FY19 Interim Perfo FY 19 Interim Performance Report

INTERIM PERFORMANCE REPORT

For Projects with Award Dates after October 1, 2019

Burden Estimate and Request for Public Comments. Send comment regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Institute of Museum and Library Services, , 955 L’Enfant Plaza North, SW, Suite 4000, Washington, DC 20024-2135. Approved as OMB No. 3137-0100, expires TBD. IMLS-CLR-F-0022.

Please consult the IMLS Interim Performance Report Line Item Instructions when filling out this form.

1. Federal agency and organization element to which report is submitted: Institute of Museum and Library Services		2. Federal award or other identifying number assigned by federal agency:			Page	of Pages
					3a. DUNS number:
					3b. EIN/TIN:
4. Recipient organization (name and complete address, including ZIP+4/postal code):					5. Recipient identifying or account number:
6a. Award period of performance start date (MM/DD/YYYY):	6b. Award period of performance end date (MM/DD/YYYY):			7. Reporting period end date (MM/DD/YYYY):
8. Project URLs, if any:					9. Report frequency: ☐ annual ☐ semi-annual ☐ quarterly ☐ other If other, describe:
10. Other attachments? ☐ Yes ☐ No Contact the appropriate IMLS program office to receive instructions for transmitting additional attachments.
11a. Name and title of Project Director:			11b. Telephone (area code, number, extension):
			11c. Email address:
12. Certification: By submitting this report, I certify to the best of my knowledge and belief that the information contained within this report is accurate and complete.
13a. Signature of Authorized Certifying Official:			13b. Date report submitted (MM/DD/YYYY):
13c. Name and title of Authorized Certifying Official:				13d. Telephone (area code, number, extension):

The purpose of the Interim Performance Report is to provide a record of grant-funded project activities at annual intervals throughout the grant period. If you have questions concerning the interim performance reporting requirements, you may address them to the Program Officer assigned to your grant and whose name and contact information appears in your Official Award Notification. IMLS may share Interim Performance Reports with grantees, potential grantees, and the general public to further the mission of the agency and the development of museum and library services. Reports may be distributed in a number of ways and formats, including online.

14. Project Title:

15. Project Summary:

16. Objectives and Accomplishments

Objectives and Accomplishments	Comparison of Actual Accomplishments to the Objects of the Federal Award	Reason why Established Accomplishments were not met

17. Changes in the Project (that had a significant impact on supported activities)

Type of Change	Description	Date of Approval (if applicable)

1

OMB No. 3137-0071, EXPIRES 01/31/2019 IMLS-CLR-F-0022