Form FRA F 252 FRA F 252 Payment Summary Spreadsheet

OMB Control No. 2130-0615 Expiration Date: XX-XX-XXXX FRA Form 252

Public Reporting Burden Paperwork Reduction Act Notice. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2130-0615. Public reporting for this collection of information is estimated to be approximately 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are required per (2 C.F.R. § 200.205). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Kim Toone, 1200 New Jersey Avenue, W34-212, Washington, D.C. 20590.

Payment Summary Spreadsheet

Award Number:

Recipient Name:

FRA Program:

Request Date:

Authorized Amount

Total Previous Requests

This Request

Total Requested to Date

Balance

Task/Activity

Personnel

Fringe Benefits

Travel

Equipment

Materials and Supplies

Contractual

Construction

Other

FRA Share

Grantee Match

Subtotal

FRA Share

Grantee Match

Subtotal

FRA Share

Grantee Match

Subtotal

FRA Share

Grantee Match

Total

FRA Share

Grantee Match

Total

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Total

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Percent:

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