Appendix

Appendix-ACF OGM PPR.docx

Generic Performance Progress Report

Appendix

OMB: 0970-0490

Document [docx]
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Shape1 Shape2 Shape3 Shape4 Shape5 Shape6 Shape7 Shape8 Shape9 Shape10 Shape11 Shape12 Shape13 ACF PERFORMANCE PROGRESS REPORT

ACF-OGM-PPR Cover Page

Administration for Children and Families

Shape14 Shape15 Shape16 Shape17 Shape18 U.S. Department of Health and Human Services



Page

of Pages

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

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

3a. DUNS Number

3b. EIN

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

5. Recipient Identifying Number or Account Number

6. Project/Grant Period

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

8. Final Report? Yes

No

Start Date: (Month, Day, Year)

End Date: (Month, Day, Year)

9. Report Frequency

annual semi-annual

quarterly other (If other, describe)

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

11. 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.

11a. Typed or Printed Name and Title of Authorized Certifying Official

11c. Telephone (area code and number) extension

11d. Email Address

11b. Signature of Authorized Certifying Official

11e. Date Report Submitted (Month, Day, Year)


12. Agency use only


Shape19 OMB Approval Number: 0970-0490 Expiration Date: 1/31/2020

ACF-OGM-PPR

COVER PAGE INSTRUCTIONS


Administration for Children and Families

U.S. Department of Health and Human Services




Item

Data Elements

Instructions

1.

Awarding Federal Agency and Organizational Element to Which Report is Submitted


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 the sub-agency within an awarding Federal agency.

2.

Federal Grant or Other

Identifying Number Assigned by the awarding Federal agency


Enter the grant/award number contained in the award document.

3a.

DUNS Number


Enter the recipient organization’s Data Universal Numbering System (DUNS) number or System for Award Management (SAM) extended DUNS Number.

3b.

EIN


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

4.

Recipient Organization


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

5.

Recipient Account Number or Account 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.

6.

Project/Grant Period

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 increment 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.

7.

Reporting Period End Date

Enter the ending date of the reporting period. For quarterly, semi-annual, and

annual reports, the following calendar quarter period end dates shall be used: 3/31; 6/30; 9/30; and 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.

8.

Final Report


Mark appropriate box. Check “yes” only if this is the final report for the project/grant period specified in Box 6.

9.

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 A-110.

10.

Performance Narrative

Leave blank and complete Form ACF-OGM SF PPR Attachment B

Shape21 Shape22 Shape23 Shape24

Shape25 Shape26 Shape27 Shape28 PPR-OGM-B


Page

of Pages

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

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

3a. DUNS

4. Reporting Period End Date (MM/DD/YYYY)

3b. EIN


Program Indicators

(1)

Item

(2)

Activity Description

(3)

Indicator

(4)

Explanation







B-01





Major activities and accomplishments during this period








B-02





Problems








B-03





Significant findings and events



Shape30 Shape31







B-04






Dissemination activities









B-05






Other Activities









B-06





Activities planned for next reporting period





Shape32 OMB NO: 0970-0490 EXPIRATION DATE: 1/31/2020


INSTRUCTIONS


Schedule


Submit the original progress report to the Office of Grants Management, Division of Discretionary Grants, and a copy to the Program Office. Reports are due 30 days after the end of the second and fourth quarters of the budget period (every six months).


A FINAL PROGRAM REPORT IS DUE 90 DAYS AFTER THE PROJECT PERIOD END DATE.


Item

Data Elements

Instructions



1


Awarding Federal agency and Organizational Element to Which Report is Submitted


Enter the name of the awarding Fede ral 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.



2


Federal Grant or Other Identifying Number Assigned by the award ing Federal agency



Enter the grant/award number contained in the award document.

3a

DUNS Number

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


3b


EIN

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




4




Reporting Period End Date

Enter the ending date of the reporting period. For quarterly, semi -annual, and annual reports, the following calendar quar ter 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.

Program Indicators


B-01(4)


Major activities and accomplishments during this period

Recommend use of project task charts from approved grant application and/or project work plan with this section. Describe any draft/final products in this section. Use additional pages if needed.



B-02(4)



Problems

Describe any deviations or departures from the original project plan including actual/anticipated slippage in task completion dates, and special problems encountered or expected. Use this report section to adv ise Project Officer and Grants Management Specialist of assistance needs. Use additional pages if needed.


B-03(4)


Significant findings and events

(To be noted by project officer, or reported to regions, States, other agencies, Program Director/Commissione r, Assistant Secretary, Secretary, etc.) Use additional pages if needed.



B-04(4)



Dissemination activities

Briefly describe project related inquiries and information dissemination activities carried out over the reporting period. Itemize and include a cop y of any newspaper, newsletter, magazine articles or other published materials considered relevant to project activities, or used for project information or public relations purposes. Use additional pages if needed.

B-05(4)

Other Activities

Briefly describe. Use additional pages if needed.


B-06(4)


Activities planned for next reporting period


Briefly describe. Use additional pages if needed.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)


Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, 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.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleACF-OGM-PPR Cover Page and Form B Program Indicators and Instructions
SubjectACF-OGM-PPR Cover Page and Form B Program Indicators and Instructions
AuthorLatasha N. Abney
File Modified0000-00-00
File Created2021-01-20

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