250 E Street SW

Washington, D.C. 20525

202-606-5000/ 800-942-2677

 

Disability Accommodation Off Set 

Request Form Instructions 

AmeriCorps State and National

November 1, 2023 
1

Overview 

These instructions apply to the FY 2024 ASN Disability Accommodation Request 

Form being submitted for use by AmeriCorps State and National (ASN) programs 

who want to receive off sets for funds spent accommodating members with 

disabilities. As grantees are responsible for all costs associated with reasonable 

accommodation, AmeriCorps expects that they initially seek assistance from local 

agencies and community organizations before submitting a request for Federal 

reimbursement. Funding is limited and most effectively utilized for services otherwise 

not covered by these institutions. 

Resources for Finding Reasonable Accommodations 

Selecting the accommodation should be a collaboration between the AmeriCorps 

member, his/ her/their supervisor, and program managers. Free technical assistance 

regarding disability accommodation is available through the Job Accommodation 

Network. 

Many individuals with disabilities may already be clients of the Department of 

Vocational Rehabilitation (a.k.a. “RSA”), an agency that exists in each state, dedicated 

to training and supporting people with disabilities in search of gainful employment. 

Please visit the directory of state-based Vocational Rehabilitation agencies. 

Each state also has an assistive technology program which can assist with information 

and referral, loan, and technical assistance questions. Please visit the directory 

organized by state. 

Process for submitting applications 

By applying for reasonable accommodation off set grants, grantees are requesting to 

be reimbursed for expenses incurred. ASN will not make advance payments to cover 

accommodation expenses. Reimbursements are made to prime grantees only. State 

commissions and national directs are expected to inform their subgrantees that they 

are to apply through the commission/national direct grantee. 

Reasonable accommodation off set grant funds is available on a noncompetitive 

basis, and requests are processed in the order in which they are received. Funding is 

limited and will be awarded on a first-come, first-served basis. Requests for off sets of 

a single expense can be submitted at any time. If you intend to request off sets for 

multiple expenses throughout the year, your initial request must estimate what your 

total reimbursable expenses will be. 

Grantees must retain (and provide upon request) documentation for each member 

for whom reasonable accommodation grant funds are requested. The documentation 

must show that:
2

• The goods or services needed to provide the reasonable accommodation 

were procured in conformance with the procurement standard specified in 

2 CFR 200.317 – 200.326

• Verification by the member that the accommodation was provided

Instructions 

Complete the FY 2024 ASN Disability Accommodation Request Form in its entirety, 

including receipts, and submit via a secure, encrypted email to 

Accommodations@americorps.gov. The encrypted email option can be found on the 

“Options” ribbon in Microsoft Outlook email message or via “Confidentially Mode” in 

Gmail. Requests must be submitted by August 30, 2024. 

Please complete all the requested fields to ensure timely processing. Incomplete 

applications cannot be processed. The form must be provided in a Section 508 

compliant format (preferably as a Word document attachment). The form requests 

the following information: 

• Name of Applying Grantee (consistent with the name of the organization in 

eGrants).

• Organization Single Point of Contact Name for Request – one person from 

the prime grantee who will act as liaison for reimbursements.

• Grant number.

• Single point of contact’s email address for request/correspondence.

• Single point of contact’s telephone number for request/correspondence.

• Prime applicant name, if different from above, and contact information. 

• Name of subgrantee/operating site (if applicable).

• Grant number of subgrantee/operating site (if applicable). 

• NSPID number for member(s) for which accommodations were requested 

(DO NOT include other Personally Identifiable Information [PII]). 

• Type of disability for which the accommodation has been provided. 

• Type of accommodation for which reimbursement is requested. 

• A statement of how the accommodation helps the member achieve full 

participation in their service assignment(s). 

• Whether outside community resources were used or consulted in arranging 

the accommodation (i.e., Department of Vocational Rehabilitation, etc.). 

• The amount of reimbursement being requested. (If there is more than one 

receipt, please submit an itemized list with the total as well as each receipt.)

• Indication of whether this is a one-time or quarterly request for multiple 

reimbursements (i.e., for providing services that will yield many receipts, 

batching them into quarterly submissions is needed).

• Estimated total reimbursement that will be needed for accommodations in 

FY 2024 if it is not a one-time request. 
3

The grantee must also attach documentation for the claimed reimbursement, such as 

copies of a contract, receipt and/or invoice and evidence of payment of the expense. 

This documentation does not need to be in a section 508 compliant format. 

Submission of the application for reasonable accommodation off set grant funds 

serves as a certification by the Grantee that the AmeriCorps member for whom funds 

are requested has a disability as defined by the Americans with Disabilities Act. 

Grantees are not required to obtain documentation that the service member has a 

disability if the disability is apparent. The grantee should obtain documentation from 

a medical or rehabilitation expert to better understand the need for the reasonable 

accommodation for member requests where a disability is not apparent, or the 

accommodation request is not straightforward. These professionals can also verify 

that someone meets disability status. Please note, there is much broader coverage 

under the ADA after the Amendments in 2008.