Form 1845-0030 2014-2015 Campus-Based Reallocation Form

DRAFT

OMB No. 1845-0030

Expires: XX/XX/XXXX

CAMPUS-BASED REALLOCATION FORM
Release 2014-2015 Unexpended Campus-Based Funds and

Request 2015-2016 Supplemental FWS Funds

Public Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1845-0030.  Public reporting burden for this collection of information is estimated to average 2 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  The obligation to respond to this collection is mandatory in accordance with 34 CFR 674.19 (Federal Perkins Loan), 34 CFR 675.19 (Federal Work-Study), and 34 CFR 676.19 and 20 U.S.C. 1094 (Federal Supplemental Educational Opportunity Grant). If you have comments or concerns regarding the status of your individual submission of this form, please contact the Grants & Campus-Based Division Call Center directly at 877/801-7168 or email [email protected].

Name of School: [Prefilled by eCB] OPEID: [Prefilled by eCB]
Address of School: [Prefilled by eCB]

City: [Prefilled by eCB] State: [Prefilled by eCB] Zip: [Prefilled by eCB]

Deadline for Submission is August 17, 2015

Section A: School release of 2014-2015 award year unexpended allocations for the Federal Supplemental Educational Opportunity Grant, Federal Work Study and Federal Perkins Loan Programs.

	Federal Supplemental Educational Opportunity Grant (FSEOG)	Federal Work - Study (FWS)	Federal Perkins Loan Federal Capital Contribution (FCC)
Unexpended 2014-2015 Allocation Amount	(1) $	(2) $	(3) $

Section B: Request for Supplemental FWS funds for the 2015-2016 award year.

(Complete only if you want Supplemental FWS funds)

(4) Did your school expend at least 5 percent of its total 2014-2015 FWS federal funds to compensate students employed as reading tutors of children or in family literacy activities as part of your community service activities?	YES NO ____ ____
(5) Amount of supplemental 2015-2016 FWS funds your school will need for community service jobs.	$

Warning: If you purposely give false or misleading information, you may be fined up to $20,000, sent to prison, or both.