This government document is issued by Emergency Services and Public Protection, Department of for use in Connecticut
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https://portal.ct.gov/demhs/-/media/demhs/_docs/program-and-unit-forms---advisories/grants/mgp/reimbursements-and-financials/dps-202-c-4--reimbursement-verification/dps-202-c-4--reimburmsement-verification.pdf?rev=9a1fe9c0b066473da0c3cb708300d634&hash=80C871FA2E010438A03B1357BBAD0A15