Budget Form

IMLSBUDGETFORM-modified062916-Fillable-C-S.PDF

Generic Clearance for IMLS Grant Forms: Budget Form, Program Information Sheet, and Digital Product Form, EGMS PIS Supplementary Sheet, eGMS Abstract form

Budget Form

OMB: 3137-0092

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IMLS BUDGET FORM 
a.

Legal name (5a from SF‐424S):

b.

Requested Grant Period From: (MM/DD/YYYY)

c.

If this is a revised budget, indicate application/grant number/date of revision:

   Through: (MM/DD/YYYY) 

1. Salaries and Wages
Name/Title or Position 

Year 1 
Grant Funds Cost  Share

Year 2 
Grant Funds Cost Share

Year 1 
Grant Funds Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Subtotal 

2. Fringe Benefits
Rate and Base

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Subtotal 
OMB Control #: 3137-0092, Expiration date: 7/31/2018

IMLS-CLR-F-0030

IMLS BUDGET FORM 
a.

Legal name (5a from SF‐424S):

3. Travel
From/To and Purpose 

Year 1 
Grant Funds Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Year 1 
Grant Funds Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Year 1 
Grant FundƐ CostShare

Year 2 
GrantFundƐ CostShare

Year 3 
GrantFundƐ Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Subtotal 

4. Supplies, Materials, and Equipment
Item 

Subtotal 

5. Contracts and Subawards
Item 
Subaward

Subaward

Subaward

Subaward
Subaward
Subaward
Subaward

Subtotal 
OMB Control #: 3137-0092, Expiration date: 7/31/2018

IMLS-CLR-F-0030

IMLS BUDGET FORM 
a.

Legal name (5a from SF‐424S):

6. Student Support
Item 

Year 1 
Grant Funds Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Year 1 
Grant Funds Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Year 1 
Grant FundƐ Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Grant Funds

Total 
Cost Share

Grand Total

Subtotal 

7. Other Costs
Item 

Subtotal 

8. Total Direct Costs

Subtotals (Items 1‐7)

OMB Control #: 3137-0092, Expiration date: 7/31/2018

IMLS-CLR-F-0030

IMLS BUDGET FORM 
a.

Legal name (5a from SF‐424S):

9. Indirect Costs (Read the instructions about Indirect Costs before completing this section.)
Current indirect cost rate(s) have been negotiated with a federal agency. 

Name of Agency: 

Indirect cost proposal has been submitted to a federal agency but not yet 
finalized

Name of Agency:

 

Expiration Date:
Proposal Date: 

Applicant chooses a rate not to exceed 10% of modified total direct costs, and declares it is eligible for the 10% rate. 
Applicant chooses not to include indirect costs.

Rate and Base 

Year 1 
Grant Funds Cost Share

Year 2 
Grant Funds Cost Share

Year 3 
Grant Funds Cost Share

Year 1 
Grant FundƐ CostShare

Year 2 
GrantFundƐ CostShare

Year 3 
GrantFundƐ CostShare

Grant Funds

Total 
Cost Share

Grand Total

GrantFundƐ

Total 
Cost Share

Grand Total

Indirect Costs Subtotal 

10. Total Project Costs

Total Direct & Indirect Costs 
Total Costs (excluding 
student support) 

OMB Control #: 3137-0092, Expiration date: 7/31/2018

IMLS-CLR-F-0030


File Typeapplication/pdf
File TitleMicrosoft Word - IMLSBUDGETFORM
Authorjmeade
File Modified2016-06-29
File Created2014-06-26

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