Basic 1 Native American Basic Performance Form FY20

Native American Library Services

Basic Grant

Performance Report Form

Use this form to submit your interim and final Performance Reports for the IMLS Native American Library Services Basic Grant. Reports are due according to the Reporting Schedule sent with your Grant Award Notification. If more space is required, continue on a separate piece of paper.

You should submit this report electronically in PDF format through your eGMS REACH account using the Form & Reports tab. If you have attachments, you may combine them into one PDF with your report form or send the attachments separately using the eGMS REACH Messages tab. PDF file size is limited to 100MB. IMLS does not accept emailed or faxed reports.

Grantee (Name of Tribe):

NG-

Grant number:

Amount of grant award:

Name of Project Director:

Telephone number of Project Director:

Library Services Plan

Describe how the grant funds were used to support library and information services. Any activities described should match those identified in the Library Services Plan approved when the grant was awarded. Please describe how you carried out your plan and if you achieved the results you anticipated. Please identify any significant differences between your approved Budget and your actual expenditures of the grant funds.

Education/Assessment Activities or Travel (if applicable)

Describe how the grant funds were used to support the following activities: attendance at continuing education courses and/or training workshops on- or off-site; attendance at conferences related to library services; and/or hiring of a consultant for an on-site professional library assessment. Please identify any significant differences between your approved Budget and your actual expenditures of the grant funds.

Total Funds expended:

Total Funds remaining (if any):

Name and title of person submitting this report:

Telephone number:

Email:

By signing below, I certify that the information provided is true and correct and that all funds were used in accordance with the grant guidelines or returned to the Institute of Museum and Library Services.

Signature of person submitting this report: ___________________________________ Date: ___________________

Burden estimate and request for public comments: Public reporting burden for this collection of information is estimated to average two 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. 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, and to the Office of Management and Budget, Paperwork Reduction Project (3137-0071), Washington DC 20503.

OMB Number 3137-0098, Expiration date: 03/31/2022 IMLS-CLR-F-0018