AoA Uniform Project Description

Updated January 28, 2010

Standard Template
AoA Program Announcements

This document is designed for use by AoA Project Officers in developing
Program Announcements for new competitive grant awards. It is designed to
standardize the format and content used for all AoA Program
Announcements. It allows for flexibility in tailoring announcements to
particular programs, but also includes standard elements (forms, formats,
text), which should be included in all AoA announcements.

Please note that instructions for the Program Officer are in
italics. Text in regular type can be used, or modified, according to
the needs of a particular funding opportunity.
FYI: Headings shown in red within the body of the template are
linked to the Table of Contents; do not worry about the red font.
When customizing your Program Announcement, please follow
these basic guidelines to help ensure your document is 508
compliant:
1. Do not underline text, underlines are reserved for hyperlinks
2. Use only round or disc bullets created through bulleted list
3. Hyperlinks must include http://

U.S. Administration on Aging

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OMB Approval No. 0985-0018
Expiration 05/31/2010

Insert Name of Opportunity
Program Announcement and Grant Application
Instructions

U.S. Administration on Aging
FY 2010

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Table of Contents

I. FUNDING OPPORTUNITY DESCRIPTION ...................................................... 4
II. AWARD INFORMATION.................................................................................... 5
III. ELIGIBILITY INFORMATION ........................................................................... 6
1. Eligible Applicants............................................................................................... 6
2. Cost Sharing or Matching .................................................................................... 6
3. Responsiveness and Screening Criteria ............................................................... 8
IV. APPLICATION AND SUBMISSION INFORMATION...................................... 9
1. Address to Request Application Package ............................................................ 9
2. Content and Form of Application Submission................................................... 10
3. Submission Dates and Times ............................................................................. 15
4. Intergovernmental Review ................................................................................. 16
5. Funding Restrictions .......................................................................................... 16
6. Other Submissions Requirements ...................................................................... 17
V. APPLICATION REVIEW INFORMATION ...................................................... 17
1. Criteria ............................................................................................................... 17
2. Review and Selection Process............................................................................ 19
3. Anticipated Announcement Award Date ........................................................... 20
VI. AWARD ADMINISTRATION INFORMATION .............................................. 20
1. Award Notices.................................................................................................... 20
2. Administrative and National Policy Requirements............................................ 20
3. Reporting............................................................................................................ 20
VII. AGENCY CONTACTS ....................................................................................... 21
VIII. OTHER INFORMATION ................................................................................. 21
1. Application Elements ......................................................................................... 22
2. The Paperwork Reduction Act of 1995 (P.L. 104-13) ....................................... 22
ATTACHMENTS ....................................................................................................... 23
Attachment A: Instructions for Completing Required Forms.................................. 24
Attachment B: Budget Narrative/Justification – Page 1 – Sample Format.............. 33
Attachment C: Budget Narrative/Justification –– Sample Template....................... 36
Attachment D: Project Work Plan, Page 1 – Sample Template............................... 37
Attachment E: Instructions for Completing the Project Summary/Abstract............ 40

DO NOT MANUALLY EDIT THE TABLE OF CONTENTS. To update the Table
of Contents page numbers, put your cursor over any Table of Contents line item;
right click; select Update Field; then choose Update Entire Table; click OK. This will
incorporate page changes that occurred when you modified the PA Template.

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Department of Health and Human Services (HHS)
Administration on Aging (AoA)
AoA Center INSERT CENTER NAME
Funding Opportunity Title: INSERT PROGRAM NAME
Announcement Type: INSERT
Insert “Initial” or “Modification” and date of funding opportunity announcement
being modified
Funding Opportunity Number: HHS-2009-AoA-xx-xxxx
Catalog of Federal Domestic Assistance (CFDA) Number: INSERT NUMBER (for
most discretionary grants – 93.048)
Key Dates: The deadline date for submission of applications is 11:59 p.m., Eastern Time,
on insert date.
In addition to deadline date, any time sensitive dates regarding the announcement
should be reflected in this section, for example letters of intent or pre-applications.
Additional Overview Content/Executive Summary: (Optional)
If the announcement is long or complex, staff may wish to include a short executive
summary before the full text (e.g., concise description of opportunity, total amount
to be awarded, who is eligible). For examples of additional overview content used
in other Program Announcements, please see [section] of the Grants Menu Toolkit.

I.

FUNDING OPPORTUNITY DESCRIPTION
This section must include a complete description of the program or project
activities and area of interest for which applications are being sought. It should
adequately describe the funding opportunity in plain language. The statutory
authority and governing program regulations, if any, must be specified in this
section.
The following additional information also may be included in this section: aprogram funding priorities, b-whether this is a new program or, if not, past
experience under the program or initiative and any changes, c-relation to
Presidential or Secretarial priorities, d-any related programs or initiatives.
Statutory Authority
The statutory authority for grants under this Program Announcement is contained
in Title IV of the Older Americans Act (OAA) (42U.S.C. 3032), as amended by the
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Older Americans Act Amendments of 2006, P.L. 109-365. (Catalog of Federal
Domestic Assistance 93.048, Title IV Discretionary Projects).

II.

AWARD INFORMATION
This section must provide an indication of the potential funding under the funding
opportunity announcement. The information provided in this section must be
consistent with any information provided in the synopsis for the data elements
related to funding. This must be an estimate of the aggregate amount of Federal
funds expected to be available for award (current year and, if available, future
years), the anticipated number of awards, the dollar range, including funding floor
and ceiling amounts, of individual awards (specifying whether on an annual or
overall project basis), anticipated start date and the expected duration of support,
i.e., length of the competitive segment. If no funding floor is provided, OGM will
include an estimated amount. This information is especially important for an
applicant not only to determine whether to apply but also for its preparation of an
application scope and budget consistent with AoA expectations.
Address the type of applications sought, e.g., new and/or competing continuation
applications or competing supplemental applications.
Indicate whether grants and/or cooperative agreements are anticipated. If
cooperative agreements are anticipated, this section or a referenced attachment
must include the complete terms and conditions of the cooperative agreement and a
statement of AoA’s anticipated substantial involvement specific to the type of
activities that are the subject of the funding opportunity announcement. By
including the complete terms and conditions of the cooperative agreement in the
Program Announcement, language can be added to the Notice of Award (NoA),
which makes the terms and conditions effective immediately upon award
notification and eliminates the need for the grantee to sign anything.
If the statement of AoA’s anticipated substantial involvement and the terms and
conditions are not included in this section, this section must provide a crossreference to the detailed information in section I.
The terms and conditions should include three sections: (1) a descriptive list of
AoA responsibilities, (2)a descriptive list of Awardee responsibilities, and (3) a
description of an arbitration process should there be post-award disagreements
and/or a statement explaining post-award changes require the mutual consent of
both parties. For examples of cooperative agreements already in use, please see
[section] of the Grants Menu Toolkit.
Suggested language to be used in a Program Announcement is:
Once a cooperative agreement is in place, requests to modify or
amend it or the work plan may be made by AoA or the awardee at
any time. Modifications and/or amendments of the Cooperative
Agreement or work plan shall be effective upon the mutual
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agreement of both parties, except where AoA is authorized under the
Terms and Conditions of award, 45 CFR Part 74 or 92, or other
applicable regulation or statute to make unilateral amendments.
This section also should address, if appropriate, whether applications for renewal or
supplementation of existing projects are eligible to compete with applications for
new awards.

III.
1.

ELIGIBILITY INFORMATION
Eligible Applicants
Unless eligibility is restricted by statute or regulation, all entities are potentially
eligible. Although all of the types of eligible organizations need not be specified, if
faith-based organizations, community-based organizations, and/or tribal
organizations are eligible, the announcement must explicitly state that they are
eligible. There may be instances where it is necessary or appropriate to limit
competition. Limited competition refers to any administrative restriction of
competition to other than all eligible applicants. Limited competition also refers to
instances where eligibility is limited to incumbent grantees. Any time a competition
is limited, or there is a deviation from policy, an official deviation request must be
submitted, and approved, by the Department. If you are unsure whether a
deviation request is required, please check with your GMS. Templates for
deviation requests are available on the Grants Menu Toolkit.
If you are holding a full and open competition, eligibility would read as follows:

Domestic public or private and non-profit entities including state and local
governments, Indian tribal governments and organizations (American
Indian/Alaskan Native/Native American), faith-based organizations, communitybased organizations, hospitals, and institutions of higher education.
2.

Cost Sharing or Matching
This section must address whether or not the applicant will be required to match or
share in project costs if an award is made (if matching or cost sharing is not
required, the announcement must so state). The statutory or regulatory basis for
the requirement should be cited. If the matching or cost sharing is required, the
announcement must indicate whether or not the presence of matching or cost
sharing will be a “responsiveness” criterion. Note that the value of matching or
cost sharing should not be used as a “responsiveness” criterion as a means of
increasing applicants’ voluntary contributions.
Any application documentation requirements related to matching or cost sharing
proposed, such as letters of commitment or other documentation must be addressed
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in the funding opportunity announcement.
The standard AoA language below may be modified as needed and inserted in the
Program Announcement.
Under this Older Americans Act (OAA) program, AoA will fund no more than
75% of the project’s total cost, which means the applicant must cover at least 25%
of the project’s total cost with non-Federal resources. In other words, for every
three (3) dollars received in Federal funding, the applicant must contribute at least
one (1) dollar in non-Federal resources toward the project’s total cost. This “threeto-one” ratio is reflected in the formula included under Item 18 in Attachment A.
You can use this formula to calculate your minimum required match. A common
error applicants make is to match 25% of the Federal share, rather than 25% of the
project’s total cost. Please note, applications with a match greater than the
minimum required will not receive additional consideration under the review.
Match is not one of the responsiveness criteria as noted in Section III, 3
Application Screening Criteria.
The language in the following 2 paragraphs cannot be modified unless the
percentage of match is different:
Under the Older Americans Act (OAA), AoA will fund no more than 75% of a
project’s total cost, which means the applicant must cover at least 25% of the
project’s total cost with non-Federal matching resources. There are two types of
match: 1) non-Federal cash and 2) non-Federal in-kind. In general, costs borne by
the applicant and cash contributions of any and all third parties involved in the
project, including sub-grantees, contractors and consultants, are considered
matching funds. Volunteered time and use of facilities to hold meetings or conduct
project activities may be considered in-kind (third party) donations. Examples of
non-Federal cash match includes budgetary funds provided from the applicant
agency’s budget for costs associated with the project. Matching costs are not
considered evaluation criteria; therefore, AoA encourages you to not exceed the
minimum match requirement.
AoA takes very seriously the current downturn in the nation’s economy; therefore
the matching requirement may be waived by AoA where severe hardship is
documented by the applicant. If you feel unable to meet the minimum matching
requirement, please provide a written justification, which explains why you cannot
meet the match through cash or in-kind contributions. The written justification
must be signed by your authorized representative and submitted with your
application through http://www.grants.gov. AoA will review your request and
contact you should additional information or justification be necessary. Applicants
are encouraged to make this hardship determination during the application phase;
waiver requests made after awards have been issued will be reviewed on a case-bycase basis.

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3.

Responsiveness and Screening Criteria
Application Responsiveness Criteria
This section must address any eligibility factors, including “responsiveness”
criteria, not addressed.
Program Officers are asked to consider including specific “responsiveness criteria”
in the Program Announcement, This will allow for more effective screening and
increased options to eliminate non-responsive applications.
Below is an example that demonstrates how “responsiveness” criteria can be used
in support of a Program.
Applications that do not meet the following responsiveness criteria will be
administratively eliminated and will not be reviewed:
Evidence Based Disease and Disability Prevention: National Resource Center
The successful applicant will be an organization that meets the following criteria:
1.

2.

3.

4.

5.

Demonstrated expertise in the implementation of evidence-based disease
and disability prevention programs for the elderly, including the Stanford
University Chronic Disease Self-Management Program, fall prevention,
and physical activity programs.
Demonstrated experience in working with state aging agencies, state health
and public health agencies, community-level aging service provider
organizations, and community health provider organizations.
The capacity to deliver value added technical assistance to each of the 24
current AoA state EBDP grantees on all phases of the EBDP program
interventions that are being implemented in their state within 30 days of
being awarded this cooperative agreement.
Demonstrated capacity and experience in working with AoA’s public and
private collaborators in the EBDP Program including CDC, AHRQ, CMS,
NIH, SAMSHA, HRSA, and national and local foundations.
Provides a project director for this project that is a national leader in the
development of EBDP programs and will work full time on this project or
on work that is consistent with and directly related to the development of
EBDP programs.

This section of the announcement also should address any special eligibility criteria
for individuals that may be involved in the project, such as the principal
investigator or project director, or eligibility for sub-recipients, beneficiaries, or
program participants other than the direct recipient of the award.
If AoA requires submission of a pre-application that will be used to “screen out”
applicants, this section must so indicate. With pre-application submissions, those
entities that do not submit one, or those that submit one that is deemed
unacceptable, will be ineligible to submit an application for consideration and this
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section must so indicate.
Application Screening Criteria
Below is standard language for this section. Additional screening criteria can be
added at the discretion of the Program Officer and may include proof of non-profit
status, letters of support, minimum effort of the Principle Investigator, or maximum
funding that may be provided to sub-contractors or others.
All applications will be screened to assure a level playing field for all applicants.
Applications that fail to meet the three screening criteria described below will not
be reviewed and will receive no further consideration.
In order for an application to be reviewed, it must meet the following screening
requirements:

IV.
1.

1.

Applications must be submitted electronically via http://www.grants.gov by
11:59 p.m., Eastern Time, Insert Date.

2.

The Project Narrative section of the Application must be double-spaced, on
8 ½” x 11” plain white paper with 1” margins on both sides, and a font size
of not less than 11.

3.

The Project Narrative must not exceed 20 pages. NOTE: The Project
Work Plan, Letters of Commitment, and Vitae of Key Project Personnel are
not counted as part of the Project Narrative for purposes of the 20-page
limit.

APPLICATION AND SUBMISSION INFORMATION
Address to Request Application Package
Application materials can be obtained from http://www.grants.gov or
http://www.aoa.gov/AoARoot/Grants/Funding/index.aspx.
Contact person regarding this Program Announcement:
U.S. Department of Health and Human Services
Administration on Aging
Insert Project Officer/Contact name
Insert Center Name
Washington, D.C. 20201
Or by calling: 202-357-XXXX
Or e-mailing: [email protected]
Please note, AoA is requiring applications for all announcements to be submitted
electronically through http://www.grants.gov. The Grants.gov
(http://www.grants.gov) registration process can take several days. If your
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organization is not currently registered with http://www.grants.gov, please begin
this process immediately. For assistance with http://www.grants.gov, please
contact them at [email protected] or 1-800-518-4726 between 7 a.m. and 9
p.m. Eastern Time. At http://www.grants.gov, you will be able to download a
copy of the application packet, complete it off-line, and then upload and submit the
application via the Grants.gov website (http://www.grants.gov).
Applications submitted via http://www.grants.gov:
•

•

•

•
•

•
•

•

•

2.

You may access the electronic application for this program on
http://www.grants.gov. You must search the downloadable application page by
the Funding Opportunity Number (HHS-20__-AoA-__-____Insert Number) or
CFDA number (Insert Number).
At the http://www.grants.gov website, you will find information about
submitting an application electronically through the site, including the hours of
operation. AoA strongly recommends that you do not wait until the application
due date to begin the application process through http://www.grants.gov
because of the time delay.
All applicants must have a Dun and Bradstreet (D&B) Data Universal
Numbering System (DUNS) number and register in the Central Contractor
Registry (CCR). You should allow a minimum of five days to complete the
CCR registration.
You must submit all documents electronically, including all information
included on the SF424 and all necessary assurances and certifications.
Prior to application submission, Microsoft Vista and Office 2007 users should
review the http://www.grants.gov compatibility information and submission
instructions provided at http://www.grants.gov (click on “Vista and Microsoft
Office 2007 Compatibility Information”).
Your application must comply with any page limitation requirements
described in this Program Announcement.
After you electronically submit your application, you will receive an automatic
acknowledgement from http://www.grants.govthat contains
http://www.grants.gov tracking number. The Administration on Aging will
retrieve your application form from http://www.grants.gov.
After the Administration on Aging retrieves your application form from
http://www.grants.gov, a return receipt will be emailed to the applicant contact.
This will be in addition to the validation number provided by
http://www.grants.gov.
Each year organizations registered to apply for Federal grants through
http://www.grants.gov will need to renew their registration with the Central
Contractor Registry (CCR). You can register with the CCR online and it will
take about 30 minutes (http://www.ccr.gov).

Content and Form of Application Submission
This section must indicate what application form and other documents need to be
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submitted to AoA in order to be considered for funding. In addition, specification of
any potentially applicable public policy requirements (e.g., lobbying or debt status)
that the applicant must address (whether in the application narrative, in an
assurance or certification, or otherwise) as part of its application submission and
how the applicant’s response/compliance will affect the evaluation and/or award
process. This section must also specify whether pre-applications are required or
letters of intent are encouraged and if proof of non-profit status is required (and
what constitutes acceptable proof) in order to determine eligibility.
If applicable, identify whether applications will be screened on whether the
application is responsive to the priority area description.
The following is standard language for AoA applications. Project Officers may
choose to modify this language to meet the needs of their grant program
a. Letter of Intent
Applicants are requested, but not required, to submit a letter of intent to apply for
this funding opportunity to assist AoA in planning for the application independent
review process. The purpose of the letter of intent is to allow our staff to estimate
the number of independent reviewers needed and to avoid potential conflicts of
interest in the review. The deadline for submission of the letter of intent is (Insert
date here). Letters of intent should be sent to:
U.S. Department of Health and Human Services
Administration on Aging
Insert Project Officer Name
Insert Office or Center Name
Email: [email protected]
Fax: 202-357-XXXX
b. DUNS Number
The Office of Management and Budget requires applicants to provide a Dun and
Bradstreet (D&B) Data Universal Numbering System (DUNS) number when
applying for Federal grants or cooperative agreements on or after October 1, 2003.
It is entered on the SF 424. It is a unique, nine-digit identification number,
which provides unique identifiers of single business entities. The DUNS number is
free and easy to obtain.
Organizations can receive a DUNS number at no cost by calling the dedicated tollfree DUNS Number request line at 1-866-705-5711 or by using this link to access a
guide: https://www.whitehouse.gov/omb/grants/duns num guide.pdf .
c. Project Narrative
The Project Narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins
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on both sides, and a font size of not less than 11. You can use smaller font sizes to
fill in the Standard Forms and Sample Formats. The suggested length for the
Project Narrative is ten to twenty pages; twenty pages is the maximum length
allowed. AoA will not accept applications with a Project Narrative that exceeds 20
pages. The Project Work Plan, Letters of Commitment, and Vitae of Key Personnel
are not counted as part of the Project Narrative for purposes of the 20-page limit,
but all of the other sections noted below are included in the limit.
The components of the Project Narrative counted as part of the 20 page limit
include:
Summary/Abstract
Problem Statement
Goal(s) and Objective(s)
Proposed Intervention
Special Target Populations and Organizations
Outcomes
Project Management
Evaluation
Dissemination
Organizational Capability
The Project Narrative is the most important part of the application, since it will be
used as the primary basis to determine whether or not your project meets the
minimum requirements for grants under Title IV of the Older Americans Act. The
Project Narrative should provide a clear and concise description of your project.
AoA recommends that your project narrative include the following components:
Summary/Abstract. This section should include a brief - no more than 265 words
maximum - description of the proposed project, including: goal(s), objectives,
outcomes, and products to be developed. Detailed instructions for completing the
summary/abstract are included in Attachment E of this document.
Problem Statement. This section should describe, in both quantitative and
qualitative terms, the nature and scope of the particular problem or issue the
proposed intervention is designed to address, including how the project will
potentially affect the elderly population and/or their caregivers (including specific
subgroups within those populations), and possibly the health care and social
services systems (e.g., the use of health care and/or nursing home services.)
Goals and Objectives. This section should consist of a description of the project’s
goal(s) and major objectives. Unless the project involves multiple, complex
interventions, we recommend you have only one overall goal.
Proposed Intervention. This section should provide a clear and concise description
of the intervention you are proposing to use to address the problem described in the
“Problem Statement”. You should also describe the rationale for using the
particular intervention, including factors such as: “lessons learned” for similar
projects previously tested in your community, or in other areas of the country;
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factors in the larger environment that have created the “right conditions” for the
intervention (e.g., existing social, economic or political factors that you’ll be able
to take advantage of, etc.). Also note any major barriers you anticipate
encountering, and how your project will be able to overcome those barriers. Be
sure to describe the role and makeup of any strategic partnerships you plan to
involve in implementing the intervention, including other organizations, funders,
and/or consumer groups.
Special Target Populations and Organizations. This section should describe how
you plan to involve community-based organizations in a meaningful way in the
planning and implementation of the proposal project. This section should also
describe how the proposed intervention will target disadvantaged populations,
including limited-English speaking populations.
Outcomes. This section of the project narrative must clearly identify the
measurable outcome(s) that will result from the project. (NOTE: AoA will not
fund any project that does not include measurable outcomes). This section should
also describe how the project’s findings might benefit the field at large, (e.g., how
the findings could help other organizations throughout the nation to address the
same or similar problems.) List measurable outcomes in the attached work plan
grid (Attachment D) under “Measurable Outcomes” in addition to any discussion
included in the narrative along with a description of how the project might benefit
the field at large.
A “measurable outcome” is an observable end-result that describes how a particular
intervention benefits consumers. It demonstrates the functional status, mental wellbeing, knowledge, skill, attitude, awareness or behavior.) It can also describe a
change in the degree to which consumers exercise choice over the types of services
they receive, or whether they are satisfied with the way a service is delivered.
Additional examples include: a change in the responsiveness or cost-effectiveness
of a service delivery system; a new model of support or care that can be replicated
in the aging network; new knowledge that can contribute to the field of aging; a
measurable increase in community awareness; or a measurable increase in persons
receiving services. A measurable outcome is not a measurable “output”, such as:
the number of clients served; the number of training sessions held; or the number of
service units provided.
You should keep the focus of this section on describing what outcome(s) will be
produced by the project. You should use the Evaluation section noted below to
describe how the outcome(s) will be measured and reported.
Your application will be scored on the clarity and nature of your proposed
outcomes, not on the number of outcomes cited. It is totally appropriate for a
project to have only ONE outcome that it is trying to achieve through the
intervention reflected in the project’s design.
Project Management. This section should include a clear delineation of the roles
and responsibilities of project staff, consultants and partner organizations, and how
they will contribute to achieving the project’s objectives and outcomes. It should
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specify who would have day-to-day responsibility for key tasks such as: leadership
of project; monitoring the project’s on-going progress, preparation of reports;
communications with other partners and AoA. It should also describe the approach
that will be used to monitor and track progress on the project’s tasks and objectives.
Evaluation. This section should describe the method(s), techniques and tools that
will be used to: 1) determine whether or not the proposed intervention achieved its
anticipated outcome(s), and 2) document the “lessons learned” – both positive and
negative - from the project that will be useful to people interested in replicating the
intervention, if it proves successful.
Dissemination. This section should describe the method that will be used to
disseminate the project’s results and findings in a timely manner and in easily
understandable formats, to parties who might be interested in using the results of
the project to inform practice, service delivery, program development, and/or
policy-making, including and especially those parties who would be interested in
replicating the project.
Organizational Capability Statement. Each application should include an
organizational capability statement and vitae for key project personnel. The
organizational capability statement should describe how the applicant agency (or
the particular division of a larger agency which will have responsibility for this
project) is organized, the nature and scope of its work and/or the capabilities it
possesses. It should also include the organization’s capability to sustain some or all
project activities after Federal financial assistance has ended.
This description should cover capabilities of the applicant agency not included in
the program narrative, such as any current or previous relevant experience and/or
the record of the project team in preparing cogent and useful reports, publications,
and other products. If appropriate, include an organization chart showing the
relationship of the project to the current organization. Please attach short vitae for
key project staff only. Neither vitas nor an organizational chart will count towards
the narrative page limit. Also include information about any contractual
organization(s) that will have a significant role(s) in implementing project and
achieving project goals.
d. Work Plan
Below you will find standard language which can be used, or modified as needed,
for a one year grant program.
The Project Work Plan should reflect and be consistent with the Project Narrative
and Budget. It should include a statement of the project’s overall goal, anticipated
outcome(s), key objectives, and the major tasks / action steps that will be pursued
to achieve the goal and outcome(s). For each major task / action step, the work
plan should identify timeframes involved (including start- and end-dates), and the
lead person responsible for completing the task. Please use the Sample Work Plan
format included in Attachment D.
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Standard language which can be used, or modified as needed, for multiple-year
grants can be found below.
The Project Work Plan should reflect and be consistent with the Project Narrative
and Budget and should cover all three (3) years of the project period. It should
include a statement of the project’s overall goal, anticipated outcome(s), key
objectives, and the major tasks / action steps that will be pursued to achieve the
goal and outcome(s). For each major task / action step, the work plan should
identify timeframes involved (including start- and end-dates), and the lead person
responsible for completing the task. Please use the Sample Work Plan format
included in Attachment D.
e. Letters of Commitment from Key Participating Organizations and
Agencies
Include confirmation of the commitments to the project (should it be funded) made
by key collaborating organizations and agencies in this part of the application.
Any organization that is specifically named to have a significant role in carrying
out the project should be considered an essential collaborator. For applications
submitted electronically via http://www.grants.gov, signed letters of commitment
should be scanned and included as attachments. Applicants unable to scan the
signed letters of commitment may fax them to the AoA Office of Grants
Management at 202-357-3467 by the application submission deadline. In your fax,
be sure to include the funding opportunity number and your agency name.
f.

Budget Narrative/Justification

Below you will find standard language which can be used, or modified as needed,
for a one year grants program.
The Budget Narrative/Justification should be provided using the format included as
Attachment C of this Program Announcement. Applicants are encouraged to pay
particular attention to Attachment B which provides an example of the level of
detail sought
Standard language which can be used, or modified as needed, for multiple-year
grants can be found below.
The Budget Narrative/Justification should be provided using the format included as
Attachment C of this Program Announcement. Applicants are encouraged to pay
particular attention to Attachment B, which provides an example of the level of
detail sought. A combined multi-year Budget Narrative/Justification, as well as a
detailed Budget Narrative/Justification for each year of potential grant funding is
required
3.

Submission Dates and Times
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This section must specify the deadline for application submission and, if required,
appropriate pre-applications or letters of intent.
The following is standard AoA language that may be modified to meet specific
grant program requirements.
The deadline for the submission of applications under this Program Announcement
is insert date, 2010. Applications must be submitted electronically by 11:59 p.m.
Eastern Time, insert date, 2010.
Applications that fail to meet the application due date will not be reviewed and will
receive no further consideration.
Grants.gov (http://www.grants.gov) will automatically send applicants a tracking
number and date of receipt verification electronically once the application has been
successfully received and validated in http://www.grants.gov. After the
Administration on Aging retrieves your application form from
http://www.grants.gov, a return receipt will be emailed to the applicant contact.
This will be in addition to the validation number provided by
http://www.grants.gov.
4.

Intergovernmental Review
If the funding opportunity is subject to Executive Order (EO) 12372,
‘‘Intergovernmental Review of Federal Programs,’’ the program staff must say so.
In alerting applicants that they must contact their State’s Single Point of Contact
(SPOC) to find out about and comply with the State’s process under EO 12372, you
should inform them that the names and addresses of the SPOCs are listed in the
Office of Management and Budget’s home page at:
http://www.whitehouse.gov/omb/grants/spoc.html.
If not subject to the EO, indicate the following:
This funding opportunity announcement is not subject to the requirements of
Executive Order 12372, “Intergovernmental Review of Federal Programs”

5.

Funding Restrictions
Identify any activities which are not fundable under the grant program, e.g.,
construction and/or major rehabilitation of buildings. This section also may include
any other types of funding restrictions, e.g., ceiling amounts for particular activities
if an application will consist of multiple programmatic components. This section
should also indicate whether pre-award costs are allowable.
The following activities are not fundable:
•
Construction and/or major rehabilitation of buildings
•
Basic research (e.g. scientific or medical experiments)
Page 16 of 40

•

6.

Continuation of existing projects without expansion or new and innovative
approaches

Other Submissions Requirements
This section must indicate where applications, pre-applications and/or letters of
intent should be submitted. This section may also be used for information not
included in any other section of IV. Application and Submission Information.
The following is standard AoA language that may be modified to meet specific
grant program requirements.
Letters of intent should be emailed or faxed to:

Insert Project Officer Name
Email:[email protected]
Fax: 202-357-____

V.

APPLICATION REVIEW INFORMATION
This section must include the evaluation criteria and any sub-criteria that will be
used in the application review.
Below are standard AoA review criteria which should be supplemented or
modified, as appropriate, to address the priorities and goals of each funding
opportunity.

1.

Criteria
Applications are scored by assigning a maximum of 100 points across five criteria:
a. Project Relevance & Current Need - (20 points);
b. Approach - (30 points);
c. Budget – (10 points);
d. Project Impact - (20 points); and
e. Organizational Capacity - (20 points).

a. Project Relevance & Current Need
Weight: 20 points
i. Does the proposed project clearly and adequately identify the relevance of the
priority areas, as described in this Program Announcement, in relation to current
state/community needs? (10 points).
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ii. Does the application adequately and appropriately describe and document the
key problem(s)/condition(s) relevant to the applicant’s purpose/need? Is the
proposed project justified in terms of the most recent, relevant, and available
information and knowledge? (10 points)
b. Approach
Weight: 30points
i. Is the intervention clearly defined? Does it reflect a coherent and feasible
approach for successfully addressing the identified problem and achieving the
identified outcome(s)? Does the project take into account barriers and
opportunities that exist in the larger environment that may impact on the project’s
success? Does the intervention optimize the use of potential partnerships with other
organizations and/or consumer groups, as appropriate? (10 points)
ii. Is the project work plan clear and comprehensive? Does it include sensible and
feasible timeframes for the accomplishment of tasks presented? Does the work
plan include specific objectives and tasks that are linked to measurable outcomes?
Does the proposal include a clear and coherent management plan? Are the roles and
responsibilities of project staff, consultants and partners clearly defined and linked
to specific objectives and tasks? Are the qualifications of the project staff,
consultants and/or partners, and the proposed level of effort, adequate to carryout
the project? (10 points)
iii. Does the application describe how local community-based organizations will be
involved in a meaningful way in the planning and implementation of the proposed
project? Does the application include disadvantaged populations, including
limited-English speaking populations in its target population? (10 points)
c. Budget
Weight: 10 points
i. Is the budget justified with respect to the adequacy and reasonableness of
resources requested? Is the time commitment of the proposed director and other
key project personnel sufficient to assure proper direction, management and timely
completion of the project? (5 points)
ii. Are budget line items clearly delineated and consistent with work plan
objectives? (5 points)
d. Project Impact
Weight: 20 points
i. Are the expected project benefits/results clear, realistic, and consistent with the
objectives and purpose of the project? Are the anticipated outcomes of the
proposed project likely to be achieved and will they significantly benefit the
populations affected by the intervention, and the field of aging as a whole? Are the
proposed outcomes quantifiable and measurable, consistent with the definition of a
project outcome contained in Attachment E of the Program Announcement? (10
points)
ii. Does the project evaluation reflect a thoughtful and well-designed approach that
will be able to successfully measure whether or not the project has achieved its
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proposed outcome(s)? Does the plan include the qualitative and/or quantitative
methods necessary to reliably measure outcomes? Is the evaluation also designed
to capture “lessons learned” from the overall effort that might be of use to others in
the field of aging, especially those who might be interested in replicating the
project? (10 points)
iii. Is there a realistic plan to try to secure resources to continue some or all project
activities after Federal financial assistance has ended? (5 points)
iv. Will the dissemination plan get relevant and easy to use information in a timely
manner to parties that might be interested in making use of its findings, particularly
to those who might want to replicate the project? (5 points)
e. Organizational Capacity
Weight: 20 points
i. Does the applicant organization clearly identify their capacity for carrying out
the proposed project and evaluation? (10 points)
ii. Do the proposed project director(s), key staff and consultants have the
background, experience, and other qualifications required to carry out their
designated roles? Are letters from participating organizations included, as
appropriate, and do they express the clear commitment and areas of responsibility
of those organizations, consistent with the work plan description of their intended
roles and contributions? (10 points)
2.

Review and Selection Process
This section should provide a brief explanation of the review process that will be
used. When non-Federal reviewers are used, the announcement should indicate
that applicants have the option of omitting from the application copies (not the
original) of specific salary rates or amounts for individuals specified in the
application budget. Please do not include Social Security Numbers in your
submission.
Below we have detailed standard AoA review and selection process requirements
which may be supplemented or modified, as appropriate, for a particular funding
opportunity.
An independent review panel of at least three individuals will evaluate applications
that pass the screening and meet the responsiveness criteria if applicable. These
reviewers are experts in their field, and are drawn from academic institutions, nonprofit organizations, state and local government, and Federal government agencies.
Based on the Application Review Criteria as outlined under section V.1, the
reviewers will comment on and score the applications, focusing their comments
and scoring decisions on the identified criteria.
Final award decisions will be made by the Assistant Secretary for Aging (ASA). In
making these decisions, the ASA will take into consideration: recommendations of
the review panel; reviews for programmatic and grants management compliance;
Page 19 of 40

the reasonableness of the estimated cost to the government considering the
available funding and anticipated results; and the likelihood that the proposed
project will result in the benefits expected.
Applicants have the option of omitting from the application specific salary rates or
Social Security Numbers for individuals specified in the application budget.
3.

VI.
1.

Anticipated Announcement Award Date
(Optional)
This section should be used if the Program Officer wants to include information
about when applicants can expect to learn about the disposition of their
applications, whether successful or unsuccessful. You may list the earliest possible
date or a date range, understanding they are target dates.

AWARD ADMINISTRATION INFORMATION
Award Notices
This section should indicate that successful applicants will receive formal
notification of their award in the form of an electronic Notice of Award. Below we
have detailed standard AoA award notice language which may be supplemented or
modified, as appropriate, for a particular funding opportunity.
Successful applicants will receive an electronic Notice of Award. The Notice of
Award is the authorizing document from the U.S. Administration on Aging
authorizing official, Officer of Grants Management, and the AoA Office of Budget
and Finance. Unsuccessful applicants are generally notified within 30 days of the
final funding decision and will receive a disapproval letter via e-mail or U.S. mail.

2.

Administrative and National Policy Requirements
This section must specify applicable administrative regulations, program policies or
other requirements that will become terms and conditions of the award.
Below is standard AoA language for this section which may be supplemented or
modified, as appropriate, for a particular funding opportunity.
The award is subject to DHHS Administrative Requirements, which can be found
in 45CFR Part 74 and 92 and the Standard Terms and Conditions implemented
through the HHS Grants Policy Statement located at
http://www.hhs.gov/grantsnet/adminis/gpd/index.htm.

3.

Reporting
This section must specify the type and frequency of post-award reporting
Page 20 of 40

requirements, (both performance and financial), any required form or formatting,
and the means of submission.
Below we have detailed standard AoA language which may be supplemented or
modified, as appropriate, for a particular funding opportunity.
Instructions for annual financial and semi-annual program performance reports will
be included with the award packets sent to successful applicants. An original and
two copies of the financial report and the AoA program progress report are
requested. Awardees will receive instructions for both reports with their Notice of
Financial Assistance Award. Final performance and financial reports are due 90
days after the end of the project period. For more information see DHHS / AoA
Standard Terms and Conditions.
Grantees are required to submit a quarterly Federal Cash Transaction Report (SF272) to the Payment Managements System as identified in their award documents
for the calendar quarters ending 3/31, 6/30, 9/30, and 12/31 through the life of their
award. In addition, a Financial Status Report (SF-269) will be required as denoted
in the Notice of Award. Please Note: HHS is transitioning to the combined
Federal Financial Report (FFR) known as the SF-425, which will replace the
Financial Status SF-269 and Federal Cash Transaction Report SF-272. HHS/AOA
will provide further guidance implementing the use of the new form at a later date.

VII. AGENCY CONTACTS
Project Officer:
U.S. Department of Health and Human Services
Administration on Aging
Washington, DC 20201
Attn: ______________
Telephone: (202) 357-_____, e-mail: [email protected]
Grants Management Officer:
U.S. Department of Health and Human Services
Administration on Aging
Washington, DC 20201
Attn: ______________
Telephone: (202) 357-____, e-mail: [email protected]

VIII. OTHER INFORMATION
This section is not required and should be used only for information that is not
integral to a potential applicant’s understanding of the funding opportunity or that
does not require an applicant’s compliance. It may include information that may
be useful to a potential applicant in deciding whether or not to apply and in
preparing an application.
Page 21 of 40

Below is information that is included in AoA grant opportunities which may be
supplemented or modified, as appropriate, for a particular funding opportunity.
1.

Application Elements
a. SF 424 – Application for Federal Assistance (See Attachment A for
Instructions).
b. SF 424A – Budget Information. (See Attachment A for Instructions).
c. Separate Budget Narrative/Justification (See Attachments B and C for a
Budget Narrative/Justification Sample Format with Examples and a Sample
Template).
NOTE: Applicants requesting funding for multi-year grant projects
are REQUIRED to provide a combined multi-year Budget
Narrative/Justification, as well as a detailed Budget
Narrative/Justification for each year of potential grant funding.
d. SF 424B – Assurances. Note: Be sure to complete this form according to
instructions and have it signed and dated by the authorized representative
(see item 18d on the SF 424).
e. Lobbying Certification
f.

Proof of non-profit status, if applicable

g. Copy of the applicant's most recent indirect cost agreement, if requesting
indirect costs. If any sub-contractors or sub-grantees are requesting
indirect costs, copies of their indirect cost agreements must also be included
with the application.
h. Project Narrative with Work Plan (See Attachment D for Sample Work
Plan Format).

2.

i.

Organizational Capability Statement and Vitae for Key Project Personnel.

j.

Letters of Commitment from Key Partners.

The Paperwork Reduction Act of 1995 (P.L. 104-13)
An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control
number.
The project description and Budget Narrative/Justification is approved under OMB
control number 0985-0018 which expires on 5/31/10.
Public reporting burden for this collection of information is estimated to average 10
hours per response, including the time for reviewing instructions, gathering and
maintaining the data needed and reviewing the collection information.

Page 22 of 40

ATTACHMENTS

Attachment A:
Instructions for Completing Required Forms
(SF 424, Budget (SF 424A), Budget Narrative/Justification)
Attachment B:
Budget Narrative/Justification Format – Sample Format with Examples
Attachment C:
Budget Narrative/Justification – Sample Template
Attachment D:
Project Work Plan - Sample Template
Attachment E:
Instructions for Completing the Summary/Abstract

Page 23 of 40

Attachment A: Instructions for Completing Required Forms
(SF 424, Budget (SF 424A), Budget Narrative/Justification)
This section provides step-by-step instructions for completing the four (4) standard Federal
forms required as part of your grant application, including special instructions for
completing Standard Budget Forms 424 and 424A. Standard Forms 424 and 424A are
used for a wide variety of Federal grant programs, and Federal agencies have the discretion
to require some or all of the information on these forms. AoA does not require all the
information on these Standard Forms. Accordingly, please use the instructions below in
lieu of the standard instructions attached to SF 424 and 424A to complete these forms.
a. Standard Form 424
1. Type of Submission: (Required): Select one type of submission in accordance with
agency instructions.
• Preapplication
• Application
• Changed/Corrected Application – If AoA requests, check if this submission is to
change or correct a previously submitted application.
2. Type of Application: (Required) Select one type of application in accordance with
agency instructions.
• New
• Continuation
• Revision
3. Date Received: Leave this field blank.
4. Applicant Identifier: Leave this field blank
5a Federal Entity Identifier: Leave this field blank
5b. Federal Award Identifier: For new applications leave blank. For a continuation or
revision to an existing award, enter the previously assigned Federal award (grant) number.
6. Date Received by State: Leave this field blank.
7. State Application Identifier: Leave this field blank.
8. Applicant Information: Enter the following in accordance with agency instructions:

a. Legal Name: (Required): Enter the name that the organization has registered with the
Central Contractor Registry. Information on registering with CCR may be obtained by
visiting the Grants.gov website (http://www.grants.gov).
b. Employer/Taxpayer Number (EIN/TIN): (Required): Enter the Employer or
Taxpayer Identification Number (EIN or TIN) as assigned by the Internal Revenue
Service.
Page 24 of 40

c. Organizational DUNS: (Required) Enter the organization’s DUNS or DUNS+4 number
received from Dun and Bradstreet. Information on obtaining a DUNS number may be
obtained by visiting the Grants.gov website (http://www.grants.gov).
d. Address: (Required) Enter the complete address including the county.
e. Organizational Unit: Enter the name of the primary organizational unit (and
department or division, if applicable) that will undertake the project.
f. Name and contact information of person to be contacted on matters involving this
application: Enter the name (First and last name required), organizational affiliation (if
affiliated with an organization other than the applicant organization), telephone number
(Required), fax number, and email address (Required) of the person to contact on
matters related to this application.
9. Type of Applicant: (Required) Select the applicant organization “type” from the
following drop down list.
A. State Government B. County Government C. City or Township Government D. Special
District Government E. Regional Organization F. U.S. Territory or Possession G.
Independent School District H. Public/State Controlled Institution of Higher Education I.
Indian/Native American Tribal Government (Federally Recognized) J. Indian/Native
American Tribal Government (Other than Federally Recognized) K. Indian/Native
American Tribally Designated Organization L. Public/Indian Housing Authority M.
Nonprofit with 501C3 IRS Status (Other than Institution of Higher Education) N.
Nonprofit without 501C3 IRS Status (Other than Institution of Higher Education) O.
Private Institution of Higher Education P. Individual Q. For-Profit Organization (Other
than Small Business) R. Small Business S. Hispanic-serving Institution T. Historically
Black Colleges and Universities (HBCUs) U. Tribally Controlled Colleges and
Universities (TCCUs) V. Alaska Native and Native Hawaiian Serving Institutions W. Nondomestic (non-US) Entity X. Other (specify)
10. Name Of Federal Agency: (Required) Enter U.S. Administration on Aging
11. Catalog Of Federal Domestic Assistance Number/Title: The CFDA number can be
found on page one of the Program Announcement.
12. Funding Opportunity Number/Title: (Required) The Funding Opportunity Number
and title of the opportunity can be found on page one of the Program Announcement.
13. Competition Identification Number/Title: Leave this field blank.
14. Areas Affected By Project: List the largest political entity affected (cities, counties,
state etc).
15. Descriptive Title of Applicant’s Project: (Required) Enter a brief descriptive title of
the project.
16. Congressional Districts Of: (Required) 16a. Enter the applicant’s Congressional
District, and 16b. Enter all district(s) affected by the program or project. Enter in the
Page 25 of 40

format: 2 characters State Abbreviation – 3 characters District Number, e.g., CA-005 for
California 5th district, CA-012 for California 12th district, NC-103 for North Carolina’s
103rd district. If all congressional districts in a state are affected, enter “all” for the district
number, e.g., MD-all for all congressional districts in Maryland. If nationwide, i.e. all
districts within all states are affected, enter US-all.
17. Proposed Project Start and End Dates: (Required) Enter the proposed start date and
final end date of the project. Therefore, if you are applying for a multi-year grant, such as
a 3 year grant project, the final project end date will be 3 years after the proposed start
date. In general, all start dates on the SF424 should be the 1st of the month and the end
date of the last day of the month of the final year. The Grants Officer can alter the start
and end date at their discretion.
18. Estimated Funding: (Required) Enter the amount requested or to be contributed
during the first funding/budget period by each contributor. If a multi-year application
insert the total amount requested over the entire period. Value of in-kind contributions
should be included on appropriate lines, as applicable. If the action will result in a dollar
change to an existing award, indicate only the amount of the change. For decreases,
enclose the amounts in parentheses.
NOTE: Applicants should review cost sharing or matching principles contained in Subpart
C of 45 CFR Part 74 or 45 CFR Part 92 before completing Item 18 and the Budget
Information Sections A, B and C noted below.
All budget information entered under item 18 should cover the upcoming budget period.
For sub-item 18a, enter the Federal funds being requested. Sub-items 18b-18e is
considered matching funds. The dollar amounts entered in sub-items 18b-18f must total at
least 1/3rd of the amount of Federal funds being requested (the amount in 18a). For a full
explanation of AoA’s match requirements, see the information in the box below. For subitem 18f, enter only the amount, if any, that is going to be used as part of the required
match.
There are two types of match: 1) non-Federal cash and 2) non-Federal in-kind. In general,
costs borne by the applicant and cash contributions of any and all third parties involved in
the project, including sub-grantees, contractors and consultants, are considered matching
funds. Generally, most contributions from sub-contractors or sub-grantees (third parties)
will be non-Federal in-kind matching funds. Volunteered time and use of facilities to hold
meetings or conduct project activities may be considered in-kind (third party) donations.
Examples of non-Federal cash match includes budgetary funds provided from the
applicant agency’s budget for costs associated with the project.
NOTE: Indirect charges may only be requested if: (1) the applicant has a current
indirect cost rate agreement approved by the Department of Health and Human
Services or another Federal agency; or (2) the applicant is a state or local government
agency. State governments should enter the amount of indirect costs determined in
accordance with DHHS requirements. If indirect costs are to be included in the
application, a copy of the approved indirect cost agreement must be included
with the application. Further, if any sub-contractors or sub-grantees are
requesting indirect costs, copies of their indirect cost agreements must also be
Page 26 of 40

included with the application.

AOA’s Match Requirement
Under this and other OAA programs, AoA will fund no more than 75 % of the project’s
total cost, which means the applicant must cover at least 25% of the project’s total cost
with non-Federal resources. In other words, for every three (3) dollars received in Federal
funding, the applicant must contribute at least one (1) dollar in non-Federal resources
toward the project’s total cost (i.e., the amount on line 18g.). This “three-to-one” ratio is
reflected in the following formula which you can use to calculate your minimum required
match:
Federal Funds Requested (i.e., amount on line 15a) / 3

= Minimum Match Requirement

For example, if you request $100,000 in Federal funds, then your minimum match
requirement is $100,000/3 or $33,333. In this example the project’s total cost would be
$133,333.
A common error applicants make is to match 25% of the Federal share, rather than 25%
of the project’s total cost, so be sure to use one of the formulas above to calculate your
match requirement.
If the required non-Federal share is not met by a funded project, AoA will disallow
any unmatched Federal dollars.

19. Is Application Subject to Review by State Under Executive Order 12372 Process?
Check c. Program is not covered by E.O. 12372
20. Is the Applicant Delinquent on any Federal Debt? (Required) This question applies
to the applicant organization, not the person who signs as the authorized representative. If
yes, include an explanation on the continuation sheet.
21. Authorized Representative: (Required) To be signed and dated by the authorized
representative of the applicant organization. Enter the name (First and last name required)
title (Required), telephone number (Required), fax number, and email address (Required)
of the person authorized to sign for the applicant. A copy of the governing body’s
authorization for you to sign this application as the official representative must be on file in
the applicant’s office. (Certain Federal agencies may require that this authorization be
submitted as part of the application.)

Page 27 of 40

b. Standard Form 424A
NOTE: Standard Form 424A is designed to accommodate applications for multiple
grant programs; thus, for purposes of this AoA program, many of the budget item
columns and rows are not applicable. You should only consider and respond to the
budget items for which guidance is provided below. Unless otherwise indicated, the
SF 424A should reflect a one year budget.

Section A - Budget Summary
Line 5: Leave columns (c) and (d) blank. Enter TOTAL Federal costs in column
(e) and total non-Federal costs (including third party in-kind contributions and any
program income to be used as part of the grantee match) in column (f). Enter the
sum of columns (e) and (f) in column (g).

Section B - Budget Categories
Column 3: Enter the breakdown of how you plan to use the Federal funds being
requested by object class category (see instructions for each object class category
below).
Column 4: Enter the breakdown of how you plan to use the non-Federal share by
object class category.
Column 5: Enter the total funds required for the project (sum of Columns 3 and 4)
by object class category.

Page 28 of 40

Separate Budget Narrative/Justification Requirement
Applicants requesting funding for multi-year grant programs are REQUIRED
to provide a combined multi-year Budget Narrative/Justification, as well as a
detailed Budget Narrative/Justification for each year of potential grant funding.
A separate Budget Narrative/Justification is also REQUIRED for each potential
year of grant funding requested.
For your use in developing and presenting your Budget Narrative/Justification, a
sample format with examples and a blank sample template have been included in
these Attachments. In your Budget Narrative/Justification, you should include a
breakdown of the budgetary costs for all of the object class categories noted in
Section B, across three columns: Federal; non-Federal cash; and non-Federal in-kind.
Cost breakdowns, or justifications, are required for any cost of $1,000 or for the
thresholds as established in the examples. The Budget Narratives/Justifications
should fully explain and justify the costs in each of the major budget items for each
of the object class categories, as described below. Non-Federal cash as well as, subcontractor or sub-grantee (third party) in-kind contributions designated as match must
be clearly identified and explained in the Budget Narrative/Justification The full
Budget Narrative/Justification should be included in the application immediately
following the SF 424 forms.
Line 6a: Personnel: Enter total costs of salaries and wages of applicant/grantee staff. Do
not include the costs of consultants, which should be included under 6h - Other.
In the Justification: Identify the project director, if known. Specify the key
staff, their titles, and time commitments in the budget justification.
Line 6b: Fringe Benefits: Enter the total costs of fringe benefits unless treated as part of
an approved indirect cost rate.
In the Justification: If the total fringe benefit rate exceeds 35% of Personnel
costs, provide a break-down of amounts and percentages that comprise fringe
benefit costs, such as health insurance, FICA, retirement, etc. A percentage of
35% or less does not require a break down but you must show the percentage
charged for each full/part time employee.
Line 6c: Travel: Enter total costs of all travel (local and non-local) for staff on the project.
NEW: Local travel is considered under this cost item not under Other. Local
transportation (all travel which does not require per diem is considered local
travel). Do not enter costs for consultant's travel - this should be included in line
6h.
In the Justification: Include the total number of trips, number of travelers,
destinations, purpose (e.g., attend conference), length of stay, subsistence
allowances (per diem), and transportation costs (including mileage rates).
Line 6d: Equipment: Enter the total costs of all equipment to be acquired by the project.
For all grantees, "equipment" is non-expendable tangible personal property
Page 29 of 40

having a useful life of more than one year and an acquisition cost of $5,000 or
more per unit. If the item does not meet the $5,000 threshold, include it in your
budget under Supplies, line 6e.
In the Justification: Equipment to be purchased with federal funds must be
justified as necessary for the conduct of the project. The equipment must be used
for project-related functions. Further, the purchase of specific items of equipment
should not be included in the submitted budget if those items of equipment, or a
reasonable facsimile, are otherwise available to the applicant or its sub-grantees.
Line 6e: Supplies: Enter the total costs of all tangible expendable personal property
(supplies) other than those included on line 6d.
In the Justification: . For any grant award that has supply costs in excess of 5%
of total direct costs (Federal or Non-Federal), you must provide a detailed break
down of the supply items (e.g., 6% of $100,000 = $6,000 – breakdown of
supplies needed). If the 5% is applied against $1 million total direct costs (5% x
$1,000,000 = $50,000) a detailed breakdown of supplies is not needed. Please
note: any supply costs of $5,000 or less regardless of total direct costs does not
require a detailed budget breakdown (e.g., 5% x $100,000 = $5,000 – no
breakdown needed).
Line 6f: Contractual: Regardless of the dollar value of any contract, you must follow
your established policies and procedures for procurements and meet the minimum
standards established in the Code of Federal Regulations (CFR’s) mentioned
below. Enter the total costs of all contracts, including (1) procurement contracts
(except those which belong on other lines such as equipment, supplies, etc.).
Note: The 33% provision has been removed and line item budget detail is not
required as long as you meet the established procurement standards. Also
include any contracts with organizations for the provision of technical assistance.
Do not include payments to individuals on this line.
In the Justification: Provide the following three items – 1) Attach a list of
contractors indicating the name of the organization; 2) the purpose of the
contract; and 3) the estimated dollar amount. If the name of the contractor and
estimated costs are not available or have not been negotiated, indicate when this
information will be available. The Federal government reserves the right to
request the final executed contracts at any time. If an individual contractual item
is over the small purchase threshold, currently set at $100K in the CFR, you must
certify that your procurement standards are in accordance with the policies and
procedures as stated in 45 CFR 74.44 for non-profits and 92.36 for states, in lieu
of providing separate detailed budgets. This certification should be referenced in
the justification and attached to the budget narrative.
Line 6g: Construction: Leave blank since construction is not an allowable costs for this
program.
Line 6h: Other: Enter the total of all other costs. Such costs, where applicable, may
include, but are not limited to: insurance, medical and dental costs (i.e. for project
volunteers this is different from personnel fringe benefits),non-contractual fees
and travel paid directly to individual consultants, postage, space and equipment
rentals/lease, printing and publication, computer use, training and staff
Page 30 of 40

development costs (i.e. registration fees). If a cost does not clearly fit under
another category, and it qualifies as an allowable cost, then rest assured this is
where it belongs.
In the Justification: Provide a reasonable explanation for items in this category.
For example, individual consultants explain the nature of services provided and
the relation to activities in the work plan or indicate where it is described in the
work plan. Describe the types of activities for staff development costs.
Line 6i: Total Direct Charges: Show the totals of Lines 6a through 6h.
Line 6j: Indirect Charges: Enter the total amount of indirect charges (costs), if any. If
no indirect costs are requested, enter "none." Indirect charges may be requested
if: (1) the applicant has a current indirect cost rate agreement approved by the
Department of Health and Human Services or another federal agency; or (2) the
applicant is a state or local government agency. State governments should enter
the amount of indirect costs determined in accordance with DHHS
requirements. An applicant that will charge indirect costs to the grant must
enclose a copy of the current rate agreement. Indirect Costs can only be claimed
on Federal funds, more specifically, they are to only be claimed on the Federal
share of your direct costs. Any unused portion of the grantee’s eligible Indirect
Cost amount that are not claimed on the Federal share of direct charges can be
claimed as un-reimbursed indirect charges, and that portion can be used towards
meeting the recipient match.
Line 6k: Total: Enter the total amounts of Lines 6i and 6j.
Line 7: Program Income: As appropriate, include the estimated amount of income, if
any, you expect to be generated from this project that you wish to designate as
match (equal to the amount shown for Item 15(f) on Form 424). Note: Any
program income indicated at the bottom of Section B and for item 15(f) on the
face sheet of Form 424 will be included as part of non-Federal match and will be
subject to the rules for documenting completion of this pledge. If program
income is expected, but is not needed to achieve matching funds, do not include
that portion here or on Item 15(f) of the Form 424 face sheet. Any anticipated
program income that will not be applied as grantee match should be described in
the Level of Effort section of the Program Narrative.

Section C - Non-Federal Resources
Line 12: Enter the amounts of non-Federal resources that will be used in carrying out
the proposed project, by source (Applicant; State; Other) and enter the total amount
in Column (e). Keep in mind that if the match requirement is not met, Federal dollars
may be reduced.

Section D - Forecasted Cash Needs - Not applicable.
Section E - Budget Estimate of Federal Funds Needed for Balance of
Page 31 of 40

the Project
Line 20: Section E is relevant for multi-year grant applications, where the project
period is 24 months or longer. This section does not apply to grant awards where the
project period is less than 17 months.

Section F - Other Budget Information
Line 22: Indirect Charges: Enter the type of indirect rate (provisional,
predetermined, final or fixed) to be in effect during the funding period, the base to
which the rate is applied, and the total indirect costs. Include a copy of your current
Indirect Cost Rate Agreement.
Line 23: Remarks: Provide any other comments deemed necessary.
c. Standard Form 424B - Assurances
This form contains assurances required of applicants under the discretionary funds
programs administered by the Administration on Aging. Please note that a duly
authorized representative of the applicant organization must certify that the
organization is in compliance with these assurances.
d. Certification Regarding Lobbying
This form contains certifications that are required of the applicant organization
regarding lobbying. Please note that a duly authorized representative of the applicant
organization must attest to the applicant’s compliance with these certifications.
Proof of Non-Profit Status
Non-profit applicants must submit proof of non-profit status. Any of the following
constitutes acceptable proof of such status:
o A copy of a currently valid IRS tax exemption certificate.
o A statement from a State taxing body, State attorney general, or other
appropriate State official certifying that the applicant organization has a
non-profit status and that none of the net earnings accrue to any private
shareholders or individuals.
o A certified copy of the organization’s certificate of incorporation or similar
document that clearly establishes non-profit status.
Indirect Cost Agreement
Applicants that have included indirect costs in their budgets must include a copy of
the current indirect cost rate agreement approved by the Department of Health and
Human Services or another Federal agency. This is optional for applicants that have
not included indirect costs in their budgets.

Page 32 of 40

Attachment B: Budget Narrative/Justification – Page 1 – Sample Format
Object Class
Category
Personnel

Federal
Funds

$47,700

Non-Federal
Cash

$23,554

Non-Federal
In-Kind

$0

TOTAL

Justification

$71,254

Federal
Project Director (name) = .5 FTE @ $95,401/yr =
Non-Fed Cash
Officer Manager (name) = .5FTE @ $47,108/yr =
Total

Fringe
Benefits

$17,482

$8,632

$0

$26,114

Travel

$4,707

$2,940

$0

$7,647

Federal
Fringe on Project Director at 36.65% = $17,482
FICA (7.65%)
Health (25%)
Dental (2%)
Life (1%)
Unemployment (1%)
Non-Fed Cash
Fringe on Office Manager at 36.65% = $8,632
FICA (7.65%)
Health (25%)
Dental (2%)
Life (1%)
Unemployment (1%)
Federal
Local travel: 6 TA site visits for 1 person
Mileage: 6RT @ .585 x 700 miles
Lodging: 15 days @ $110/day
Per Diem: 15 days @ $40/day
Total
Non-Fed Cash
Travel to National Conference in (Destination) for 3 people
Airfare 1 RT x 3 staff @ $500
Lodging: 3 days x 3 staff @ $120/day
Per Diem: 3 days x 3 staff @ $40/day
Total

$47,700
$23,554
$71,254

$2,457
$1,650
$600
$4,707

$1,500
$1,080
$360
$2,940
Page 33 of 40

Attachment B: Budget Narrative/Justification – Page 2 – Sample Format
Object Class
Category
Equipment

Federal
Funds

$10,000

Non-Federal
Cash

$0

Non-Federal
In-Kind

$0

TOTAL

Justification

$10,000

No Equipment requested OR:
Call Center Equipment
Installation =
Phones =
Total

Supplies

$3,700

$5,784

$0

$9,484

Contractual

$30,171

$0

$0

$30,171

$5,000
$5,000
$10,000

Federal
2 desks @ $1,500
$3,000
2 chairs @ $300
$600
2 cabinets @ $200
$400
Non-Fed Cash
2 Laptop computers
$3,000
Printer cartridges @ $50/month
$300
Consumable supplies (pens, paper, clips etc…)
@ $182/month
$2,184
Total
$9,484
(organization name, purpose of contract and estimated dollar amount)
Contract with AAA to provide respite services:
11 care givers @ $1,682 =
$18,502
Volunteer Coordinator =
$11,669
Total
$30,171
If contract details are unknown due to contract yet to be made provide
same information listed above and:
A detailed evaluation plan and budget will be submitted by (date), when
contract is made.

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Attachment B: Budget Narrative/Justification – Page 3 – Sample Format
Object Class
Category
Other

Indirect
Charges

Federal
Funds

$5,600

$20,934

Non-Federal
Cash

$0

$0

Non-Federal
In-Kind

$5,880

$0

TOTAL

Justification

$11,480

Federal
2 consultants @ $100/hr for 24.5 hours each =
Printing 10,000 Brochures @ $.05 =
Local conference registration fee (name conference) =
Total
In-Kind
Volunteers
15 volunteers @ $8/hr for 49 hours =
21.5 % of salaries and fringe =

$20,934

$4,900
$500
$200
$5,600

$5,880
$20,934

IDC rate is attached.
TOTAL

$140,294

$40,910

$5,880

$187,084

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Attachment C: Budget Narrative/Justification –– Sample Template
Object
Class
Category
Personnel

Federal
Funds

NonFederal
Cash

NonFederal
In-Kind

TOTAL

Justification

Fringe
Benefits
Travel
Equipment

Supplies
Contractual
Other
Indirect
Charges
TOTAL

Page 36 of 40

Attachment D: Project Work Plan, Page 1 – Sample Template
Goal:
Measurable Outcome(s):
* Time Frame (Start/End Dates by Month in Project Cycle)
Major Objectives

Key Tasks

Lead Person

1* 2* 3* 4* 5* 6* 7* 8* 9* 10* 11* 12*

1.

2.

Page 37 of 40

Attachment D: Project Work Plan, Page 2 – Sample Template
Goal:
Measurable Outcome(s):
* Time Frame (Start/End Dates by Month in Project Cycle)
Major Objectives

Key Tasks

Lead Person

1* 2* 3* 4* 5* 6* 7* 8* 9* 10* 11* 12*

3.

4.

Page 38 of 40

Attachment D: Project Work Plan, Page 3 – Sample Template
Goal:
Measurable Outcome(s):
* Time Frame (Start/End Dates by Month in Project Cycle)
Major Objectives

Key Tasks

Lead Person

1* 2* 3* 4* 5* 6* 7* 8* 9* 10* 11* 12*

5.

6.

NOTE: Please do note infer from this sample format that your work plan must have 6 major objectives. If you need more pages,
simply repeat this format on additional pages.

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Attachment E: Instructions for Completing the Project
Summary/Abstract
•

All applications for grant funding must include a Summary/Abstract that concisely
describes the proposed project. It should be written for the general public.
• To ensure uniformity, please limit the length to no more than 265 words on a single
page with a font size of not less than 11, doubled-spaced.
• The abstract must include the project’s goal(s), objectives, overall approach (including
target population and significant partnerships), anticipated outcomes, products, and
duration. The following are very simple descriptions of these terms, and a sample
Compendium abstract.
Goal(s) – broad, overall purpose, usually in a mission statement, i.e. what you want to
do, where you want to be
Objective(s) – narrow, more specific, identifiable or measurable steps toward a goal.
Part of the planning process or sequence (the “how”). Specific performances which
will result in the attainment of a goal.
Outcomes - measurable results of a project. Positive benefits or negative changes, or
measurable characteristics that occur as a result of an organization’s or program’s
activities. (outcomes are the end-point)
Products – materials, deliverables.
• A model abstract/summary is provided below:
The grantee, Okoboji University, supports this three year Dementia Disease
demonstration (DD) project in collaboration with the local Alzheimer’s Association and
related Dementias groups. The goal of the project is to provide comprehensive,
coordinated care to individuals with memory concerns and to their caregivers. The
approach is to expand the services and to integrate the bio-psycho-social aspects of care.
The objectives are: 1) to provide dementia specific care, i.e., care management fully
integrated into the services provided; 2) to train staff, students and volunteers; 3) to
establish a system infrastructure to support services to individuals with early stage
dementia and to their caregivers; 4) to develop linkages with community agencies; 5) to
expand the assessment and intervention services; 6) to evaluate the impact of the added
services; 7) to disseminate project information. The expected outcomes of this DD
project are: patients will maintain as high a level of mental function and physical
functions (thru Yoga) as possible; caregivers will increase ability to cope with changes;
and pre and post – project patient evaluation will reflect positive results from expanded
and integrated services. The products from this project are: a final report, including
evaluation results; a website; articles for publication; data on driver assessment and inhome cognitive retraining; abstracts for national conferences.

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