Free affidavit form 37
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Office of Contracts and Grants
Per Diem Affidavit Form
Location of Travel:

From:

To:

Statement of Principal Investigator
I have reviewed the attached list of unallowable costs pertaining to federal grants.
I certify that I have spent the per diem that is being reimbursed to me exclusively for items that are allowable by
federal grants and by my specific award.
I certify that no alcohol was purchased and expenses incurred were solely for the purpose of carrying out the work on
the sponsored grant or contract and not for entertainment purposes.
Comments:

Principal Investigator/ Project Director Name:

Date

.
Principal Investigator/ Project Director Signature

Business Manager Name:

Date

.
Business Manager Signature

Senior Grants Accountant, OCG Name:

Date

.
Senior Grants Accountant, OCG Signature