Form Report Form 1 Report Form 1 Discretionary Grant Performance Report - Cover Sheet

IMLS Grant Program Application and Post-Award Report Forms

Discretionary Grant Performance Report Cover Sheet

Discretionary Grant Performance Report

OMB: 3137-0071

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OMB	No.	3137-0071,	exp.	7/31/2010

Cover Sheet
for Performance
Reports
Interim
Performance
Report Narrative
Page                  of                 

1.	
2.	

Institute	of	Museum	and	Library	Services-funded	projects	vary	a	great	deal	in	their	goals	and	
Grantactivities.	Please	address	the	topics	below	as	they	apply	to	this	project	during	this	reporting	
or other identifying number assigned by IMLS: 		
	
	
	
	
	
	
	
period.	Interim	narrative	reports	are	typically	3-5	pages.
Recipient organization (name and address, including zip code):

3a.	 DUNS number: 	

	

	

	

	

	

3b.	 EIN: 	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

Please	include	the	IMLS	grant	number	at	the	top	of	each	page	of	narrative.		Use	the	
following	sequence:
4.	 Recipient identifying or account number:
1. Cover	Sheet	

5a.	 Project/Grant period start date (mo/day/yr): 	 	

	

	

	

	

	

6a.	 Reporting period end date (mo/day/yr): 	

5b.	 Project/Grant
period end date (mo/day/yr): 	 	
	
	
6b.	 Final Report?    Yes    No
2. Compare	actual	accomplishments	with	goals	established	for	the	report	period.	Whenever	

possible,	describe	activities	or	services	in	both	quantitative	and	qualitative	terms.	If	
	
	
	
	
8.	 Report frequency:
interim	project	goals	have	not	been	met,	explain	why,	describe	what	steps	have	been	taken	
	  annual   	  semi-annual 	  quarterly 	
 other
	
	
	
	
	
	
to	get	the	project	back	on	schedule,	and	discuss	the	likelihood	that	the	project	will	be	
	
If other, describe: 	
	
	
	
	
	
	
	
	
	
	
completed	by	the	expiration	date	of	the	grant.		

7.	

Project URLs, if any: 	 	

	

	

	

	

	

	

9.	

Please transmit the performance report as instructed by the Institute of Museum and Library Services.

	

3. Describe	any	significant	findings	or	accomplishments	in	this	period.		

10.	 Other attachments?    Yes    No
	

Transmit
documents with this cover as instructed by the Institute of Museum and Library Services
4. accompanying
Include	other	comments	or	anecdotal	information	that	shows	project	achievements	or	

lessons	learned	in	this	period.

11.	 Certification: By submitting this report I certify to the best of my knowledge and belief that this information is correct and complete 	
	
for performance of activities for the purposes set forth in the award documents.  

REMINDER:	IMLS	understands	that	unavoidable	changes	may	occur	during	a	project.	If	a	

11a.	Namechange	occurs	in	key	project	personnel	(Project	Director,	Principal	Investigator,	grant-funded	
and title of authorized certifying official:
11c. 	Telephone (area code, number, extension):
	

	

	

	

	staff,	consultants,	or	authorizing	official),	or	a	substantial	change	is	contemplated	in	the	
	
	
	
	
	
	
	
	
	
	
	
	
	

	

	

	

	
	
	
	
	project	budget,	scope,	or	schedule	as	described	in	the	approved	application,	approval	must	be	
	
	
	
	
	
	
11d. Email address: 	

	

	

	

requested	by	the	Authorizing	Official	in	a	separate	document.	Refer	to	the	IMLS	General	
11b.	Signature
of authorized certifying official
	
Terms	and	Conditions	(http://www.imls.gov/pdf/GTC0606.pdf)	for	instructions.		
Terms	and	Conditions	(http://www.imls.gov/pdf/GTC0606.pdf
	

	

	

	

	

	

	

12a.	Name and title of Principal Investigator/Project Director:

11e.	Date report submitted (mo/day/yr): 	

	

	

	

12b.	Telephone (area code, number, extension):

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

12c. Email address: 	

	

	

	

	

	

	

	

	

	

	

13.	 Agency use only: 	

	

	

	

	

	

	

	

	

	

Directions	for	submitting	this	report	are	available	at	http://www.imls.gov/recipients/administration.shtm.	For	assistance	or	questions	contact	your	
Instructions	for	submitting	this	report	are	available	at	http://www.imls.gov/recipients/administration.shtm.	For	assistance	or	questions	contact	your	
Program	Officer.	

Burden	Estimate	and	Request	for	Public	Comments:		Public	reporting	burden	for	this	collection	of	information	(Final	Report,	Parts	1	and	2)	is	
estimated	to	average	eight	to	thirteen	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,	
Chief	Information	Officer,	1800	M	Street,	NW,	9th	Floor,	Washington,	DC	20036-5802,	and	to	the	Office	of	Management	and	Budget,	Paperwork	
Reduction	Project	3137-0029,	Washington,	DC	20503.
Reduction	Project	3137-0071,	Washington,	DC	20503.


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