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Public Safety, Essential Services Tax Quarterly Reports

  1. Public Safety & Essential Services Quarterly Reports Form
    Each quarter, agencies that receive funds from the Humboldt County Local Public Safety and Essential Services tax must submit reports to the county on a quarterly basis detailing their expenditures and activities carried out with the funding they have received. This form is used to submit that information.
  2. The agency submitting this report
  3. Additional Attachments
    If you need to submit more attachments than this form allows, please submit what you can and fill out another form.
  4. Have you posted your quarterly update to social media?*
  5. Exhibit D of your agreement discusses social media reporting requirements
    Example social media posts could read: “#MeasureZ update: Over the last quarter we [____brief description of Measure Z activities completed and/or total numbers served____]. During our efforts this quarter we’ve seen [____brief description of the difference Measure Z funding has made in our community and for the population you are serving____].
  6. Do you have any notes or special instructions for your report submission?
  7. Leave This Blank:

  8. This field is not part of the form submission.