Form NPS 10-320 NPS 10-320 Annual Program Report – Part I Funding Report

NPS Form 10-320 (Rev. 06/2019) OMB Control No. 1024-NEW

National Park Service Expiration Date ##/##/####

ANNUAL PROGRAM REPORT - PART I FUNDING REPORT

(Private)

NATIONAL HERITAGE AREAS PROGRAM OFFICE

1849 C Street NW, MS 7508

Washington, DC 20240

Telephone: (202) 354-2222

Email: [email protected]

Website: www.nps.gov/heritageareas

Heritage Area Name:	Deadline:

Purpose

The information collected on this form is used by the National Park Service (NPS), National Heritage Areas (NHA) Program Office for:

• allocating funds to heritage area management or coordinating entities

• preparing the annual NPS Budget Justification and

• responding to directives from Congress.

Reporting Instructions

The information reported in this form shall be for the federal fiscal year unless otherwise noted. Please respond to all of the questions below, unless otherwise noted.

Identify the name of the heritage area you represent at the top of this page. The complete form includes your NHA name, responses to applicable questions below, and a scanned copy of this page with your name, signature and date verifying the accuracy of the information provided.

Email this form to the NHA Program Office at [email protected] and copy your regional coordinator by close-of-business on the date listed at the top of this form.

Retain all supporting documentation used to complete this form until the program evaluation for your heritage area is concluded. Per 2 CFR Part 215.53, the NPS, as well as the Inspector General or Comptroller General, reserve the right to review supporting documents. The NPS reviews these forms and may contact you periodically to ensure consistent and accurate reporting.

PLEASE NOTE: All forms submitted may be disclosed by the Department of the Interior to any person upon request pursuant to the Freedom of Information Act (FOIA). If the coordinating entity believes that the report(s) contains confidential or financial information exempt from disclosure under the Freedom of Information Act (5 U.S.C. 552), the cover page of the form, as well as each page of the form containing such information is to be labeled.

Assurance Statement

As the authorized representative of the local coordinating entity, I certify that the information reported below is supported by documentation that is verifiable in our records.

Name:

Signature:

Date:

1. INFORMATION FOR FUNDING ALLOCATIONS

The measures below are linked to Heritage Partnership Program (HPP) funding.

1. Paid Full-Time Equivalent Staff

An FTE is the equivalent of one paid person working full-time or 8 hours a day, 5 days a week for 52 weeks a year (e.g., 1 person working full time at 2080 hours a year is 1 FTE.). To calculate FTEs, divide the total number of labor hours for one year by 2080.

1a. Total number of NHA coordinating entity full-time equivalent (FTE) positions at the time of completion of this form: Click here to enter text. FTE

2. HPP Funding and Non-Federal Match

Please account for the HPP funding expended and non-federal matching funds secured for this past fiscal year. Secured match is cash or in-kind donations that is on hand and those that conform to Federal match requirements (see 2 CFR 215.23 and Office of Management and Budget policy circulars). Please note: Other Federal funds may not be used for your HPP match.

2a. Annual total HPP Funds expended from all open task agreements or modifications this past fiscal year $ Click here to enter text.

2b. Annual total Non-Federal HPP match¹ secured this past fiscal year $ Click here to enter text.

2c. Of the secured match reported in 2b above, how much is in cash and in-kind (donated goods and services)?

Cash match $ Click here to enter text.

In-kind (Donated goods and/or services) match $ Click here to enter text.

2d. In the space below, please indicate the exact source of the cash and/or in-kind matching funds reported above. For example, the City of Annapolis provided $55,000 in cash for trail maintenance.

3. Organizational Sustainability Planning

Organizational sustainability plans identify strategies for diversifying funding sources, developing partnerships, and building organizational capacity. National Heritage Area entities develop and implement a number of plans that relate to organizational sustainability, including: strategic, business, fundraising, financial resource development, endowment campaign plans, etc.

3a. Nonprofit Organizational Sustainability Plans. If your coordinating entity is a nonprofit, please list the name and date of the organizational sustainability plan(s) currently in use:

3b. Public Organizational Sustainability Plans. If your coordinating entity is a public (local government, state agency, university, or federal commission) organization, please list the name and date of the organizational sustainability plan(s) currently in use:

2. INFORMATION FOR BUDGET JUSTIFCATIONS & ANNUAL REPORTS

1. Accomplishments. Please identify your primary accomplishments for this past fiscal year. In 1 – 3 sentences please identify the project, funding sources and partner organizations that assisted with implementation. List no more than 5 accomplishments.

2. Challenges. If applicable, please identify any significant challenges you encountered this past fiscal year, i.e., natural disasters, financial constraints, changes in leadership or other challenges within your heritage area. In 1 – 3 sentences explain your challenge. List no more than 5 challenges.

3. Unfunded Project and Program Needs. If applicable, please identify projects, programs, or other activities related to fulfilling your legislative mandate and implementing your management plan that have not been advanced due to a lack of HPP funding. In 1- 3 sentences identify the project, program, or activity name(s) and the estimated additional HPP funding amount needed to advance these activities. Do not identify projects that could not be funded with HPP funds, such as land acquisition.

4. Organizational Sustainability Accomplishments. If applicable, please identify your organizational sustainability accomplishments related to your coordinating entity’s funding diversification, partnership development and capacity building for this past fiscal year. List no more than 3 accomplishments.

NOTICES

Privacy Act Statement

General: This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974), December 21, 1984, for individuals completing this form. All forms submitted may be disclosed by the Department of the Interior to any person upon request pursuant to the Freedom of Information Act (FOIA). If the Coordinating entity believes that the report(s) contains confidential or financial information exempt from disclosure under the Freedom of Information Act (5 U.S.C. 552), the cover page of the form, as well as each page of the form containing such information is to be labeled.

Authority: 54 USC Ch. 3201, Historic Sites Act of 1935, as amended; 44 U.S.C. 3501, et seq., Paperwork Reduction Act of 1995; and individual pieces of legislation and associated amendments in 54 USC 100702 that enable the NPS, on behalf of the Secretary of the Interior, to provide federal financial, technical, and other assistance for the preservation of natural, cultural, historic, and scenic resources.

Purposes and Uses: The NPS intends to track the progress of each heritage area on implementing its management plan and meeting performance goals. The information collected is used by the NHA program office in monitoring the progress of each heritage area. The collection of this information is necessary to allow for national oversight, analysis, coordination, technical and financial assistance, and support to National Heritage Areas to ensure consistency and accountability across the country.

Effects of Nondisclosure: Financial disclosure is in accordance with 54 USC Ch. 3201, Pub. L. 113–291, div. B, title XXX, §3052(a)(2), Dec. 19, 2014, 128 Stat. 3802.

Information Regarding Disclosure of Your Social Security Number Under Public Law 93-579 Section 7(b): Your Social Security Number is not needed to complete this form.

Paperwork Reduction Act Statement

We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) in response to the NHAs individual authorizing legislation requiring annual reporting as mandated by Congress. The information provided by NHA Coordinating Entities allows the NHA program office to allocate funding to heritage area management, prepare NPS budget justifications, and track management planning and implementation across NHAs. We may not conduct or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB Control Number. OMB has reviewed and approved this survey and assigned OMB Control Number: 1024-­###, Expiration Date: ##/##/####.

Estimated Burden Statement

Public Reporting burden for this form is estimated to average 10 hours per response, including the time it takes for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Comments regarding this burden estimate or any aspect of this form should be sent to the Information Collection Clearance Officer, National Park Service, 1201 Oakridge Drive, Fort Collins, CO 80525.

1 Match is the non-federal share of costs that heritage area entities or their partners contribute to accomplish projects identified in an annual work plan and project budget. For more guidance on match visit www.nps.gov/heritageareas.