1. Please identify which terms in the original grant agreement you would like amended:
2. Please identify what you are requesting the new terms be:
3. Please explain why you are requesting this change:
*Authorized Signature: ________________________________________ Date:___________________
Name: ____________________________________________________
Title: _____________________________________________________
*Grant agreement amendment requests should be submitted to the AOC Grant Program
Administrator no later than thirty (30) days prior to the expiration of the original grant
agreement and must be signed by the judge or administrator of the requesting grantee court.
AOC Grant Program
Grant Agreement Amendment Request Form
Fiscal Year 2021 Grant Cycle
Grant Type/Funding Stream:
Uniform System for Judicial Records Grant
Trial Court Improvement Grant
Grantee Court:
Grant Agreement Number:
Grant Project Manager:
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