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
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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:
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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
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|||
Subrecipient (Subgrantee or Contractor) |
Certified Local Government?
|
Federal Share of Subgrant/ Contract Award |
Federal Share Cost not Incurred as of 9/30/XXXX |
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|
$ |
$ |
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|
$ |
$ |
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|
$ |
$ |
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$ |
$ |
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|
$ |
$ |
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|
$ |
$ |
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|
$ |
$ |
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$ |
$ |
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$ |
$ |
CLG SUBGRANT TOTAL |
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|
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.
File Type | application/msword |
Author | renaudj |
File Modified | 2007-11-27 |
File Created | 2007-11-27 |