Form FY16 Basic Fina FY16 Basic Fina FY16 Basic Final Financial & Performance Reporting

OMB No. 3137-0071
Exp. date: 9/30/2015

Native American Library Services
Basic Grant and
Basic Grant with Education/Assessment Option
Financial and Performance Report
Use this form to submit your interim and final Financial and Performance Reports for the IMLS Native American Library
Services Basic Grant or Basic Grant with Education/Assessment Option. Reports are due according to the Reporting
Schedule sent with your Grant Award Notification. If more space is required, continue on a separate piece of paper.
You may submit this report electronically to [email protected] or mail it to Grants Administration, Institute
of Museum and Library Services, 1800 M Street, NW / 9th Floor, Washington, DC 20036-5802.
Grantee (Name of Tribe):
Grant number:
Amount of grant award:
Name of Project Director:
Telephone number of Project Director:
__________________________________________________________________________________________
Part A. Basic Grant
Describe how the grant funds were used to support library and information services. The activities described should follow
the categories identified in the spending plan approved when the grant was awarded. Please identify any significant
differences between your approved spending plan and your actual expenditures of the grant funds.

Funds expended in Part A:
Funds remaining (if any):

Part B. Education/Assessment Option (if applicable)
Describe how the grant funds were used to support the following activities: attendance at continuing education courses
and/or training workshops on- or off-site; attendance at conferences related to library services; and/or hiring of a
consultant for an on-site professional library assessment. The activities described should follow the categories identified in
the spending plan approved when the grant was awarded. Please identify any significant differences between your
approved spending plan and your actual expenditures of the grant funds.

Funds expended in Part B:
Funds remaining (if any):
Total funds expended:
Total funds remaining, if any:
(Part A + Part B)
Total project expenditures:
(Part A + Part B)
__________________________________________________________________________________________
Name and title of person submitting this report:

Telephone number:
Email:
By signing below, I certify that the information provided is true and correct and that all funds were used in accordance with
the grant guidelines or returned to the Institute of Museum and Library Services.
Signature of person submitting this report: ___________________________________ Date: ___________________
Burden estimate and request for public comments: Public reporting burden for this collection of information is estimated to average two 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, 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.