Form 1222 Notice of Award

OMB Approval No.: 3245-0140
Expiration Date: 6/30/2009

NOTICE OF AWARD

U.S. Small Business Administration

2. Grant/Cooperative Agreement No.:

1. AUTHORIZATION (Legislation/Regulation)

(Mo./Day/Yr.)

4. PROJECT PERIOD (Mo./Day/Yr.)
3. RECIPIENT: (Name, Organizational Unit, Address)
From

Through
(Mo./Day/Yr.)

5. BUDGET PERIOD (Mo./Day/Yr.)
From

Through

6. FEDERAL CATALOG NO.

7. ADMINISTRATIVE CODES

8. TITLE OF PROJECT/PROGRAM (limit to 53 spaces)
9. AWARD AMOUNT
Amount of SBA Financial Assistance

10. DIRECTOR OF PROJECT (Program or Center Director,

11. RECOMMENDED FUTURE SUPPORT (Subject to the availability of

Coordinator or Principal Investigator)

funds and satisfactory progress of the project)

NAME
Last

First

BUDGET
YEAR

Initial

ADDRESS:

a.

12. Approved Budget (Excludes SBA Direct Assistance)
SBA Funds
Only

TOTAL
DIRECT COST

BUDGET
YEAR

TOTAL
DIRECT COST

b.

13. REMARKS (Other Terms & Conditions Attached)

Yes

No

Total project costs including all other financial
participation.

Federal
Share

Non-Federal
Share

a. Personal Service
14.

b. Fringe Benefits

THIS AWARD IS SUBJECT TO THE FOLLOWING COST PRINCIPLES
AND OMB UNIFORM ADMINISTRATIVE REQUIREMENTS:

c. Consultants
d. Travel

2 CFR Part 220 - Cost Principles for Educational
Institutions

e. Equipment

2 CFR Part 225 - Cost Principles for State and Local Governments

f. Supplies
2 CFR Part 230 - Cost Principles for Non-Profit Organizations

g. Contractual
h. Other
i. TOTAL DIRECT COSTS

0.00

FAR Subpart 31.2 -- Principles for Determining Cost
Applicable to Awards with For-Profit Organizations

0.00

j. Indirect cost
(Rate).

13 C.F.R. Part 143 -- Uniform Administrative Requirements for
Grants and Cooperative Agreements to State and Local Governments

% of S & W/TADC

k. OTHER APPL. COSTS
l. TOTAL APPROVED BUDGET

0.00

2 CFR Part 215 -- Uniform Administrative Requirements for
Grants and Agreements with Institutions of Higher Education, Hospitals and
Other Non-Profit Organizations.

0.00

*Must meet all matching or cost participation requirements
subject to adjustment in accordance with SBA policy

OMB Circular - A - 133 - Audits of States,
Local Governments, and other Non-Profit Orgs.

15. THIS AWARD IS SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE
16. CRS - EIN
19a. CITY CODE

17. COUNTY NAME
b. COUNTY CODE

BUDGET CODE
20a.

c. STATE CODE

DOCUMENT NO.
b.

18. CONGRESSIONAL
DISTRICT NO.
d. PROGRAM CODE

AMT. ACTION FIN. ASST.
c.

TYPE OF ORGANIZATION
d.

21. AGENCY OFFICIAL (Signature, Name and Title)

22. DATE ISSUED (Mo./Day/Yr.)

23. RECIPIENT OFFICIAL (Signature, Name and Title)

24. DATE

SBA FORM 1222 (6-07) Previous editions obsolete

(Mo./Day/Yr.)

THIS AWARD IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR
BY REFERENCE IN THE FOLLOWING.
A.

The program legislation and/or regulation cited in block 1.

B.

This award notice including terms and conditions, if any, noted under block 13, Remarks.

C.

SBA Federal Assistance Regulations or Manual issuances in effect as the beginning date of
the budget period.

D.

The applicable program announcement, if any.

E.

SBA Policy Guidelines in effect as of the beginning date of the budget period.

F.

SBA Administrative Regulations/Guidelines in effect as of the beginning date of the budget
period.

In the event, there are conflicting or otherwise inconsistent policies applicable to this award, the
above order of precedence shall prevail. Acceptance of ALL terms and conditions is acknowledged
by the Recipient's Signature in block 23.
Note: The estimated burden completing this form is 80 hours per response. You will not be required to
respond to any collection of information unless it displays a currently valid OMB approval number.
Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409, 3rd St.,
S.W., Washigton, D.C. 20416 and Desk Office for Small Business Administration, Office of Management and
Budget, New Executive Office Building, room 10202 Washington, D.C. 20503. OMB Approval (3245-0140).
PLEASE DO NOT SEND FORMS TO OMB.

SBA FORM 1222 (6-07) Previous editions obsolete