Form Library Program In Library Program In Library Program Information Form FY22

Generic Clearance for IMLS Grant Forms: Budget Form, Library and Museum Program Information Form, and Digital Product Form, EGMS PIS Supplementary Sheet, eGMS Abstract form

IMLS Library Program Information Form FY22 without codes 20201203

IMLS Library - Discretionary Program Information Form

OMB: 3137-0092

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IMLS LIBRARY - DISCRETIONARY PROGRAM INFORMATION FORM [Note: This will be a dynamic form so answers to certain questions will determine what questions the applicant sees next.]

PLEASE NOTE: Information contained within this form may be published online or otherwise shared by IMLS. Therefore, please do not include any sensitive, proprietary, or confidential information.


Section 1. Organizational Financial Information

  1. Please complete the following table for the Organizational Unit, beginning with the most recently completed fiscal year.


Fiscal Year

Total Revenue*

Total Expenses**

Surplus or Deficit














* For nonprofit tax filers, Total Revenue can be found on Line 12 of the IRS Form 990.

** For nonprofit tax filers, Total Expenses can be found on Line 18 of the IRS Form 990.


  1. If the Total Revenue amounts declined by more than 15% for any year over year listed OR if there was a deficit of more than 10% of the Total Revenue for two or more years listed above, explain the circumstances in the box below.

Shape1






  1. Were there any material weaknesses identified in your prior year’s audit report?

  • Yes

    • No

  • Not applicable


A material weakness is a deficiency, or combination of deficiencies, in internal control, such that there is a reasonable possibility that a material misstatement of the entity's financial statements will not be prevented, or detected and corrected on a timely basis. If yes, please explain in the box below.

Shape2





  1. Has your organization had a single or program-specific audit in the past three years?

  • Yes

  • No




Section 2. Agency-Level Goals and Objectives

Select the IMLS agency-level goal that best aligns with your proposed project. Once you have selected a goal, select an associated objective.


  • Goal 1: Champion Lifelong Learning

    • Objective 1.1: Advance shared knowledge and learning opportunities for all.

    • Objective 1.2: Support the training and professional development of the museum and library workforce.

  • Goal 2: Strengthen Community Engagement

  • Objective 2.1: Promote inclusive engagement across diverse audiences.

  • Objective 2.2: Support community collaboration and foster civic discourse.


  • Goal 3: Advance Collections Stewardship and Access

    • Objective 3.1: Support collections care and management.

    • Objective 3.2: Promote access to museum and library collections.


Section 3. Grant Program

Select the program to which you are applying.

o Laura Bush 21st Century Librarian Program

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one:

  • Planning

  • National Forum

  • Project

  • Early Career Research Development

  • Applied Research


o National Leadership Grants for Libraries

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one:

  • Planning

  • National Forum

  • Project

  • Applied Research


o Native American Library Services: Enhancement Grants

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one:

  • Digital Services

  • Educational Programming

  • Preservation and Revitalization


o Native Hawaiian Library Services

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one:

  • Digital Services

  • Educational Programming

  • Preservation and Revitalization


o Native American Library Services: Basic Grants



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSandra Narva
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File Created2021-02-19

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