Form Doi 477 Annual Financial Expenditure Report (Page 2 of 2) in pdf

U.S. Department of the Interior

Public Law 102-477

Annual Financial Expenditure Report - Instructions

Please type or print legibly. The following general instructions explain how to use the form itself. You may need

additional information to complete certain items correctly or to decide whether a specific item is applicable to this

award. Usually, such information will be found in the Federal agency's grant regulations or in the terms and conditions

of the award. You may also contact the Federal agency directly.

1. Enter the complete name of the Tribe or Tribal organization

2. Enter the Award or Grant number assigned by the Department of the Interior

3. Enter the complete mailing address of the Tribe or Tribal organization

4. Specify the status of this report submission; is this the original or a revised edition

5. Specify if this is the final financial report for the Plan Period. The Total Unexpended Funds must be zero in a final

report.

6. Enter the beginning date (From) for the Annual Report Period and the date it ends (To). An Annual Report shall be

prepared and submitted for each Plan Period until all of the funds available for the Plan Period have been fully

expended and reported. For example, if there were Unexpended Funds at the end of the Plan Period from 10/01/2013

to 9/30/2016, for the Annual Report Period from 10/01/2016 to 9/30/2017 there would be a two reports. One report for

the 10/01/2013 to 9/30/2016 Plan Period and one report for the 10/01/2016 to 9/30/2019 Plan Period.

7. Enter the beginning date (From) for this approved Pub. L. 102-477 Plan Period and the date it ends (To). This will

usually be a three year period.

8. Tranactions: The purpose of columns I, II and III is to show the effect of this Annual Report Period's transactions on

cumulative financial status for the Plan Period. The amounts entered in column I will be the same as those in column

III of the previous report in the same Plan Period. If this is the first or only report of the Plan Period, leave column I

blank. Column II will reflect the transactions for this Annual Report Period and column III will be the total of columns

I and II.

8.a: Enter the total of Federal funds available as of the Annual Report Period end date (i.e., funds awarded this period

and carried over from previous periods within this Plan Period)

8. b-f: Refer to cost category definitions to determine appropriate placement of expenditure per category (see attached)

8. g: Enter the sum of lines b-f for the total Federal expenditures as of this Annual Report Period end date

8.h: Enter the total amount of funds not yet expended that will be carried over to the next Annual Report Period

9.a-d are self explanatory

Form DOI-477

OMB Control No.

Expiration Date

Form Doi 477 Annual Financial Expenditure Report Page 2