Form 3155, Base/Operational Grant Budget Revision Request

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Effective Date: 9/2020


Updated 9/2018


Prior written approval of the Texas Health and Human Services Commission (HHSC) grant manager for budget revisions is required in the following circumstances:

  • cumulative transfers among direct cost categories exceed, or are expected to exceed, 10 percent of the current total approved budget;
  • the revision includes a cost type where prior approval is required by the applicable cost principles,
  • the revision results in the need for additional funding;
  • the revision transfers funds allotted for training to other line items or categories; or
  • the revision transfers amounts budgeted for indirect cost to absorb increases in direct cost.

Copies and Distribution

Submit the original version of this request, signed by the financial administration authority identified in the grant application, to the HHSC grant manager, when appropriate.


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

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

Detailed Instructions

  1. Enter the grantee name.
  2. Enter the grant number (see Statement of Grant Award).
  3. Request number: Indicate the sequential number of the Base/Operational Grant Budget Revision Request (beginning with 1).
  4. Supply the information for the federal funds or state funds provided by HHSC, and program income or match funds as follows:
  • Fill in the Approved Budget spaces with the amounts from either the Notice of Grant Award from the approved grant application (if the budget has not been revised to date) or from the latest approved Base/Operational Grant Budget Revision Request.
  • Enter Requested Changes for each category to be revised. Indicate decreases by preceding the amount with a minus sign (-) or by enclosing the amount in parentheses, for example, -$400 or $(400). The column total must equal zero.
  • The "cumulative transfer" total is either the total of the increases or the decreases, not both.
  • Calculate the resulting Revised Budget for each category by adding or subtracting the Requested Change for each category to or from the Current Approved Budget and entering the result in the appropriate space.

Note that the totals for the Approved Budget and the Revised Budget must be the same amount.

  1. Justification: Provide the rationale for the requested budget revision(s) in the space provided and/or on additional attached pages. The justification should be sufficiently detailed to explain the circumstances that warranted the budget revision.

The financial administration authority must sign the request, enter his or her position title, and date the request form.