Form FEMA Form 009-0-11 FEMA Form 009-0-11 Quarterly Progress Report

OMB No. 1660-0017

Expiration Date: July 31 2016

PRIVACY ACT STATEMENT AUTHORITY: The Robert T. Stafford Disaster Relief and Emergency Assistance Act as amended, 42 U.S.C. §§ 5170 and 5172. PRINCIPAL PURPOSE(S): This information being collected via Excel Spreadsheet is for the primary purpose of monitoring status of Grantees’ disaster Public Assistance projects. ROUTINE USE(S): The information on this form may be disclosed as generally permitted under the Freedom of Information Act and 5 U.S.C. 552, and 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by routine uses published in DHS/FEMA-004 Grant Management Information Files System of Records, 74 Fed. Reg. 39705 (August 7, 2009) and upon written request, by agreement, or as required by law. DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may delay or prevent the individual from receiving disaster services and/or assistance.

PAPERWORD REDUCTION ACT BURDEN DISCLOSURE NOTICE Public reporting burden for this spreadsheet is estimated to average 100 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the spreadsheet. This collection of information is required to obtain or retain a benefit. You are not required to respond to this collection of information unless it displays a valid OMB control number near the title of the electronic collection instrument, or for on-line applications, on the first screen viewed by the respondents. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (1660-0017) NOTE: Do not send your completed form to this address.

Region

State

Disaster Number

Sub-grantee Name

Applicant ID

Project #

Latest Version Number

Category

Project Title

Total Eligible

Federal Share Obligated

Date Obligated

Applicant Expenditures To Date

Total Grantee Drawdown

Date of Last Drawdown

Federal Funds Disbursed

Date Final Payment Made to Applicant

Approved Completion Date

Time Ext.

Pct Work Complete

Actual Completion Date

Comments

Calculation of UDO

Excess funds Yes-No

Deobligation Amount

Final Report Y/N

FEMA Comments