Public reporting burden for this collection of information is estimated to average 3 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 this burden to the Office of Management and Budget, Paperwork Reduction Project (0348-0041), Washington, D.C. 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
This sheet is to be used for the following types of applications: (1) “New” (means a new [previously unfunded] assistance award); (2) “Continuation” (means funding in a succeeding budget period which stemmed from a prior agreement to fund); and (3) “Revised” (means any changes in the Federal government's financial obligations or contingent liability from an existing obligation). If there is no change in the award mount there is no need to complete this form. Certain Federal agencies may require only an explanatory letter to effect minor (no cost) changes. If you have questions please contact the Federal agency.
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Fld Name / |
Instruction |
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Column a.
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If this is an application for a “New” project, enter the total estimated cost of each of the items listed on lines 1 through 16 (as applicable) under “Cost Classifications.” If this application entails a change to an existing award, enter the eligible amounts approved under the previous award for the items under “Cost Classification.” |
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Column b.
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If this is an application for a “New” project, enter that portion of the cost of each item in Column a. which is not allowable for Federal assistance. Contact the Federal agency for assistance in determining the allowability of specific costs. If this application entails a change to an existing award, enter the adjustment [+ or (–)] to the previously approved costs (from column a.) reflected in this application. |
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Column c.
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This is the net of the lines in columns “a.” and “b.”.
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1-3) Administration and Legal Expenses |
Enter estimated amounts needed to cover administrative expenses. Do not include costs which are related to the normal functions of government. Allowable legal costs are generally only those associated with the purchase of land which is allowable for Federal participation and certain services in support of construction of the project for each column. |
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12) Subtotal |
Total of items 1 through 3 for each column. |
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13) Contingencies |
Enter estimated contingency costs. (Consult the Federal agency for the percentage of the estimated construction cost to use.) |
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14) Subtotal |
Enter the total of lines 12 and 13. |
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15) Project (program) Income |
Enter estimated program income to be earned during the grant period, e.g., salvaged materials, etc. |
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16) Total Project Costs |
Subtract line 15 from line 14.
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17) Enter Federal Assistance Requested |
Enter eligible costs from line 16c, multiplied by 999% (Consult Federal agency for Federal percentage share.) |