HRI Monthly Expenditure Report

The monthly expenditure report filed with Health Research, Inc., tracking Prior Periods, Current Period and To-Date expenditures against budget with a remaining Balance column.

Free download · no signup

Excel workbook · 8 KB · blank & scrubbed

Download the template

Rebuilt from a real filed form with every client name, amount, and identifying detail removed. Columns, categories, and formulas are preserved exactly as the funder issues them.

Who files this

Providers on NYSDOH-funded contracts administered through HRI — AIDS Institute, Center for Community Health, Wadsworth Center and related programs.

Key requirements

Funder

Health Research, Inc. — NYSDOH fiscal agent

Jurisdiction

New York State

Fringe range

8.25%–35%

Indirect cost basis

No indirect or administrative-overhead line exists on the Monthly Expenditure Report — overhead must be embedded within the direct cost categories rather than claimed as a standalone rate

What gets this form kicked back

HRI is the fiscal agent, not the funder. The actual program rules come from whichever NYSDOH program funds your contract, and they vary.

There is no standalone indirect line — overhead is embedded in the direct categories.

A separate NYS Claim for Payment form (AC3253-S) is filed alongside this schedule; it is a generic state form, not an HRI one.

Allowable OTPS categories

The categories Health Research, Inc. recognizes on a budget or voucher. Using wording outside this list is a routine cause of returned submissions.

Contractual Services
Travel
Equipment
Space/Property Rent
Utilities
Operating Expenses
Others

Rules worth knowing before you file

HRI is the fiscal and administrative agent for New York State Department of Health programs (Wadsworth Center, AIDS Institute, Center for Community Health and others) — it is not itself the funding program, so fiscal rules vary by which NYSDOH program actually funds the contract
The voucher is monthly, tracking Prior Periods, Current Period, and To-Date expenditures against budget, plus a Balance column — there is no quarterly structure
A separate NYS Statewide Financial System Claim for Payment cover form (AC3253-S) is submitted alongside this detailed schedule

Health Research, Inc. — fiscal rules, voucher exports and setup: how Prove It Financials builds this form from your own payroll, budget and invoices.
Free voucher checker: upload a completed copy of this form and it flags unallowable costs, fringe above the ceiling, allocations that don't total 100% and totals that don't reconcile before you file. No signup; the file never leaves your browser.
Why vouchers get returned: the six checks behind most returned vouchers, and what each one looks like in a real file.

Stop filling this in by hand

Prove It Financials generates this exact form every month, populated from your own budget, payroll and invoices — with allocation percentages, fringe, and indirect already calculated and validated against Health Research, Inc.'s own rules.

See how it works

HRI Monthly Expenditure Report

Who files this

Key requirements

What gets this form kicked back

Allowable OTPS categories

Rules worth knowing before you file

Related

Stop filling this in by hand