OMB No 1845-0030 Expires: 05/31/2019
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 24 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].
Fiscal Operations Report and Application to Participate (FISAP)
Report: Award Year July 1, 2016 through June 30, 2017; Application: Award Year July 1, 2018 through June 30, 2019
Part I. Identifying Information, Certification and Warning
Section A. Identifying Information
1(a) Name and address of school ________________________________________________________________________________________________________________________________________________________________________________________________________
2. OPEID Number _____________________
3. Type of school (select one)
__ 3.1 public
__ 3.2 private/non-profit
__ 3.3 proprietary
(Select one if proprietary)
__ (a) art
__ (b) business
__ (c) cosmetology
__ (d) trade and technical
__ (e) other
5. Additional Institutions
If the data reported on this form applies to more than one eligible institution (unique 8-digit Institution OPEID not an OPEID that identifies an additional location), you must identify all institutions for which this form is applicable. See instructions
1(b) Mailing address (if different from 1(a)) ________________________________________________________________________________________________________________________________________________________________________________________________________
4. Length/type of longest program (select one)
__ 4.1 less than 1 year
__ 4.2 1 year but less than 2 years
__ 4.3 2 years but less than 3 years
__ 4.4 3 years but less than 4 years
__ 4.5 4 years (no higher than a baccalaureate degree)
__ 4.6 5 years or more
__ 4.7 post-baccalaureate only
This FISAP includes data for additional institutions.
. __ yes __ no
6. Financial Aid Administrator
Name _____________________________ Telephone No. ______________
E-mail address _____________________________ Fax No. ______________
7. Name and address of private financial aid consultant firm, if any
Name _____________________________________________
Address 1_____________________________________________
Address 2_____________________________________________
City ____________________ State ______ Zip ____________
Name of School _____________________________________________________
OPEID Number _________ State _______
Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, “New Restrictions on Lobbying.” This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative agreement.
As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $100,000, as defined at 34 CFR Part 82, Sections 82.105 and 82.110, the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement;
(b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions; and
(c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification. I further certify that the information contained in this electronic FISAP is in compliance with governing legislation and regulations and is true and accurate. I understand that all information associated with this FISAP is subject to audit and program review by representatives of the Secretary of Education.
WARNING: If you purposely give false or misleading information, you may be fined up to $20,000, sent to prison, or both.
8. Chief Executive Officer (includes President, Chancellor, and Director)
Signature _________________________________ Date signed _______________
Name ____________________________________ Telephone No. ____________
Title _____________________________________ Fax No. _________________
E-mail address _____________________________
Options for Signing the FISAP:
eSignature (Recommended) – The CEO may sign the FISAP electronically through the eSignature Tab within the eCampus-Based (eCB) system. Instructions are available through the Help Tab.
Manual
Signature - The
CEO may provide an original signature on the printed form that must
be mailed or hand delivered by the September 29, 2017 deadline date.
Mail signed
form to: FISAP Administrator
8405
Greensboro Drive
Suite 1020
McLean, VA 22102
Application to Participate, Part II
Name of School _____________________________________________________
OPEID Number _________ State _______
Part II. Application to Participate for Award Year July 1, 2018 through June 30, 2019
Section A. Request for Funds for the 2018-2019 Award Year
1. Federal Perkins Loan Level of Expenditures $ _________
2. Federal Perkins Loan Federal Capital Contribution $ _________
3. FSEOG federal funds $ _________
4. FWS federal funds $ _________
Section B. Federal Perkins Loan Program Liquidation Request
(Applies only to certain schools; see instructions)
5. My school wishes to liquidate its Federal Perkins Loan Program portfolio. __ yes __ no
Section C. Waiver Request for the Underuse of Funds
My school has returned more than 10 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the 2016-2017 award year.
6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional Information screen, a written explanation of the circumstances. __ yes __ no
Application to Participate, Part II (continued)
Name of School _____________________________________________________
OPEID Number _________ State _______
Part II. Application to Participate for Award Year July 1, 2018 through June 30, 2019
Section D. Information on Enrollment
My school’s calendar is __Traditional __Non-Traditional
Schools with a traditional calendar that had 2016-2017 enrollment, fill in Field 7.
7. Total number students, 2016-2017 (a) Undergraduate ____________ (b) Graduate/Professional ____________
Schools with a traditional calendar that did not have 2016-2017 enrollment, fill in Field 8.
8. Estimated number students, 2017-2018 (a) Undergraduate ____________ (b) Graduate/Professional ____________
Schools with a non-traditional calendar that had 2016-2017 enrollment, fill in fields 9 through 20.
Undergraduate Undergraduate Graduate/Professional Graduate/Professional
Continuing Students New Starts Continuing Students New Starts
(a) (b) (c) (d)
9. July 1, 2016 ____________ ____________ ____________ ____________
10. August 1 ____________ ____________ ____________ ____________
11. September 1 ____________ ____________ ____________ ____________
12. October 1 ____________ ____________ ____________ ____________
13. November 1 ____________ ____________ ____________ ____________
14. December 1 ____________ ____________ ____________ ____________
15. January 1, 2017 ____________ ____________ ____________ ____________
16. February 1 ____________ ____________ ____________ ____________
17. March 1 ____________ ____________ ____________ ____________
18. April 1 ____________ ____________ ____________ ____________
19. May 1 ____________ ____________ ____________ ____________
20. June 1 ____________ ____________ ____________ ____________
21. TOTAL ____________ ____________ ____________ ____________
Section E. Assessments and Expenditures
Undergraduate (a) Graduate/Professional (b)
22. Total tuition and fees for the award year July 1, 2016 to June 30, 2017 $____________ $____________
23. Total Federal Pell Grants expenditures for the 2016-2017 award year $____________
24. Total expended for state grants and scholarships made to
undergraduates for the award year July 1, 2016 to June 30, 2017 $____________
Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year 2016-2017
Dependent Undergraduate Independent Undergraduate Independent
Without Baccalaureate/ With Baccalaureate Without Baccalaureate/ With Baccalaureate/ Graduate/
1st Prof. Degree (a) 1st Prof. Degree (b) 1st Prof Degree (c) 1st Prof. Degree (d) Professional (e)
25. Students with an
“Automatic” Zero EFC ____________ ____________ ____________ ____________ ____________
Taxable and Untaxed Income Taxable and Untaxed Income
26. $0 - $2,999 ___________ ___________ $0 - $999 ___________ ___________ ___________
27. $3,000 - $5,999 ___________ ___________ $1,000 - $1,999 ___________ ___________ ___________
28. $6,000 - $8,999 ___________ ___________ $2,000 - $2,999 ___________ ___________ ___________
29. $9,000 - $11,999 ___________ ___________ $3,000 - $3,999 ___________ ___________ ___________
30. $12,000 - $14,999 ___________ ___________ $4,000 - $4,999 ___________ ___________ ___________
31. $15,000 - $17,999 ___________ ___________ $5,000 - $5,999 ___________ ___________ ___________
32. $18,000 - $23,999 ___________ ___________ $6,000 - $7,999 ___________ ___________ ___________
33. $24,000 - $29,999 ___________ ___________ $8,000 - $9,999 ___________ ___________ ___________
34. $30,000 - $35,999 ___________ ___________ $10,000 - $11,999 ___________ ___________ ___________
35. $36,000 - $41,999 ___________ ___________ $12,000 - $13,999 ___________ ___________ ___________
36. $42,000 - $47,999 ___________ ___________ $14,000 - $15,999 ___________ ___________ ___________
37. $48,000 - $53,999 ___________ ___________ $16,000 - $17,999 ___________ ___________ ___________
38. $54,000 - $59,999 ___________ ___________ $18,000 - $19,999 ___________ ___________ ___________
39. $60,000 and over ___________ ___________ $20,000 and over ___________ ___________ ___________
40. TOTAL ___________ ___________ TOTAL ___________ ___________ ___________
Fiscal Operations Report, Part III
Name of School _____________________________________________________
OPEID Number _________ State _______
Part III. Federal Perkins Loan Program for Award Year July 1, 2016 through June 30, 2017
Section A. Fiscal Report (Cumulative) as of June 30, 2017
Field Item Amount Number of Borrowers Debit Balances Credit Balances
(a) (b) (c) (d)
1.1. Cash on hand and in depository as of 6/30/2017 $__________
1.2. Cash on hand and in depository as of 10/31/2017 $_________
2. Funds receivable from federal government $__________
3. Funds receivable from school $__________
4. Funds advanced to students _________________ $__________
5. Loan principal collected _________________ $__________
6. Loan principal assigned to and accepted by the United
States _________________ $__________
Loan principal canceled for the following categories:
7. teaching/military service (applies to loans made prior to
07/01/1972) _________________ $__________
8. certain subject matter teaching service (math,
science, foreign languages, bilingual education) _________________ $__________
9. all other authorized pre-K or K-12 teaching service _________________ $__________
10. military service (applies to loans made 07/01/1972 and after) _________________ $__________
11. volunteer service _________________ $__________
12. law enforcement and corrections officer service _________________ $__________
13. child/family/early intervention service _________________ $__________
nurse/medical technician service ____________________ $____________
pre-K or child care program staff member service ____________________ $____________
service as an attorney in a public defender organization ____________________ $____________
fire fighter service ____________________ $____________
Tribal College or University faculty service ____________________ $____________
librarian service ____________________ $____________
speech-language pathology service ____________________ $__________
21. death/disability _________________ $__________
22. disability based on VA determination _____________________ $____________
23. bankruptcy _________________ $__________
24. surviving spouses of public service victims of 9-11 terrorist attacks _________________ $__________
25. loans discharged due to closed schools _________________ $__________
26. Loan principal adjustments – other _________________ $__________
27. Federal Capital Contributions $__________
28. Repayments of fund capital to federal government $__________
29.1. Short-term loans to the Fund $___________
29.2. ICC deposited to the Fund $___________
29.3. Institutional Capital Contributions $__________
30.1. Repayment of short-term loans to the fund $___________
30.2. Repayments of excess/liquidated fund capital to Institution $___________
30.3.Repayments of fund capital to school $__________
31. Interest income on loans $__________
32. Other income $__________
33. Reimbursements to the Fund of the amounts canceled
on loans made 07/01/1972 and after $__________
34.1. Administrative cost allowance $_________
34.2. Collection costs $_________
34.3. Administrative cost allowance and collection costs (control) $__________
Cost of loan principal and interest canceled for the following categories:
35. teaching/military service (applies to loans made prior to
07/01/1972) $__________
36. certain subject matter teaching service (math, science,
foreign languages, bilingual education) $__________
37. all other authorized pre-K or K-12 teaching service (applies to loans made
07/01/1972 and after) $__________
38. military service (applies to loans made 07/01/1972 and after) $__________
39. volunteer service in the Peace Corps or under the
Domestic Volunteer Service Act of 1973 $__________
Fiscal Operations Report, Part III (continued)
Name of School _____________________________________________________
OPEID Number _________ State _______
Part III. Federal Perkins Loan Program for Award Year July 1, 2016 through June 30, 2017
Section A. Fiscal Report (Cumulative) as of June 30, 2017
Field Item Amount Number of Borrowers Debit Balances Credit Balances
(a) (b) (c) (d)
40. law enforcement and corrections officer service $__________
41. child/family/early intervention service $__________
42. nurse/medical technician service $__________
43. pre-K or child care program staff member service $____________
service as an attorney in a public defender organization $____________
fire fighter service $____________
Tribal College or University faculty service $____________
librarian service $____________
speech-language pathology service $____________
49. death/disability $__________
50. VA disability determination $____________
51. bankruptcy $__________
52. surviving spouses of public service victims of 9-11 terrorist attacks $__________
53. Cost of loan principal and interest assigned to and accepted by the United States $__________
54. Cost of loan principal and interest canceled for loans discharged due to closed schools $__________
55. Other costs or losses $__________
56. Balancing Adjustments (Debits) $__________
57. Balancing Adjustments (Credits) $__________
58. Total debits and credits (Sum of fields 1.1 through 57) $__________ $__________
Section B. Fund Activity (Annual) During the 2016-2017 Award Year (July 1, 2016 through June 30, 2017)
Number of Borrowers Amount
(a) (b)
1. Final adjusted Federal Capital Contribution (FCC) authorization $__________
2. FWS funds transferred to the Fund +$___________
3. FCC transferred to:
(a) FSEOG -$__________
(b) FWS -$__________
4. Total federal funds available for the 2016-2017 award year (fields 1 + 2 – 3(a) – 3(b)) $__________
5. The unexpended amount of final adjusted authorized FCC for award year 2016-2017
that was NOT requested from G5 by June 30, 2017. This amount will be reduced
from your total award amount next spring (see instructions). $__________ 6. Institutional Capital Contribution (ICC) deposited into the Fund between July 1,
2016 and June 30,2017 $__________
7. Loans advanced to students from the Fund during the 2016-2017 award year
(minus 2016-2017 award year refunds) $__________
8. Administrative cost allowance claimed for the 2016-2017 award year (see
instructions) $__________
9. Total principal and interest repaid by borrowers from all sources during the 2016-2017 award year _________________ $__________
10. Total principal repaid by borrowers from all sources during the 2016-2017 award
year for loans in default for more than 2 years but not more than 5 years _________________ $__________
11. Total principal repaid by borrowers from all sources during the 2016-2017 award
year for loans in default for more than 5 years _________________ $__________
Fiscal Operations Report, Part III (continued)
Name of School _____________________________________________________
OPEID Number _________ State _______
Part III. Federal Perkins Loan Program for Award Year July 1, 2016 through June 30, 2017
Section C. Cumulative Repayment Information as of June 30, 2017
Status of Borrowers as of June 30, 2017
Amount Number of Amount Lent Principal Amount
Borrowers Outstanding
(a) (b) (c) (d)
1.1. Borrowers whose loans are fully retired ________ $__________
1.2. Loans that have been purchased $_________
2. Borrowers whose loans were assigned to and officially accepted
by the U.S. Department of Education as of June 30, 2017
(Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) ________ $__________ $____________
2.1. Assignments due to default or liquidation ________ $__________ $____________
2.2. Assignments due to total and permanent disability discharge ________ $__________ $____________
3. Total borrowers not in repayment status ________ $____________
4. Borrowers on schedule in repayment status ________ $____________
5.1. In default less than 240 days (monthly installments) or less than
270 days (other installments) ________ $__________ $____________
5.2. In default 240 days or more (monthly installments) or 270 days
or more (other installments), up to 2 years ________ $__________ $____________
5.3. In default more than 2 years but not more than 5 years ________ $__________ $____________
5.4. In default more than 5 years ________ $__________ $____________
Cohort Default Rate (Sections D and E)
Schools with fewer than 30 borrowers who entered repayment in the 2015-2016 award year should skip to Section E.
Section D. Schools with 30 or More Borrowers Who Entered Repayment in the 2015-2016Award Year
1.1. Number of borrowers who entered repayment in 2015-2016 __________________________
1.2. Number of borrowers from Field 1.1 above with loans in default by June 30, 2017 __________________________
1.3. Cohort default rate ((Field 1.2 / Field 1.1) x 100) __________________________
Section E. Schools with Fewer than 30 Borrowers Who Entered Repayment in the 2015-2016 Award Year
2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by:
(a) 2013-2014 (07/01/2013-06/30/2014) __________ (a) June 30, 2015(those in 2.1(a) only) __________
(b) 2014-2015 (07/01/2014-06/30/2015) __________ (b) June 30, 2016 (those in 2.1(b) only) __________
(c) 2015-2016 (07/01/2015-06/30/2016) __________ (c) June 30, 2017 (those in 2.1(c) only) __________
2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1(b) + 2.1(c)) __________
2.4. Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c)) __________
2.5. Cohort default rate ((Field 2.4 / Field 2.3) x 100) __________
Fiscal Operations Report, Part IV
Name of School _____________________________________________________
OPEID Number _________ State _______
Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 2016 through June 30, 2017
Section A. Federal Funds Authorized for FSEOG
1. Final adjusted FSEOG authorization $____________
Section B. Federal Funds Available for FSEOG Expenditures
2. FWS funds transferred to and spent in FSEOG +$____________
3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG +$____________
4. FSEOG funds transferred to and spent in FWS -$___________
5. 2017-2018 FSEOG funds carried back and spent in 2016-2017 +$____________
6. Additional 2017-2018 FSEOG funds carried back and spent for 2017 summer enrollment +$____________
7. 2015-2016 funds carried forward and spent in 2016-2017 +$____________
8. 2016-2017 funds carried forward to be spent in 2017-2018 - $____________
9. 2016-2017 funds carried back and spent in 2015-2016 - $____________
10. Additional 2016-2017 funds carried back and spent for 2016 summer enrollment - $____________
11. Total federal funds available for 2016-2017 FSEOG
(fields 1 + 2 + 3 + 5 + 6 + 7) minus (fields 4 + 8 + 9 + 10) $____________
Section C. Funds to FSEOG Recipients
12. Total funds to FSEOG recipients (fields 13 + 14) $____________
13. Nonfederal share of funds to FSEOG recipients (25 percent of Field 12) $____________
(a) Cash outlay contributed $____________
(b) Other resources designated $____________
Section D. Federal Funds Spent for FSEOG Program
14. Federal share of funds to FSEOG recipients (75 percent of Field 12) $____________
15. Administrative cost allowance claimed (see instructions) +$____________
16. Federal funds spent for FSEOG (fields 14 + 15) $____________
Section E. Use of FSEOG Authorization
17. Expended FSEOG authorization (fields 4 + 8 + 9 + 10 + 16) minus (fields 2 + 3 + 5 + 6 + 7) $____________
18. Unexpended FSEOG authorization (Field 1 - Field 17) (cannot be negative) $____________
Fiscal Operations Report, Part V
Name of School _____________________________________________________
OPEID Number _________ State _______
Part V. Federal Work-Study (FWS) Program for Award Year July 1, 2016 through June 30, 2017
Section A. Federal Funds Authorized for FWS
1. Final adjusted FWS authorization $____________
Section B. Federal Funds Available for FWS Expenditures
2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS +$____________
3. FSEOG funds transferred to and spent in FWS +$_____________
4. FWS funds transferred to and spent in:
(a) FSEOG -$____________
(b) Federal Perkins Loan Program -$__________
(c) Work Colleges Program -$____________
5. 2017-2018 FWS funds carried back and spent in 2016-2017 +$____________
6. Additional 2017-2018 FWS funds carried back and spent for 2017 summer employment +$____________
7. 2015-2016 funds carried forward and spent in 2016-2017 +$____________
8. 2016-2017 funds carried forward to be spent in 2017-2018 - $____________
9. 2016-2017 funds carried back and spent in 2015-2016 - $____________
10. Additional 2016-2017 funds carried back and spent for 2016 summer employment - $____________
Total federal funds available for 2016-2017 FWS
(fields 1 + 2 + 3 + 5 + 6 + 7) minus (fields 4(a) + 4(b) + 4(c) + 8 + 9 + 10) $____________
Section C. Total Compensation for FWS
12. Total earned compensation for FWS Program $____________
(a) On-campus earned compensation $____________
(b) Off-campus earned compensation for public or private non-profit
agencies, excluding amounts reported in Field 12(c) $____________
(c) Off-campus earned compensation for agencies that were unable to pay
regular nonfederal share and had a federal share up to 90 percent $____________
(d) Off-campus earned compensation for private for-profit organizations $____________
13. Total institutional share of earned compensation (see instructions) $____________
Section D. Funds Spent from Federal Share of FWS
14. Total federal share of FWS earned compensation $____________
(a) Federal share paid at a rate up to 75 percent $____________
(b) Federal share paid at a rate up to 100 percent for waivers of
nonfederal share $____________
(c) Federal share paid at a rate up to 90 percent for agencies that were
unable to pay regular nonfederal share $____________
(d) Federal share paid at a rate up to 50 percent for off-campus, private
for-profit organizations $____________
15. Administrative cost allowance claimed (see instructions) +$____________
16. Federal share of Job Location and Development (JLD) Program expenditures +$____________
17. Total federal funds spent for FWS (fields 14 + 15 + 16) $____________
Fiscal Operations Report, Part V (continued)
Name of School _____________________________________________________
OPEID Number _________ State _______
Part V. Federal Work-Study (FWS) Program for Award Year July 1, 2016 through June 30, 2017
Section E. Use of FWS Authorization
18. Expended FWS authorization (fields 4(a) + 4(b) + 4(c) + 8 + 9 + 10 + 17) minus (fields 2 + 3 + 5 + 6 + 7) $____________
19. Unexpended FWS authorization (Field 1 - Field 18) $____________
Section F. Information About the Job Location and Development (JLD) Program
20. Total expenditures for the JLD Program $____________
21. Institutional expenditures for the JLD Program (see instructions) $____________
22. Number of students for whom jobs were located or developed ____________
23. Total earnings of the students in Field 22 above $____________
Section G. Information About FWS Students Employed in Community Service Activities
24. Number of students in community service employment _____________
25. Federal share of community service earned compensation $____________
26. Nonfederal share of community service earned compensation $____________
Section H. Information About FWS Students Employed as Reading Tutors of Children or Employed in
Family Literacy Activities
27. Number of FWS students employed as reading tutors of children or employed in family literacy
activities _____________
28. Federal share of earned compensation for FWS students employed as reading tutors of children
or employed in family literacy activities $____________
(a) Amount of the federal share in Field 28 spent on community service
employment $____________
29. Total earned compensation for FWS students employed as reading tutors of children or employed
in family literacy activities $____________
Section I. Information About FWS Students Employed as Mathematics Tutors of Children
30. Number of FWS students employed as mathematics tutors of children _____________
31. Federal share of earned compensation for FWS students employed as mathematics tutors of
children $____________
32. Total earned compensation for FWS students employed as mathematics tutors of children $____________
Section J. Information About FWS Students in Civic Education and Participation Activities
33. Number of students in civic education and participation activities _______________
34. Federal share spent for students in civic education and participation activities $______________
35. Total spent for students in civic education and participation activities $______________
Section K. Information About FWS Disaster-Affected Students
36. Number of disaster-affected students receiving FWS funds _______________
37. Federal share of funds to disaster-affected students $______________
38. Total funds to disaster-affected students $______________
Fiscal Operations Report, Part VI
Name of School _____________________________________________________
OPEID Number _________ State _______
Part VI. Program Summary for Award Year July 1, 2016 through June 30, 2017
Section A. Distribution of Program Recipients and Expenditures by Type of Student
Taxable and Untaxed Federal Perkins Loan FSEOG FWS Unduplicated
Income Category Recipients Funds Recipients Funds Recipients Funds Recipients
Student Type (a) (b) (c) (d) (e) (f) (g)
Undergraduate
Dependent
1. $0 - $ 5,999 _________ _________ _________ _________ _________ _________ _________
2. $6,000 - $11,999 _________ _________ _________ _________ _________ _________ _________
3. $12,000 - $23,999 _________ _________ _________ _________ _________ _________ _________
4. $24,000 - $29,999 _________ _________ _________ _________ _________ _________ _________
5. $30,000 - $41,999 _________ _________ _________ _________ _________ _________ _________
6. $42,000 - $59,999 _________ _________ _________ _________ _________ _________ _________
7. $60,000 - $69,999 _________ _________ _________ _________ _________ _________ _________
8. $70,000 - $79,999 _________ _________ _________ _________ _________ _________ _________
9. $80,000 - $89,999 _________ _________ _________ _________ _________ _________ _________
10. $90,000 - $99,999 _________ _________ _________ _________ _________ _________ _________
11. $100,000 and over _________ _________ _________ _________ _________ _________ _________
Undergraduate
Independent
12. $0 - $ 1,999 _________ _________ _________ _________ _________ _________ _________
13. $2,000 - $ 3,999 _________ _________ _________ _________ _________ _________ _________
14.. $4,000 - $ 7,999 _________ _________ _________ _________ _________ _________ _________
15. $8,000 - $11,999 _________ _________ _________ _________ _________ _________ _________
16. $12,000 - $15,999 _________ _________ _________ _________ _________ _________ _________
17. $16,000 - $19,999 _________ _________ _________ _________ _________ _________ _________
18. $20,000 - $24,999 _________ _________ _________ _________ _________ _________ _________
19. $25,000 - $29,999 _________ _________ _________ _________ _________ _________ _________
20. $30,000 - $34,999 _________ _________ _________ _________ _________ _________ _________
21. $35,000 - $39,999 _________ _________ _________ _________ _________ _________ _________
22. $40,000 and over _________ _________ _________ _________ _________ _________ _________
23. Graduate/Professional _________ _________ does not apply does not apply _________ _________ _________
24. TOTAL (fields 1-23) _________ _________ _________ _________ _________ _________ _________
25. Total less-than-full-time
students
(from fields 1-23) _________ _________ _________ _________ _________ _________ _________
26. Total “Automatic” Zero
EFC students
(from fields 1-23) _________ _________ _________ _________ _________ _________ _________
Fiscal Operations Report, Part VI (continued)
Name of School _____________________________________________________
OPEID Number _________ State _______
Part VI. Program Summary for Award Year July 1, 2016 through June 30, 2017
Section B. Calculating the Administrative Cost Allowance
Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews)
Step 1. Calculate the amount spent in 2016-2017 on which the administrative cost allowance is based.
1. Total compensation in FWS (amount from Part V, Section C, Field 12) $____________
2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 7) +$____________
3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 12) +$____________
4. Total amount spent (fields 1 + 2 + 3) $____________
Step 2. Calculate the administrative cost allowance.
Schools whose total amount spent was $2,750,000 or less
5. Enter total amount spent (Field 4) $____________
6. Multiply x 0.05
7. Total administrative cost allowance—go to Step 3 $____________
Schools whose total amount spent was more than $2,750,000 but less than $5,500,000
8. Enter total amount spent (Field 4) $____________
9. Subtract - $ 2,750,000
10. Expenditures over $2,750,000 (Field 8 - Field 9) $____________
11. Multiply x 0.04
12. Administrative cost allowance on expenditures over $2,750,000 (Field 10 x Field 11) $____________
13. Add administrative cost allowance on expenditures of $2,750,000 ($2.75 million x .05) +$ 137,500
14. Total administrative cost allowance (Field 12 + Field 13)—go to Step 3 $____________
Schools whose total amount spent was $5,500,000 or more
15. Enter total amount spent (Field 4) $____________
16. Subtract - $ 5,499,999
17. Expenditures of $5,500,000 or more (Field 15 - Field 16) $____________
18. Multiply x 0.03
19. Administrative cost allowance on expenditures of $5,500,000 or more (Field 17 x Field 18) $____________
20. Add administrative cost allowance on expenditures less than $5,500,000 (($2.75 million x .05) + Field 12) +$ 247,500
21. Total administrative cost allowance (Field 19 + Field 20)—go to Step 3 $____________
Step 3. Decide how much administrative cost allowance your school claimed.
22. How much administrative cost allowance did your school claim? (The amount may be the same or less
than the amount calculated in Step 2.) $____________
23. How much administrative cost allowance did your school claim in each program?
(a) Federal Perkins Loan (must be the same as Part III, Section B, Field 8) $____________
(b) FSEOG (must be the same as Part IV, Section D, Field 15) $____________
(c) FWS (must be the same as Part V, Section D, Field 15) $____________
FISAP
Version:
Page A-
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | 2013-2014 FISAP Form Rel 13.0 |
| Author | Gay, Tammy |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |