DOE F 540.4 U.S. DOE Weatherization Annual Training, Technical Assis

Weather Assistance Program (WAP)

WAP Annual Report 2016 Forms

Weather Assistance Program (WAP)

OMB: 1910-5127

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DOE F 540.4 OMB Control No. 1910-5127

Expiration Date: 11/30/2016

U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM

ANNUAL TRAINING, TECHNICAL ASSISTANCE, MONITORING, AND LEVERAGING REPORT


State______________________ Program Year________________ Grant Number ______________


Reporting period ___/___/___ - ___/___/___


TRAINING AND TECHNICAL ASSISTANCE ACTIVITIES


Please describe the training and technical assistance (T&TA) activities conducted during the past program year.





U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM

ANNUAL TRAINING, TECHNICAL ASSISTANCE, MONITORING, AND LEVERAGING REPORT


State______________________ Program Year________________ Grant Number ______________



Reporting period ___/___/___ - ___/___/___


MONITORING ACTIVITIES


Please list the subgrantees monitored during the reporting period and indicate the focus and significant findings of each monitoring activity, as appropriate.





U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM

ANNUAL TRAINING, TECHNICAL ASSISTANCE, MONITORING, AND LEVERAGING REPORT


State______________________ Program Year________________ Grant Number ______________


Reporting period ___/___/___ - ___/___/___


LEVERAGING ACTIVITIES


For each leveraging activity, please describe the type of project, the project highlights, the organizations providing resources, the leveraged resources (funding and completed units), the participating subgrantees, and the status and impact.




Submitted by_________________________________________________________________ Date_____________


Type name___________________________________________________________________


Title ___________________________________________________________________



OMB Burden Disclosure Statement


Public reporting burden for this collection of information is estimated to average 3 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 comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0043), Washington, DC 20503.


PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.




U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM

ANNUAL FILE WORKSHEET

INSTRUCTIONS


The Annual Training, Technical Assistance, Monitoring, and Leveraging Report is to be submitted annually, 30 days after the end of the reporting period.


State: Name of state or tribal organization submitting the report.

Program Year: The beginning and ending dates (mm/dd/yy) for the Program Year reported.

Grant number: The seven-digit Federal identification number assigned to the grant (R999999).

Reporting period: The starting and ending dates (mm/dd/yy) for the reporting period for the WAP program year.





Item


Explanation


Training and Technical Assistance Activities


Please describe the training and technical assistance (T&TA) activities conducted during the past year.




Monitoring Activities

Please list the subgrantees monitored during the reporting period and indicate the focus and significant findings of each monitoring activity, as appropriate.




Leveraging Activities

For each leveraging activity, please describe the type of project, the project highlights, the organizations providing resources, the leveraged resources (funding and completed units), the participating subgrantees, and the status and impact.







Submitted by: Signature of the person submitting the report.


Date signed.


Typed name and title of the submitter.

Application Package



File Typeapplication/msword
File TitleDOE #_____________
AuthorAlex Moore
Last Modified ByAskew, Christine
File Modified2016-10-19
File Created2016-10-19

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