Form Report Form 4 Report Form 4 Native American Library Services Basic Grant and Basic G

OMB No. 3137-0071
Exp. date: 7/31/2010

Native American Library Services
Basic Grant and
Basic Grant with Education/Assessment Option
Final Financial and Performance Report
Use this form to submit your final financial and performance report for the IMLS Native American Library Services Basic
Grant with Education/Assessment Option. Final reports are due ninety (90) days after the end of the grant period. If more
space is required, continue on a separate piece of paper.
Grantee (Name of Tribe):
Grant number:
Amount of grant award:
Name of Project Director:
Telephone number of Project Director:
__________________________________________________________________________________________
Part A. Basic Grant
Describe how the grant funds were used to support library and information services. The activities described should
follow the categories identified in the spending plan approved when the grant was awarded (e.g., salaries and wages,
books and journals, equipment and supplies). Please identify any significant differences between your approved
spending plan and your actual expenditures of the grant funds.

Funds expended in Part A:
(up to $6,000)
Funds remaining (if any):
Part B. Education/Assessment Option (if applicable)
Describe how the grant funds were used to support the following activities: attendance at continuing education courses
and/or training workshops on- or off-site; attendance at conferences related to library services; and/or hiring of a
consultant for an on-site professional library assessment. The activities described should follow the categories identified

in the spending plan approved when the grant was awarded. Please identify any significant differences between your
approved spending plan and your actual expenditures of the grant funds. Part B funds may not be spent for activities
under Part A.

Funds expended in Part B:
(up to $1,000)
Funds remaining (if any):

Total funds expended:
(up to $7,000)
Total funds remaining
(Part A + Part B,if any)*:
Total project expenditures
(Part A + Part B):
*If funds were already drawn down, the remainder is to be returned to IMLS with this Final Report, check payable to IMLS,
sent to address below. If not draw down, request only the funds that were expended.
__________________________________________________________________________________________
Name and title of person submitting this report (if different than Project Director):

Telephone number of person submitting this report:
Email of person submitting this report:
By signing below, I certify that the information provided is true and correct and that all funds were used in accordance with
the grant guidelines or returned to the Institute of Museum and Library Services.
Signature of person submitting this report: ___________________________ Date: ______________
You may submit this report electronically to [email protected]; or fax it to IMLS Grants Administration at
202-653-4604; or mail it to Grants Administration, Institute of Museum and Library Services, 1800 M Street, NW /
9th Floor, Washington, DC 20036-5802.
Burden estimate and request for public comments: Public reporting burden for this collection of information is estimated to average two hours per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comment regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Institute of Museum and
Library Services, 1800 M Street NW, 9th Floor, Washington DC 20036-5802, and to the Office of Management and Budget, Paperwork Reduction Project (3137-0071),
Washington DC 20503.