Reporting Requirement - State Unexpected Carryover Funds Table and Statement

Procedures for State, Tribal, and Local Government Historic Preservation Programs; 36 CFR 61

State HPF Grant Carryover Statement, 1024-0038

Reporting Requirement - State Unexpected Carryover Funds Table and Statement

OMB: 1024-0038

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OMB Control Number: 1024-0038

Expiration Date: November 30, 2007


EXHIBIT 25-C CARRYOVER STATEMENT


Each State must complete the Carryover Statement and the Table of Unexpended Carryover Funds as part of the End-of-Year Report. Only the Federal Share should be included.


OMB Control Number 1024-0038

Expiration Date: November 30, 2007


Carryover Statement


Item

Amount (Federal Share)

Costs Incurred First Fiscal Year

$

Committed Subgrants/Contracts Unexpended Balance to be Carried Over

$

Uncommitted Carryover

$

Total (Should Equal Grant Award)

$ 0.00

The total uncommitted dollar amount awarded in FY (just completed fiscal year) to be carried over into FY (current fiscal year) that is not committed to subgrants/contracts is $ ."


Please check and complete one of the following sentences (choose the one that applies):


This amount does not exceed 25% of the amount apportioned by NPS, as demonstrated by the attached Unexpended Carryover Funds Table.


OR


As demonstrated by the attached Unexpended Carryover Funds Table, this amount exceeds 25% of the amount apportioned by NPS by $ . I am seeking a waiver for this amount to carry these funds over into the next Federal Fiscal Year for the reasons attached.


Signature of SHPO Date

Comments:




If the proposed uncommitted carry over amount exceeds 25%, see Chapter 3, Sections D.6. and K. which discuss Waivers and the Carryover (Use or Lose) policy on HPF funds.

OMB Control Number: 1024-0038

Expiration Date: November 30, 2007



EXHIBIT 25-D UNEXPENDED CARRYOVER FUNDS TABLE


OMB Control Number 1024-0038

Expiration Date: August 31, 2000


Unexpended Carryover Funds Table




Subrecipient (Subgrantee or Contractor)

Certified

Local

Government?


Federal Share of

Subgrant/

Contract Award

Federal Share

Cost not Incurred as of 9/30/XXXX



$

$



$

$



$

$



$

$



$

$



$

$



$

$



$

$



$

$

CLG SUBGRANT TOTAL



GRAND TOTAL

0.00

0.00



Enter with a check mark, or “yes” all subgrants that are passed through to a Certified Local Government in the second column. All of the subgrants/contracts listed in the Project/Activity Database Report must be included in the Unexpended Carryover Funds Table.

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