Form 10-2065 Grant Products Summary

NPS Form 10-2065 (Rev. 11/2020)
National Park Service

OMB Control Number 1024-0038
Expiration Date: XX/XX/XXXX

Instructions for the Anticipated Activities List (a.k.a. Workplan)
The Anticipated Activities List (also known as the “Workplan” identifies the HPF-funded activities that the THPO
plans to accomplish with HPF funds to help achieve the goals and objectives stated in the Tribe’s Historic
Preservation Plan.
The Workplan must include a list of all HPF funded program areas, and under each, a clear and descriptive title for
each activity it proposes to undertake. The HPF program areas are listed below.
Administration
Planning
Survey and Inventory
Review and Compliance
National Register
Development/Acquisition/Covenants
Tax Credits
Local Government Certification
Other or Education (optional program area)
Each Program Area must be included in the Workplan, even if only to indicate that no major projects/activities are
planned. For example, if a Tribe plans only “Routine Review and Compliance Activities,” it should state this in the
Workplan.
Each activity listed must reference the THPO’s Program Plan goal(s) and objective(s) that correspond to that
project/activity, though there does not need to be a one-to-one correlation between every activity and the Tribe’s
Program Plan.
Project/activity titles must be descriptive rather than numeric. For example, "Inventory Computerization" or "PreHistoric Hunter’s Camp Archeological Survey," are good titles; however, “14-BAL-42B10" is not.
Projects consisting of multiple phases must identify the number of the phase under which the work will be
completed, for example, “Archeological Survey of the Sully Basin, Phase 2.”
There must be enough information in the descriptive title to indicate the tangible nature of the project or activity.
Multiple goals and objectives may be referenced for an activity, if that activity helps achieve more than one goal or
objective.
NEPA REVIEW PROCESS: Activities in the Workplan that NPS identify as requiring review under the National
Environmental Policy Act (NEPA) will be flagged. NPS will contact the THPO and schedule a conference call to
complete an HPF Grant- NEPA Worksheet and determine if further action is necessary (such as an Environmental
Assessment (EA) or Environmental Impact Statement (EIS)). The grant will not be approved until the review is
complete and no further action is deemed necessary. Most work proposed under the THPO HPF grants fall under
an approved categorical exclusion so that no further action is necessary.
Grant Budget – The grant budget should not be part of the narrative Workplan. The budget must be submitted on
the SF424a, Non-Construction Budget Form, which is part of the application that is completed on Grants.gov.
However, all costs listed in the budget must correspond to the activities in the Workplan.

NPS Form 10-2065 (Rev. 11/2020)
National Park Service

OMB Control Number 1024-0038
Expiration Date: XX/XX/XXXX

HISTORIC PRESERVATION FUND THPO GRANT APPLICATION ANTICIPATED
ACTIVIES LIST (A.K.A. WORKPLAN)
Tribe:
THPO Name:
Federal Fiscal Year:

Limit Report to 5 pages.
Administration:

Planning:

Survey and Inventory:

Review and Compliance:

National Register:

Development/Acquisition/Covenants:

Tax Credits:

Local Government Certification:

Other or Education (optional program area):

*A proposed budget for work described herein must be submitted on the budget form(s) when applying for
a THPO Historic Preservation Fund (HPF) grant on www.grants.gov. Do not include a budget with this
form.
*Attach images separately with captions.
NOTICES
PRIVACY ACT STATEMENT
Authority: 54 U.S.C. 300101 et. seq., the National Historic Preservation Act and 36 CFR 61, Procedures for State,
Local, and Tribal Government Historic Preservation Programs.
Purpose: The National Park Service collects this information as part of the process for reviewing the procedures and
programs of State, tribal, and local governments participating in the National Historic Preservation Program and the
Historic Preservation Fund grant program.
Routine Uses: The information collected will be used to evaluate programs and procedures for consistency with the
National Historic Preservation Act, as amended, (54 U.S.C. 300101 et. seq.) and compliance with governmentwide grant
requirements.
Disclosure: Your response is required to obtain or retain a benefit under these programs. Failure to provide the
information requested may impede the processing of your form.
PAPERWORK REDUCTION ACT STATEMENT
We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) to provide Historic
Preservation Program managers the information needed to administer program participation and grant management. All
applicable parts of the form must be completed in order for your request to be considered. You are not required to
respond to this or any other Federal agency-sponsored information collection unless it displays a currently valid OMB
control number. OMB has approved this collection of information and assigned Control No. 1024-0038.
ESTIMATED BURDEN STATEMENT
The public reporting burden for the collection of this information is estimated to average 6 hours per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing the burden, to the Information Collection
Clearance Officer, National Park Service, 112201 Sunrise Valley Drive, Reston, Virginia 20192. Do not send your
completed form to this address.