Fiscal Operations Report for 2021-2022 and Application to Participate 2022-2023 (FISAP) and Reallocation Form

OMB No. 1845-0030

Expires: 5/31/2023

CAMPUS-BASED REALLOCATION FORM
Release 2020–21 Unexpended Campus-Based Funds and

Request 2021–22 Supplemental FWS Funds

Public Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1845-0030. Public reporting burden for this collection of information is estimated to average 2 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is mandatory in accordance with 34 CFR 675.19 (Federal Work-Study), and 34 CFR 676.19 and 20 U.S.C. 1094 (Federal Supplemental Educational Opportunity Grant). If you have comments or concerns regarding the status of your individual submission of this form, please contact the Common Origination and Disbursement (COD) School Relations Center directly at 1-800-848-0978 or email [email protected].

Name of School: [Prefilled by COD] OPEID: [Prefilled by COD]
Address of School: [Prefilled by COD]

City: [Prefilled by COD] State: [Prefilled by COD] Zip: [Prefilled by COD]

Deadline for Submission is August 16, 2021

Section A: School release of 2020–21 award year unexpended allocations for the Federal Supplemental Educational Opportunity Grant and Federal Work Study Programs.

You must ensure that any unexpended funds listed in Section A to be returned have not already been drawn down in G5.

	Federal Supplemental Educational Opportunity Grant (FSEOG)	Federal Work Study (FWS)
Unexpended 2020–21 Allocation Amount	(1) $	(2) $

Section B: Request for Supplemental FWS funds for the 2021–22 award year.

(Complete only if you want Supplemental FWS funds)

(4) Did your school expend at least 5 percent of its total 2020–21 FWS federal funds to compensate students employed as reading tutors of children or in family literacy activities as part of your community service activities?	YES NO NA NA
(5) Amount of supplemental 2021–22 FWS funds your school will need for community service jobs.	$

Warning: If you purposely give false or misleading information, you may be fined up to $20,000, sent to prison, or both.