Request for Distribution of County CARES Act Funds
Local Government/Public Entity/Political Subdivision
Purpose of this form:
This form is to be completed by the authorized representative of the Applicant and submitted to
the County. Submission of the requested information is required to make a determination
regarding eligibility for the funding request. Failure to submit required information in order to
evaluate the Application and make a funding award decision will result in denying the
Application and any award of funds.
Applicants are encouraged to review section 601(d) of the Social Security Act, as added by
section 5001 of the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”);
Coronavirus Relief Fund Guidance for State, Territorial, Local, and Tribal Governments issued
by the United States Department of Treasury, dated April 22, 2020; and Coronavirus Relief Fund
Frequently Asked Questions issued by the United States Department of Treasury, updated most
recently as of May 4, 2020.
Instructions regarding completing this form:
A. Requirements of the CARES Act. The CARES Act provides that payments from the Fund
may only be used to cover costs that: (1) are necessary expenditures incurred due to the public
health emergency with respect to the Coronavirus Disease 2019 (COVID–19); (2) were not
accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment
of the CARES Act) for the State or government; and (3) were incurred during the period that
begins on March 1, 2020, and ends on December 30, 2020.
B. Necessary Expenditures. The requirement that expenditures be incurred “due to” the public
health emergency means that expenditures must be used for actions taken to respond to the
public health emergency. These may include expenditures incurred to allow the State, territorial,
local, or Tribal government to respond directly to the emergency, such as by addressing medical
or public health needs, as well as expenditures incurred to respond to second-order effects of the
emergency, such as by providing economic support to those suffering from employment or
business interruptions due to COVID-19-related business closures.
Funds may not be used to fill shortfalls in government revenue to cover expenditures that would
not otherwise qualify under the statute. Although a broad range of uses is allowed, revenue
replacement is not a permissible use of Fund payments.
With respect to Section 5 titled “Intended Use of Funds,” all funds must be for “Necessary
Expenditures” incurred due to the public health emergency with respect to the Coronavirus
Disease 2019 (COVID-19). On April 22, 2020, the federal government provided guidance on the
definition of Necessary Expenditure.