HUD 40077 Grant Progress Report

Alaska Native/Native Hawaiian Institutions Assisting Communities (AN/NHAIC)

40077

Alaska Native/Native Hawaiian Institutions Assisting Communities (AN/NHAIC)

OMB: 2528-0206

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Office of University Partnerships
Grant Progress Report
U. S. Department of Housing
and Urban Development

OMB Approval No. 2528-0198
(exp. 9/30/2012)

Public reporting burden for the collection of information is estimated to average 6 hours per response. This includes the time for collecting, reviewing,
and reporting the data. Response to this request for information is required in order to receive the benefits to be derived. This agency may not collect
this information, and you are not required to complete this form unless it displays a currently valid OMB control number.
The information collected will be used to monitor the progress of activities on the grant. The information collected is not confidential. If the Grantee
fails to submit the required reports on time, the GTR is authorized to withhold payment of funds until the Grantee is in conformance with the
program requirements. Failure to respond to the GTR requests or warnings of non-compliance will be used to make a determination of
non-performance, action to suspend and/or terminate the award. In addition, non-compliance will be taken into consideration if a grantee requests
funding in the future.

REQUIRED // DO NOT SUBMIT WITHOUT INCLUDING THIS INFORMATION
Grantee Institution Name:
Grant Award Number:
Report Prepared by:

// Grant Award Date:

// Report Submission Date:

// Preparer’s E-mail:

All sections with headings highlighted in blue must be filled out completely for each report submitted. The section
headings highlighted in red are only to be completed for the final report.

Grant Information
Leveraging Information
Grant amount: $
Proposed leverage amount (as stated in original application): $
Amount of leveraged resources in this reporting period: $
Cumulative amount of leveraged resources: $
Percentage of total resources leveraged against OUP grant:

(do not fill in; this field auto-calculates)

Activity Information
Number of activities proposed in your application narrative and Logic Model:
Number of activities completed as of this reporting period:
Cumulative number of activities completed:
Percentage of proposed activities completed:
(do not fill in; this field auto-calculates)
Space is provided on page 2 for narrative on each of your activities.

Reporting Period
Please enter the period for which this report is being submitted (example: 9/30, 12/31, 3/31, 6/30):
Have you formally requested a no-cost extension?
Yes
Extensions may not be requested through this report.

No

Date the extension was approved:
What is the new end date for your project?

Page 1 of 4

form HUD-40077 (11/09)

Office of University Partnerships
Grant Progress Report
U. S. Department of Housing
and Urban Development

OMB Approval No. 2528-0198
(exp. 9/30/2012)

REQUIRED // DO NOT SUBMIT WITHOUT INCLUDING THIS INFORMATION
Grantee Institution Name:
Grant Award Number:
Report Prepared by:

// Grant Award Date:

// Report Submission Date:

// Preparer’s E-mail:

Additional Forms
Please complete and include the electronic versions of the following forms with each report:
SF–269–A, Financial Status Report
HUD–96010, Program Logic Model
Task Chart

Narrative of Activities

List all proposed program activities as outlined in your application narrative and Logic Model. Provide a brief discussion
on your progress, listing both accomplishments and obstacles to reaching each objective this reporting period. Please
follow the maximum word counts indicated in each activity section.
To ensure that this file remains small enough to transmit electronically, DO NOT INCLUDE PHOTOGRAPHS WITH
THIS REPORT.
This form provides space for five activities. If you have more than five proposed activities, duplicate the “Activity”
section (be sure to update the activity number) and enter the appropriate information.

Activity 1
Name of activity:
For Census tracking, please provide ZIP code(s) that corresponds with activity’s primary location:
Please provide status of activity (maximum word count: 250):
Percentage of the activity completed to this point:
If this is the end of the grant period, has the activity been completed?
If you responded yes, please describe the outcomes here (maximum word count: 250):
If you responded no, please provide brief explanation here (maximum word count: 250):
Please discuss briefly any approved changes, significant problems, the impact they will have on successfully completing
this project, and the corrective actions that were taken or planned (maximum word count: 500):

Page 2 of 4

form HUD-40077 (11/09)

Office of University Partnerships
Grant Progress Report
U. S. Department of Housing
and Urban Development

OMB Approval No. 2528-0198
(exp. 9/30/2012)

Activity 2
Name of activity:
For Census tracking, please provide ZIP code(s) that corresponds with activity’s primary location:
Please provide status of activity (maximum word count: 250):
Percentage of the activity completed to this point:
If this is the end of the grant period, has the activity been completed?
If you responded yes, please describe the outcomes here (maximum word count: 250):
If you responded no, please provide brief explanation here (maximum word count: 250):
Please discuss briefly any approved changes, significant problems, the impact they will have on successfully completing
this project, and the corrective actions that were taken or planned (maximum word count: 500):

Activity 3
Name of activity:
For Census tracking, please provide ZIP code(s) that corresponds with activity’s primary location:
Please provide status of activity (maximum word count: 250):
Percentage of the activity completed to this point:
If this is the end of the grant period, has the activity been completed?
If you responded yes, please describe the outcomes here (maximum word count: 250):
If you responded no, please provide brief explanation here (maximum word count: 250):
Please discuss briefly any approved changes, significant problems, the impact they will have on successfully completing
this project, and the corrective actions that were taken or planned (maximum word count: 500):

Activity 4
Name of activity:
For Census tracking, please provide ZIP code(s) that corresponds with activity’s primary location:
Please provide status of activity (maximum word count: 250):
Percentage of the activity completed to this point:
Page 3 of 4

form HUD-40077 (11/09)

Office of University Partnerships
Grant Progress Report
U. S. Department of Housing
and Urban Development

OMB Approval No. 2528-0198
(exp. 9/30/2012)

If this is the end of the grant period, has the activity been completed?
If you responded yes, please describe the outcomes here (maximum word count: 250):
If you responded no, please provide brief explanation here (maximum word count: 250):
Please discuss briefly any approved changes, significant problems, the impact they will have on successfully completing
this project, and the corrective actions that were taken or planned (maximum word count: 500):

Activity 5
Name of activity:
For Census tracking, please provide ZIP code(s) that corresponds with activity’s primary location:
Please provide status of activity (maximum word count: 250):
Percentage of the activity completed to this point:
If this is the end of the grant period, has the activity been completed?
If you responded yes, please describe the outcomes here (maximum word count: 250):
If you responded no, please provide brief explanation here (maximum word count: 250):
Please discuss briefly any approved changes, significant problems, the impact they will have on successfully completing
this project, and the corrective actions that were taken or planned (maximum word count: 500):

Final Report
Is this your final report?

Yes

No

If you answered yes, please complete and include the electronic versions of the following forms with your final report:
Final SF–269–A, Financial Status Report
Closeout Certification

Property Statement

Grant expiration date?
Date you submitted final report:
Final reports must be submitted within 90 days of your closeout date.
Did you complete your project on time, or did you need to request an extension?*

* If you indicated that you required an extension, please provide a brief explanation:
Page 4 of 4

form HUD-40077 (11/09)


File Typeapplication/pdf
File TitleREQUIRED // DO NOT SUBMIT WITHOUT INCLUDING THIS INFORMATION
AuthorK. White
File Modified2010-06-29
File Created2010-06-29

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