CAR FSR Form

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Overview

Interim FSR
Final FSR

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Sheet 1: Interim FSR

INTERIM FINANCIAL STATUS REPORT (FSR) FORM

I: State Name:

II: Federal Funding Period:

III: Reporting Period:

IV: Accounting Basis:

V: Grant Award Numbers: State Basic Grant (Title I) -

Tech Prep Grant (Title II) -

VI: Title I Grant Award Amount:

VII: Title II Grant Award Amount:

VIII: Title II Funds Consolidated with Title I Funds:

IX: Total Title I Funds (Title I Award + Title II Consolidated Funds):

X. Total Title II Funds Remaining (Title II - Title II Consolidated Funds) :

XI. Amended Interim FSR: * Date of Filing Amended FSR:

1

2

3

4

5

6

7

8

9

10

11

Net Outlays

Total Outlays

Program

Net Outlays

Net Outlays

Non-Federal

Total Federal Share

Federal Share

Fed. Share of Outlays &

Federal Funds

Balance of Unobligated

Row

Previously Reported

This Report Period

Income

This Report Period

To Date

Share of Outlays

of Outlays

of Unliquidated

Unliquidated Obligations

Authorized

Federal funds

Credits

(Column 2 - 3)

(Column 5 - 6)

Obligations

(Column 7 + 8)

(Column 10 - 9)

A

* TOTAL TITLE I FUNDS *

No information is entered on this row

B

LOCAL USES OF FUNDS

No information is entered on this row

C

RESERVE

No information is entered on this row

D

Funds for Secondary Recipients

E

Funds for Postsecondary Recipients

F

Total (Row D + E)

G

FORMULA DISTRIBUTION

No information is entered on this row

H

Funds for Secondary Recipients

I

Funds for Postsecondary Recipients

J

Total (Row H + I)

K

TOTAL LOCAL USES OF FUNDS (Row F + J)

L

STATE LEADERSHIP

No information is entered on this row

M

Nontraditional Training and Employment

N

State Institutions

O

Other Leadership Activities

P

TOTAL STATE LEADERSHIP (Row M + N + O)

Q

STATE ADMINISTRATION

No information is entered on this row

R

TOTAL STATE ADMINISTRATION

S

TOTAL TITLE I FUNDS (Row K + P + R)

T

* TOTAL TITLE II FUNDS *

No information is entered on this row

U

Funds for State Administration

V

Funds for Local Consortia

W

TOTAL TITLE II FUNDS (Row U + V)

ADDITIONAL INFORMATION:

XII: Certification: I understand that the use of my PIN to certify and submit this FSR is the same as certifying and signing this document.

Signature or PIN of an Authorized State Official:

Title/Agency:

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Sheet 2: Final FSR

FINAL FINANCIAL STATUS REPORT (FSR) FORM

I: State Name:

II: Federal Funding Period:

III: Reporting Period:

IV: Accounting Basis:

V: Grant Award Numbers: State Basic Grant (Title I) -

Tech Prep Grant (Title II) -

VI: Title I Grant Award Amount:

VII: Title II Grant Award Amount:

VIII: Title II Funds Consolidated with Title I Funds:

IX: Total Title I Funds (Title I Award + Title II Consolidated Funds):

X. Total Title II Funds Remaining (Title II - Title II Consolidated Funds) :

XI. Amended Final FSR: * Date of Filing Amended FSR:

1

2

3

4

5

6

7

8

9

10

11

Net Outlays

Total Outlays

Program

Net Outlays

Net Outlays

Non-Federal

Total Federal Share

Federal Share

Fed. Share of Outlays &

Federal Funds

Balance of Unobligated

Row

Previously Reported

This Report Period

Income

This Report Period

To Date

Share of Outlays

of Outlays

of Unliquidated

Unliquidated Obligations

Authorized

Federal funds

Credits

(Column 2 - 3)

(Column 1 + 4)

(Column 5 - 6)

Obligations

(Column 7 + 8)

(Column 10 - 9)

A

* TOTAL TITLE I FUNDS *

No information is entered on this row

B

LOCAL USES OF FUNDS

No information is entered on this row

C

RESERVE

No information is entered on this row

D

Funds for Secondary Recipients

E

Funds for Postsecondary Recipients

F

Total (Row D + E)

G

FORMULA DISTRIBUTION

No information is entered on this row

H

Funds for Secondary Recipients

I

Funds for Postsecondary Recipients

J

Total (Row H + I)

K

TOTAL LOCAL USES OF FUNDS (Row F + J)

L

STATE LEADERSHIP

No information is entered on this row

M

Nontraditional Training and Employment

N

State Institutions

O

Other Leadership Activities

P

TOTAL STATE LEADERSHIP (Row M + N + O)

Q

STATE ADMINISTRATION

No information is entered on this row

R

TOTAL STATE ADMINISTRATION

S

TOTAL TITLE I FUNDS (Row K + P + R)

T

* TOTAL TITLE II FUNDS *

No information is entered on this row

U

Funds for State Administration

V

Funds for Local Consortia

W

TOTAL TITLE II FUNDS (Row U + V)

ADDITIONAL INFORMATION:

XII: Certification: I understand that the use of my PIN to certify and submit this FSR is the same as certifying and signing this document.

Signature or PIN of an Authorized State Official:

Title/Agency:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 160 minutes/hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is mandatory under Carl D. Perkins Career and Technical Education Act of 2006 (Perkins IV) required to obtain or retain benefit under section 113(c) of Perkins IV and voluntary. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20210-4537 or email [email protected] and reference the OMB Control Number 1830-0569. Note: Please do not return the completed Perkins IV Consolidated Annual Report application to this address.