State Organization Chart and Staffing Summary

OMB Control Number 1024-0038

Expiration Date: XX/XX/2017

SAMPLE ORGANIZATIONAL CHART

This is a sample organization chart only. States may use any format they wish as long as the information stipulated in Section C.1.f. of this chapter is included. Please note that whatever format is used, it should readily indicate what the reporting relationships are.

State Historic Preservation Officer:

Deputy State Historic Preservation Officer(s):

HPF Grants Manager:

36 CFR 61 Qualified Staff (please note discipline in parentheses):

Staff Responsible for Title VI and Section 504 Compliance:

The Organization chart must detail all positions associated with State staff work that is charged in full or in part to the HPF or Matching share. The Organization Chart must include the following components: a) All positions by title, noting which positions fulfill 36 CFR 61 staff requirements; b) Names of incumbents of all positions paid in full or part by HPF funds, or claimed as nonfederal share costs; c) Which positions are supervisory; d) Reporting relationships; e) Assigned Chapter 6 Program Areas for each staff person; f) Which staff person has primary responsibility for HPF Grants Management (both grant-assisted internal operations and subgrants); and g) Which staff person has responsibility for Title VI and Section 504 compliance (see Chapter 10, Section C.5.f.).

The staff person’s primary program area should be indicated in parentheses. Reporting relationships may be indicated with arrows or lines between the relevant boxes. Please use the following abbreviations:

SUPERVISOR Supervisory Positions

36 CFR 61 Staff meeting the professional qualification requirements in 36 CFR 61

HPF Staff paid with HPF funds

MATCH Staff paid with matching funds

[See the Grants Manual for Grants-related Paperwork Reduction Act Statement]

Paperwork Reduction Act Statement. We (National Park Service) collect this information as part of the process for reviewing the procedures and programs of State, tribal, and local governments participating in the national historic preservation program and the Historic Preservation Fund grant program. The information is required to obtain or retain a benefit. We use the information to evaluate those programs and procedures for consistency with the National Historic Preservation Act, as amended, (16 U.S.C. 470 et seq.) and compliance with Governmentwide grant requirements. We provide no assurance of confidentiality with the exception of some location information concerning some properties included in government historic preservation property inventories. Pursuant to Section 304 of the National Historic Preservation Act of 1966, as amended, release of information is tightly controlled when such release could have the potential of damaging those qualities that make a property historic.

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 currently valid OMB control number. The Office of Management and Budget has reviewed and approved these information collection requirements and assigned OMB Control Number 1024-0038. We estimate that it will take you 2 hours to complete the Organization and Staffing Chart, including time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Service Information Collection Clearance Officer, National Park Service, 1849 C Street, NW. (2600), Washington, DC 20240.