10-902 LWCF Project Agreement Form

NPS Form 10-902A (Rev. 12/2019)
National Park Service

OMB Control No. 1024-0031
Expiration Date xx/xx/xxxx

AMENDMENT TO PROJECT AGREEMENT
Land and Water Conservation Fund

State:
Project Amendment No.

THIS AMENDMENT to Project Agreement No.

[Legacy # / FBMS #] is hereby made and agreed upon by the United States of

America, acting through the Director of the National Park Service and by the State of

pursuant to the Land and

Water Conservation Fund Act of 1965, 78 Stat. 897 (1964).
The State and the United States, in mutual consideration of the promises made herein and in the agreement of which this is an
amendment, do promise as follows:
That the above mentioned agreement is amended by adding the following:

In all other respects the agreement of which this is an amendment, and the plans and specifications relevant thereto, shall remain in full
force and effect. In witness thereof the parties hereto have executed this amendment as of the date entered below.
THE UNITED STATES OF AMERICA

STATE OF ______________________________________

By

By

(Signature)

(Title)
National Park Service
United States Department of the Interior

(Signature)

(Title)

(Agency)

Date

RECORDS RETENTION – PERMANENT ACTIVE. (NPS Records Schedule, National Assistance Programs (Item 8.A.2) (N1-79-08-7))

NPS Form 10-902A (Rev. 11/2019)
National Park Service

OMB Control No. 1024-0031
Expiration Date xx/xx/xxxx

NOTICES
Paperwork Reduction Act Statement
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), please note the following. This information collection is authorized
by the Land and Water Conservation Fund Act of 1965 (54 U.S.C. 200301 et. seq.). Your response is required to obtain or retain a
benefit. We use this information to document changes made to original grant agreement following the close-out of the grant. We may
not conduct or sponsor and you are not required to respond to a collection of information unless it displays a currently valid Office of
Management and Budget control number. OMB has assigned control number 1024-0031 to this collection.
Estimated Burden Statement
Public reporting burden for this form is estimated to average 1 hour per response including the time it takes to read, gather data, review
instructions, and complete the form. Direct comments regarding this burden estimate, or any aspects of this form to Phadrea Ponds,
Acting NPS Information Collection Clearance Officer, 1201 Oakridge Drive, Fort Collins, CO 80525. Please do not send your form to
this address.