Form 1 ACF-OGM-PPR-B

ACF PERFORMANCE PROGRESS REPORT
ACF-OGM-SF-PPR Cover Page
Administration for Children and Families
U.S. Department of Health and Human Services
Page
1. Federal Agency and Organization Element to
Which Report is Submitted

2. Federal Grant or Other Identifying
Number Assigned by Federal Agency

of
Pages
3a. DUNS Number
3b. EIN

4. Recipient Organization (Name and complete address including zip code)

5. Recipient Identifying Number
or Account Number

6. Project/Grant Period

8. Final Report?

Start Date: (Month, Day, Year)

10. Performance Narrative

7. Reporting Period End Date
End Date: (Month, Day, Year)

(Month, Day, Year)

Yes
No

9. Report Frequency
annual
semi-annual
quarterly
other
(If other, describe: __________
__________________________)

(attach performance narrative as instructed by the awarding Federal Agency)

11. Certification: I certify to the best of my knowledge and belief that this report is correct and complete
for performance of activities for the purposes set forth in the award documents.
11a. Typed or Printed Name and Title of Authorized Certifying Official

11c. Telephone (area code, number and
extension)
11d. Email Address

11b. Signature of Authorized Certifying Official

11e. Date Report Submitted (Month, Day,
Year)

12. Agency use only

OMB Approval Number: XXXX-XXXX
Expiration Date: XX/XX/XXXX

ACF PERFORMANCE PROGRESS REPORT
ACF-OGM SF-PPR
COVER PAGE INSTRUCTIONS
Administration for Children and Families
U.S. Department of Health and Human Services

Item
Data Elements
1.
Awarding Federal Agency
and Organizational Element
to Which Report is
Submitted
2.

3a.

Federal Grant or Other
Identifying Number
Assigned by the awarding
Federal agency
DUNS Number

Instructions
Enter the name of the awarding Federal agency and organizational element
identified in the award document or otherwise instructed by the agency. The
organizational element is the sub-agency within an awarding Federal agency.

Enter the grant/award number contained in the award document.

Enter the recipient organization’s Data Universal Numbering System (DUNS)
number or System for Award Management (SAM) extended DUNS Number.
3b.

EIN
Enter the recipient organization’s Employer Identification Number (EIN)
provided by the Internal Revenue Services.

4.

Recipient Organization
Enter the name of recipient organization and address, including zip code.

5.

Recipient Account Number
or Account Number

Enter the account number or any other identifying number assigned by the
recipient to the award. This number is strictly for the recipient’s use only and is
not required by the awarding Federal agency.

6.

Project/Grant Period

Indicate the project/grant period established in the award document during which
Federal sponsorship begins and ends. Note: Some agencies award multi-year
grants for a project/grant period (e.g., 5 years) that are funded in increment
known as budget periods or funding periods. These are typically annual
increments. Please enter the project/grant period, not the budget period or
funding period.

7.

Reporting Period End Date

Enter the ending date of the reporting period. For quarterly, semi-annual, and
annual reports, the following calendar quarter period end dates shall be used:
3/31; 6/30; 9/30; and 12/31. For final PPRs, the reporting period end date shall be
the end date of the project/grant period. The frequency of required reporting is
usually established in the award document.

8.

Final Report
Mark appropriate box. Check “yes” only if this is the final report for the
project/grant period specified in Box 6.

9.

Report or Frequency

10.

Performance Narrative

Select the appropriate term corresponding to the requirements contained in the
award document. “Other” may be used when more frequent reporting is required
for high-risk grantees, as specified in OMB Circular A-110.
Leave blank and complete Form ACF-OGM SF PPR Attachment B

ACF PERFORMANCE PROGRESS REPORT
Appendix B - Program Indicators
ACF-OGM-SF-PPR
SF-PPR-OGM-B
Page

1.Federal Agency and Organization
Element to Which Report is
Submitted

2. Federal Grant
or Other
Identifying
Number
Assigned by
Federal Agency

3a. DUNS

4. Reporting Period End Date
(MM/DD/YYYY)

3b. EIN

Program Indicators

(1)
Item

(2)
Activity
Description

B-01

Major activities and
accomplishments
during this period

B-02

Problems

B-03

Significant findings
and events

(3)
Indicator

of Pages

(4)
Explanation

ACF PERFORMANCE PROGRESS REPORT
Appendix B - Program Indicators
ACF-OGM-SF-PPR

B-04

Dissemination
activities

B-05

Other Activities

B-06

Activities planned
for next reporting
period

ACF PERFORMANCE PROGRESS REPORT
Appendix B - Program Indicators
ACF-OGM-SF-PPR
INSTRUCTIONS
Schedule
Submit the original progress report to the Office of Grants Management, Division of Discretionary Grants, and a copy
to the Program Office. Reports are due 30 days after the end of the second and fourth quarters of the budget period
(every six months).
A FINAL PROGRAM REPORT IS DUE 90 DAYS AFTER THE PROJECT PERIOD END DATE.
Item

Data Elements

Instructions

1

Awarding Federal agency and
Organizational Element to Which
Report is Submitted

Enter the name of the awarding Federal agency and organizational element
identified in the award document or otherwise instructed by the agency. The
organizational element is a sub-agency within an awarding Federal agency.

2

Federal Grant or Other Identifying
Number Assigned by the awarding
Federal agency

Enter the grant/award number contained in the award document.

3a

DUNS Number

Enter the recipient organization's Data Universal Numbering System
(DUNS) number or Central Contract Registry extended DUNS number.

3b

EIN

Enter the recipient organization's Employer Identification Number (EIN)
provided by the Internal Revenue Service.

Reporting Period End Date

Enter the ending date of the reporting period. For quarterly, semi-annual,
and annual reports, the following calendar quarter reporting period end
dates shall be used: 3/31; 6/30; 9/30 and or 12/31. For final PPRs, the
reporting period end date shall be the end date of the project/grant period.
The frequency of required reporting is usually established in the award
document.

4

Program Indicators
Major activities and accomplishments
during this period

Recommend use of project task charts from approved grant application
and/or project work plan with this section. Describe any draft/final products
in this section. Use additional pages if needed.

B-02(4)

Problems

Describe any deviations or departures from the original project plan
including actual/anticipated slippage in task completion dates, and special
problems encountered or expected. Use this report section to advise
Project Officer and Grants Management Specialist of assistance needs. Use
additional pages if needed.

B-03(4)

Significant findings and events

(To be noted by project officer, or reported to regions, States, other
agencies, Program Director/Commissioner, Assistant Secretary, Secretary,
etc.) Use additional pages if needed.

B-04(4)

Dissemination activities

Briefly describe project related inquiries and information dissemination
activities carried out over the reporting period. Itemize and include a copy of
any newspaper, newsletter, magazine articles or other published materials
considered relevant to project activities, or used for project information or
public relations purposes. Use additional pages if needed.

B-05(4)

Other Activities

Briefly describe. Use additional pages if needed.

B-06(4)

Activities planned for next reporting
period

Briefly describe. Use additional pages if needed.

B-01(4)

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)
Public reporting burden for this collection of information is estimated to average 1 hour per
response, including the time for reviewing instructions, gathering and maintaining the data
needed, and reviewing the collection of information.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.