adobe Acrobat or Reader instead of the browser.

Guidance

The following documents provide guidance on using the budget template:

Sample Budgets

The following PDFs are samples of Detailed Budgets and Narrative Justification:

Additional Information for Completing Your Grant Application

Last Updated

Last Updated: 08/15/2022