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Local Agency Internal Chart Review for Restaff Certifications (SAMPLE) Instructions: The agency Coordinator (or designee) may use this form to monitor program integrity when Separation of Duties is
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Local agencies that are required to submit exhibit 1-q as part of their reporting or regulatory requirements.

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Exhibit 1-q local agency is a form that must be filed by certain local agencies to report financial information.
Local agencies that meet specific criteria as determined by regulatory authorities are required to file exhibit 1-q.
Exhibit 1-q can be filled out by providing detailed financial information as per the instructions provided on the form.
The purpose of exhibit 1-q is to provide transparency and accountability regarding the financial activities of local agencies.
Information such as revenue, expenses, assets, and liabilities must be reported on exhibit 1-q.
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