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Attachment 2
R F P N an m e : P r I am r y A s s i g n me n t O r i e NT a t i o n s
R F P N u MB e r : A S U D C 0 1 3
JUDICIAL COUNCIL OF CALIFORNIA, ADMINISTRATIVE OFFICE OF THE COURTS
STANDARD
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How to fill out 1115 extension summary page
How to fill out 1115 extension summary page
01
Obtain the 1115 extension summary page from the relevant agency or organization.
02
Fill in the required information such as the project name, funding source, and project period.
03
Provide a summary of the project activities and objectives.
04
Include any attachments or supporting documentation as needed.
05
Review the completed form for accuracy and completeness before submission.
Who needs 1115 extension summary page?
01
Organizations or agencies seeking an extension for a project that was originally approved under a Section 1115 waiver.
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What is 1115 extension summary page?
The 1115 extension summary page is a document that provides a summary of the extension request for a Section 1115 demonstration project.
Who is required to file 1115 extension summary page?
The entity responsible for the Section 1115 demonstration project is required to file the 1115 extension summary page.
How to fill out 1115 extension summary page?
The 1115 extension summary page must be filled out with all relevant information regarding the request for extension of the Section 1115 demonstration project.
What is the purpose of 1115 extension summary page?
The purpose of the 1115 extension summary page is to provide a concise summary of the extension request and its justification.
What information must be reported on 1115 extension summary page?
The 1115 extension summary page must include information such as the project name, original approval date, requested extension period, and reasons for the extension.
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