Att 1_PPMR Instrument

Att1 PPMRInstrument.pdf

National HIV Surveillance System (NHSS)

Att 1_PPMR Instrument

OMB: 0920-0573

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PERFORMANCE PROGRESS and MONITORING REPORT (PPMR)
OMB Control #0920-1132 Expiration: 08/31/2019

Page
1.Federal Agency and Organization Element to
Which Report is Submitted

2. Federal Grant or Other Identifying
Number Assigned by Federal Agency

of
Pages

3a. DUNS Number
3b. EIN

4. Recipient Organization (Name and complete address including zip code)

6. Project/Grant Period
Start Date: (Month, Day, Year)

5. Recipient Identifying Number or
Account Number

7. Reporting Period End Date
End Date: (Month, Day, Year)

8. Final Report?

(Month, Day, Year)

Yes
No

9. Report Frequency annual
semiannual
quarterly
other (If
other, describe: __________
__________________________)

10. Performance Narrative (attach performance narrative as instructed by the awarding Federal Agency)

11. Other Attachments
(attach other documents as needed or as instructed by the awarding Federal Agency)
12. Certification: I certify to the best of my knowledge and belief that this report is correct and complete for
performance of activities for the purposes set forth in the award documents.
12a. Typed or Printed Name and Title of Authorized Certifying Official

12c. Telephone (area code, number and
extension)
12d. Email Address

12e. Date Report Submitted (Month, Day,
Year)

12b. Signature of Authorized Certifying Official

13. Agency use only

Public reporting burden of this collection of information is estimated to average 2 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. An agency
may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control
number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS E-11, Atlanta, Georgia 30333; ATTN: PRA (0920-1132).

1

Performance Progress and Evaluation Report (PPER) Instructions
The Performance Progress and Evaluation Report (PPER) is a standard, CDCwide performance progress and evaluation reporting format used by the
Procurement and Grants Office (PGO) to collect performance information from
recipients of CDC funds awarded under all CDC programs, excluding those that
support research. General instructions for completing the PPER are contained
below. For further instructions on completing the PPER, please contact the
agency’s points of contact specified in the "Agency Contacts" section of your
award document.

Report Submissions
1. The recipient must submit the PPER cover page and any of the forms
(PPER A-F), which CDC requires, as specified in the award terms and
conditions.
2. The PPER must be submitted to the attention of the agency’s points of
contact specified in the "Agency Contacts" section of the award document
in accordance with the requirements established in the award document.
3. If additional space is needed to support the PPER, supplemental pages
should be attached. The additional pages must indicate the following at
the top of each page: Federal Grant or other Identifying Award Number,
Recipient Organization, DUNS Number, EIN, and period covered by the
Report. Page numbers should be used if a particular page is used more
than once.
Reporting Requirements
1. All recipients of grants or cooperative agreements awarded under all CDC
programs, excluding those that support research, are required to submit a
PPER in accordance with the terms established in the award document.
2. The PPER will be submitted in accordance with program guidance and
award terms and conditions which may be quarterly, semi-annual, or
annual. A final PPER shall be required at the completion of the award
agreement.
3. For interim PPERs, due dates will be in accordance with program guidance based
on required reporting frequency and budget period start dates. .
4. For final PPERs due dates are required not later than 90 days after the end of the
reporting period end date.

2

Performance Progress and Evaluation Report

Item
1

Data Elements
Awarding Federal agency
and Organizational
Element to Which Report
is Submitted

2

3a

Federal Grant or Other
Identifying Number
Assigned by the awarding
Federal agency
DUNS Number

3b

EIN

Enter the recipient organization's Employer Identification Number (EIN)
provided by the Internal Revenue Service.

4

Recipient Organization

Enter the name of recipient organization and address, including zip code.

5

Recipient Account
Number or Account
Number
Project/Grant Period

6

7

8
9

Line Item Instructions for PPER
Enter the name of the awarding Federal agency and organizational
element identified in the award document or otherwise instructed by the
agency. The organizational element is a sub-agency within an awarding
Federal agency.
Enter the grant/award number contained in the award document.

Enter the recipient organization's Data Universal Numbering System
(DUNS) number or Central Contract Registry extended DUNS number.

Enter the account number or any other identifying number assigned by the
recipient to the award. This number is strictly for the recipient's use only
and is not required by the awarding Federal agency.
Indicate the project/grant period established in the award document during
which Federal sponsorship begins and ends. Note: Some agencies award
multi-year grants for a project/grant period (e.g., 5 years) that are funded in
increments known as budget periods or funding periods. These are
typically annual increments. Please enter the project/grant period, not the
budget period or funding period.
Reporting Period End Date Enter the ending date of the reporting period. For quarterly, semi-annual,
and annual reports, the following calendar quarter reporting period end
dates shall be used: 3/31; 6/30; 9/30; and or 12/31. For final PPRs, the
reporting period end date shall be the end date of the project/grant period.
The frequency of required reporting is usually established in the award
document.
Final Report
Mark appropriate box. Check “yes” only if this is the final report for the
project/grant period specified in Box 6.
Report or Frequency

Select the appropriate term corresponding to the requirements contained in
the award document. “Other” may be used when more frequent reporting is
required for high-risk grantees, as specified in OMB Circular A110.

10

Performance Narrative

11

Other Attachments

Attach performance narrative as instructed by the awarding Federal
agency.
Attach other documents as needed or as instructed by the awarding
Federal agency.

3

Performance Progress and Evaluation Report

Item
Data Elements
Line Item Instructions for PPER
Remarks, Certification, and Agency Use Only
12a
12b
12c
12d
12e

13

Typed or Printed Name
and Title of Authorized
Certifying Representative
Signature of Authorized
Certifying Official
Telephone (area code,
number and extension)
Email Address

Authorized certifying official of the recipient.

Date Report Submitted
(Month, Day, Year)

Enter date submitted to the awarding Federal agency. Note: Report must
be received by the awarding Federal agency no later than 90 days after the
end of the reporting period.
This section is reserved for the awarding Federal agency use.

Agency Use Only

Original signature of the recipient's authorizing official.
Enter authorized official's telephone number.
Enter authorized official's email address.

4


File Typeapplication/pdf
File TitlePerformance Progress and Monitoring Report (PPMR)
SubjectGrant Form, Performance Progress Report, SF-PPR
AuthorCDC
File Modified2018-07-16
File Created2016-10-11

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