HHS Conference Request for Waiver
Applicable when the Net Expenses are expected to exceed $500,000
Operating/Staff Division Information | ||||||||||
| Operating or Staff Division | ||||||||||
| Office | ||||||||||
Conference Description | ||||||||||
Title/Topic
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Purpose of Conference
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Dates To Be Held (DD/MM/YYYY) | From: | To: | ||||||||
Cost Information | ||||||||||
| Total Estimated Cost | $ | |||||||||
Basis of Estimate (Insert a summary description of the total estimated costs and the basis for the estimate) |
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Description of Measures Used to Reduce/Minimize Costs (Include a summary of the options considered to reduce the costs (attendees, venue location, number of days, speaker costs, etc.) and the rationale for selecting or not implementing each option.) |
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Description of Exceptional Circumstances (Insert a description of the exceptional circumstances that exist whereby spending in excess of $500,000 on this single conference is the most cost-effective option to achieve a compelling purpose and an explanation of the impacts of either not funding the conference or reducing the approved funding amount below $500,000.) | ||||||||||
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Requestor Information | ||||||||||
| Name | ||||||||||
| Title | ||||||||||
| Office | ||||||||||
Signature
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OPDIV/STAFFDIV Approval | ||||||||||
Recommendation (Insert a statement explaining the OPDIV/STAFFDIV Head’s recommendation for approval) |
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OPDIV/STAFFDIV Head Signature | ||||||||||
| Date | ||||||||||
Secretary Approval | ||||||||||
| Concur | Non-Concur | |||||||||
Signature
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| Date | ||||||||||