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pdfFINAL PERFORMANCE REPORT
Please consult attached instructions when filling out this form.
1.
Federal agency and organization element to
which report is submitted:
Institute of Museum and
Library Services
2. Federal award or other identifying
number assigned by federal agency:
Page
of
Pages
3a. DUNS number:
3b. EIN/TIN:
4.
Recipient organization (name and complete address, including ZIP+4/postal code):
6a. Award period of performance start
date (mo/day/yr):
6b. Award period of performance
end
date (mo/day/yr):
7. Reporting period end date
(mo/day/yr):
8. Project URLs, if any:
10.
5. Recipient identifying or
account number:
9. Report frequency:
annual
semi‐
annual
quarterly other
If other, describe:
Other attachments? Yes No
Contact the IMLS program office to receive instructions for transmitting additional attachments.
11a. Name and title of Project Director:
11b. Telephone (area code, number, extension):
11c. Email address:
12.
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.
13a. Signature of Authorized Certifying Official:
13c. Name and title of Authorized Certifying Official:
13b. Date report submitted (mo/day/yr):
13d. Telephone (area code, number,
extension):
13e. Email address:
14. Agency use only
1
OMB No. 3137-0071, Expiration Date: 7/31/2018
IMLS-CLR-F-0006A
File Type | application/pdf |
File Modified | 2015-12-21 |
File Created | 2015-09-29 |