Ed Grant Performance Report Cover Sheet
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1
2U.S. Department of Education
OMB No. 1890 - 0004
Grant Performance Report Cover Sheet (ED 524B)
Check only one box per Program Office instructions.
Expiration: 10-31-2007
Annual Performance Report
Final Performance Report
General Information
1. PR/Award #:
2. NCES ID #:
(Block 5 of the Grant Award Notification.)
(See Instructions.)
3. Project Title: _________________________________________________________________________________________________
(Enter the same title as on the approved application.)
4. Grantee Name
:_________________________________________________________________
(Block 1 of the Grant Award Notification.)
5. Grantee Address
(See Instructions.)
6. Project Director Name:_________________________________________Title:__________________________________________
Ph. #: (
) ________ - __________________
Ext: (
)
Fax #: (
) ________ - __________________
Email Address:___________________________________________________________
Reporting Period Information (See instructions.)
7. Reporting Period: From: ________/_______/__________ To: ________/_______/__________ (mm/dd/yyyy)
Budget Expenditures (To be completed by your Business Office. See instructions. Also see Section B.)
8. Budget Expenditures
Federal Grant Funds
Non-Federal Funds (Match/Cost Share)
a. Previous Budget Period
b. Current Reporting Period
c. Entire Project Period
(For Final Performance Reports only)
Indirect Cost Information (To be completed by your Business Office. See instructions.)
9. Indirect Costs
a. Are you claiming indirect costs under this grant?
___Yes
___No
b. If yes, do you have an Indirect Cost Rate Agreement approved by the Federal government?
___Yes
___No
c. If yes, provide the following information:
Period Covered by the Indirect Cost Rate Agreement: From:_______/______/_______ To: _______/______/_______ (mm/dd/yyyy)
Approving Federal agency:
_____ED
_____Other (Please Specify):____________________________________________
Type of Rate
Provisional
___Final
___Other (Please specify)
(For Final Performance Reports Only): ____
________________________
d. For Restricted Rate Programs (check one) -- Are you using a restricted indirect cost rate that :
____ Is included in your approved Indirect Cost Rate Agreement?
____ Complies with 34 CFR 76.564(c)(2)?
Human Subjects (See instructions.)
10. Annual Certification of Institutional Review Board (IRB) Approval?
___Yes ___No ___N/A
Performance Measures Status and Certification (See instructions.)
11. Performance Measures Status
___Yes ___No
a. Are complete data on performance measures for the current budget period included in the Project Status Chart?
b. If no, when will the data be available and submitted to the Department? ________/_______/__________ (mm/dd/yyyy)
12. To the best of my knowledge and belief, all data in this performance report are true and correct and the report fully discloses all known
weaknesses concerning the accuracy, reliability, and completeness of the data.
:
Name of Authorized Representative
Title:
Signature:
Date:
ED 524B
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