Form State Grants 1 State Grants 1 State Grants Financial Status Report - IMLS State Progra

IMLS Grant Program Application and Post-Award Report Forms

State Programs - 2008 Financial Status Report (FSR).xlt

Grants to States Library Administrative Agencies Final Year Report (SPR)

OMB: 3137-0071

Document [xlsx]
Download: xlsx | pdf
FY 2008 Allotment







Enter the name of your state. State





FINANCIAL STATUS REPORT










IMLS State Programs

















1. Federal Agency and Organizational 2. Federal Grant or Other Identifying Number Assigned By Federal Agency





OMB Approval No. Page of
Element to which Report is submitted. EXAMPLE: 00-00-0000-00 3137-0071 1 1
IMLS - State Program
LS – Enter the ten-digit Grant Award Number for your state’s FY-2008 Award. 00-08-XXXX-08

Exp. Date: 7-31-2010 Pages
Enter the name of your State Library Administrative Agency (a.k.a., the SLAA) along with the complete address. 3. Recipient Organization (Name and complete address, including ZIP codes











Enter the EIN for your SLAA. 4. Employer Identification Number
Enter the applicable number, if you use one. 5. Recipient Account Number or Identifying Number



After printing the form, check “Yes” if this is your “Final” FSR for 2008; check “No” if this is an “Interim” FSR. You cannot submit an Interim Report unless you have received approval from IMLS and a Final submission date has been approved. 6. Final Report 7.        Basis


__ Yes __ No __ Cash __ Accrual
8.  Funding Grant Period (See instructions) 9.  Period Covered by This Report
From: (Month, Day, Year) To (Month, Day, Year) From: (Month, Day, Year) To: (Month, Day, Year)
October 1, 2007 September 30, 2009 October 1, 2007 September 30, 2009
10. STATE MOE










a.  Total SLAA funds expended to meet the purposes of LSTA, including the Five-Year Plan (MOE)







10. a - Enter the total State funds that were appropriated to and expended by your SLAA to support the purposes of LSTA, including SLAA funds to support the Five-Year Plan. These funds must be in the SLAA Budget. This figure will represent your MOE.

10. STATE, LOCAL and PRIVATE MATCH










b. (1)   SLAA funds expended specifically on the Five-Year Plan







10. b (1) - Enter the state funds that the SLAA expended to specifically support your state’s current Five-Year Plan.

(2) All local or private funds expended on the Five-Year Plan







10. b (2) - Enter the funds that local governments, corporations, and foundations expended to specifically support your state’s current Five-Year Plan.

(3) Total of b(1) and b(2) (Match)








$ 0.00
10. OTHER SPECIAL FUNDS










c. All other recipient outlays not shown on lines a and b (1-3)







10. c - Enter the amount of any other funds that were used to support library development, but that are not reported in lines a and b (1-3).

10. TOTAL










d. Total recipient share of net outlays (sum of lines a, b(2) and c)








$ 0.00
10. FEDERAL SHARE










e. Total Federal funds authorized for this funding period (Allotment)







10. e - Enter the amount of the federal award (the state’s Allotment) applicable to this FSR.

f. Total unliquidated obligations (expected to clear by Dec. 30 or later IMLS-approved date)







10. f - Enter the amount of any 2008 LSTA funds that you have obligated by Sep. 30 but will not have liquidated by Dec. 30. (You can only do this if you have received prior approval from State Programs staff to go beyond the 90-day liquidation period) These are funds that you fully expect will be spent.

Enter IMLS-approved date in 11 b below








g. Unobligated balance of Federal funds (these funds will be deobligated)







10. g - Enter the amount of 2008 LSTA funds that were not obligated before Sep. 30 or that your SLAA will not be able to liquidate within the Grant Award Period, including any extensions provided by State Programs staff. These are funds that you know will not be spent and will have to be written off.

h. Federal share of net outlays (e minus f and g)








$ 0.00












i.   TOTAL OUTLAYS (sum of lines d and h)

$ 0.00
11. ADMINISTRATION OF THE ACT






















a. LSTA Administration costs
claimed by the SLAA
$ 0 x 4% = $ 0.00 11. a - “Actual” – Enter the amount (if any) of 2008 LSTA funds your SLAA spent to administer the program. This figure cannot exceed the pre-calculated amount shown in “Allowable” which represents 4% of your Allotment.
= $ 0.00
Allotment
Allowable
Actual
Difference












b. IMLS-approved date obligations in 10 f above are expected to clear






11. b - "Date" – Enter the date that has been agreed-to by State Programs staff for you to extend your liquidation period. On or before that date you must submit a Final FSR to reflect any changes. This refers to item 10 f above.










Date

12. Certification: I certify to the best of my knowledge and belief that this report is correct and complete and that











all outlays and unliquidated obligations are for the purposes are set forth in the award documents.









Enter the name and title of the SLAA’s current “Authorized Official” as reflected on the form entitled “State Legal Officer’s Certification of Authorized Certifying Official” that has been submitted by the SLAA and is on file at the State Programs office. Typed or Printed Name and Title





Enter the telephone number for the “Authorized Official”. Telephone (area code, number, extension)




Signature of Authorized Certifying Official




Enter the date the form is being submitted to the State Programs office. In the case of a re-submission of the form, enter the new date of submission along with the word “Revised”. Date Report Submitted






















IMLS 7-2-09












Burden Estimate and Request for Public Comments
Public reporting burden for this collection of information is estimated to average one hour 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 suggestion for reducing this burden,
to the Institute of Museum and Library Services, Chief Information Officer, 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.

































































































































































































































































































































































































































































































File Typeapplication/vnd.ms-excel
AuthorRobin R. Cabot
Last Modified ByKMILLER
File Modified2010-06-07
File Created2005-05-27

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