Form ARPA Program Infor ARPA Program Infor ARPA Program Information Form

IMLS PROGRAM INFORMATION FORM

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.

2. 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 of the years listed above, explain the circumstances in the box below.

3. 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.

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

Yes

No

Section 2. Agency-Level Goals

Select the IMLS agency-level goal that best aligns with your proposed project. Then choose one 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. Eligibility

Select the set of eligibility criteria under which you are applying to this funding opportunity. Please see Section C1 of the Notice of Funding Opportunity for details.

Museum Entity

Library Entity

Federally Recognized Indian Tribe

A nonprofit organization that primarily serves and represents Native Hawaiians

OMB Control #: 3137-XXXX, Expiration Date: xx/xx/xxxx