Listing of Grant Commitments (Contracts and Other Firm Committments)

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	OMB Control Number: 1024-0038
	Expiration Date:  XX/XX/2014
Attachment to SF 425 – THPO HPF Carryover Form 
Listing of Grant Commitments (Contracts and Other Commitments by Purchase Order) 

GRANT #: 


1. Amount Expended and Billed to NPS as of 12/31

$
2. Amount Expended and Sent to your Tribal Finance Office for Billing but not as yet Sent to NPS for Payment
$
3. Amount of Unexpended Committed Funds by contract or Purchase Order Being Carried Over and list below
$
4. Uncommitted Carryover
$
Total of 1, 2, 3, and 4 should equal Grant Award
$


List Committed Funds being carried over only by
Contract or Purchase Order



Unexpended Committed
Amount


$

$

$

$

$

$

$

$

Total (listed in #3)

$

NOTE: 
    • The total amount expended on commitments (Line 1 plus Line 2) must be included in item 10.e. 
    • The total amount unexpended on commitments to be carried over for second year must be included in item 10.h of the SF 425. 

 Signature:______________________________________________ Date:_____________________

Paperwork Reduction Act Statement:  This information is being collected for the annual report to NPS on the financial achievements that the Tribal Historic Preservation Office (THPO) has accomplished with its Historic Preservation Fund grant.  Your response is required to obtain or retain a benefit pursuant to the National Historic Preservation Act, as amended (16 U.S.C. 470 et seq.).  A Federal agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it displays a valid OMB (Office of Management and Budget) control number.  OMB has approved this information collection and assigned control number 1024-0038.
Estimated Burden Statement:  Public reporting burden for this information collection is estimated to average 7.08 hours per response including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the (optional) form or its equivalent.  Direct comments regarding this burden estimate to Chief, Historic Preservation Grants, National Park Service, 1849 C Street, NW. (Org. Code 2256), Washington, DC 20240.