Grants Product Summary

OMB Control Number: 1024-0038

Expiration Date: MM/DD/YYYY

Historic Preservation Fund Grants to Tribal Historic Preservation Offices Grant Products Summary Tribe: ___________________________________________________ Year: _____________________________________________ Completed By: __________________________________________ Date: __________________________________________
This form is used to record the number of tangible preservation accomplishments achieved by the Tribal Preservation Office using HPF grant funds during the last completed calendar year. All sections should be completed; if there was no activity in an area, please put a 0 (zero) in that space. This form is to be submitted with the Annual Report which is due by January 31st of each year. If you have any questions about completing this form, please call Bob Ruff at (202) 354-2068.
Section 106 Review	Number of Properties/Projects for Which Written Eligibility Opinions Were Provided	_______________________
	Findings of “Effect” or “No Effect” For Which Written Opinions Were Provided	_______________________
	Memoranda of Agreement or Programmatic Agreements Signed	_______________________
Listings on Registers (optional)	Number of Districts, Buildings, Sites, Structures, or Objects Listed on Tribal Register	_______________________
Survey	Amount of Area Surveyed (in acres)	_______________________
Inventory (Number of Properties/Sites Added to Inventory)	Architectural or Historical	_______________________
	Archeological	_______________________

Paperwork Reduction Act Statement: This information is being collected for the annual report to NPS on the achievements that Tribal Historic Preservation Office (THPO) has achieved with its Historic Preservation Fund grant. Response to this request is required to obtain a benefit pursuant to the National Historic Preservation Act, as amended (16 U.S.C. 470 et seq.). A Federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number.

Estimated Burden Statement: Public reporting burden for this information collection is estimated to average 6 hours per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding this burden estimate to the Chief, Historic Preservation Grants, National Park Service, 1849 “C” Street, NW (2255), Washington, DC 20240.