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INTERIM FINANCIAL STATUS REPORT (FSR) FORM |
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I: State Name: |
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II: Federal Funding Period: |
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III: Reporting Period: |
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IV: Accounting Basis: |
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V: Grant Award Numbers: State Basic Grant (Title I) - |
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Tech Prep Grant (Title II) - |
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VI: Title I Grant Award Amount: |
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VII: Title II Grant Award Amount: |
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VIII: Title II Funds Consolidated with Title I Funds: |
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IX: Total Title I Funds (Title I Award + Title II Consolidated Funds): |
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X. Total Title II Funds Remaining (Title II - Title II Consolidated Funds) : |
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XI. Amended Interim FSR: * Date of Filing Amended FSR: |
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1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
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Net Outlays |
Total Outlays |
Program |
Net Outlays |
Net Outlays |
Non-Federal |
Total Federal Share |
Federal Share |
Fed. Share of Outlays & |
Federal Funds |
Balance of Unobligated |
| Row |
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Previously Reported |
This Report Period |
Income |
This Report Period |
To Date |
Share of Outlays |
of Outlays |
of Unliquidated |
Unliquidated Obligations |
Authorized |
Federal funds |
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Credits |
(Column 2 - 3) |
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(Column 5 - 6) |
Obligations |
(Column 7 + 8) |
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(Column 10 - 9) |
| A |
* TOTAL TITLE I FUNDS * |
No information is entered on this row |
| B |
LOCAL USES OF FUNDS |
No information is entered on this row |
| C |
RESERVE |
No information is entered on this row |
| D |
Funds for Secondary Recipients |
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| E |
Funds for Postsecondary Recipients |
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| F |
Total (Row D + E) |
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| G |
FORMULA DISTRIBUTION |
No information is entered on this row |
| H |
Funds for Secondary Recipients |
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| I |
Funds for Postsecondary Recipients |
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| J |
Total (Row H + I) |
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| K |
TOTAL LOCAL USES OF FUNDS (Row F + J) |
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| L |
STATE LEADERSHIP |
No information is entered on this row |
| M |
Nontraditional Training and Employment |
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| N |
State Institutions |
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| O |
Other Leadership Activities |
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| P |
TOTAL STATE LEADERSHIP (Row M + N + O) |
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| Q |
STATE ADMINISTRATION |
No information is entered on this row |
| R |
TOTAL STATE ADMINISTRATION |
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| S |
TOTAL TITLE I FUNDS (Row K + P + R) |
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| T |
* TOTAL TITLE II FUNDS * |
No information is entered on this row |
| U |
Funds for State Administration |
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| V |
Funds for Local Consortia |
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| W |
TOTAL TITLE II FUNDS (Row U + V) |
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ADDITIONAL INFORMATION: |
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XII: Certification: I understand that the use of my PIN to certify and submit this FSR is the same as certifying and signing this document. |
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Signature or PIN of an Authorized State Official: |
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Title/Agency: |
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FINAL FINANCIAL STATUS REPORT (FSR) FORM |
|
I: State Name: |
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II: Federal Funding Period: |
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III: Reporting Period: |
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|
|
|
|
|
|
|
|
|
|
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IV: Accounting Basis: |
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V: Grant Award Numbers: State Basic Grant (Title I) - |
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Tech Prep Grant (Title II) - |
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VI: Title I Grant Award Amount: |
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VII: Title II Grant Award Amount: |
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VIII: Title II Funds Consolidated with Title I Funds: |
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IX: Total Title I Funds (Title I Award + Title II Consolidated Funds): |
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X. Total Title II Funds Remaining (Title II - Title II Consolidated Funds) : |
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XI. Amended Final FSR: * Date of Filing Amended FSR: |
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|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
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|
Net Outlays |
Total Outlays |
Program |
Net Outlays |
Net Outlays |
Non-Federal |
Total Federal Share |
Federal Share |
Fed. Share of Outlays & |
Federal Funds |
Balance of Unobligated |
| Row |
|
Previously Reported |
This Report Period |
Income |
This Report Period |
To Date |
Share of Outlays |
of Outlays |
of Unliquidated |
Unliquidated Obligations |
Authorized |
Federal funds |
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|
|
|
Credits |
(Column 2 - 3) |
(Column 1 + 4) |
|
(Column 5 - 6) |
Obligations |
(Column 7 + 8) |
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(Column 10 - 9) |
| A |
* TOTAL TITLE I FUNDS * |
No information is entered on this row |
| B |
LOCAL USES OF FUNDS |
No information is entered on this row |
| C |
RESERVE |
No information is entered on this row |
| D |
Funds for Secondary Recipients |
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| E |
Funds for Postsecondary Recipients |
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| F |
Total (Row D + E) |
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| G |
FORMULA DISTRIBUTION |
No information is entered on this row |
| H |
Funds for Secondary Recipients |
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| I |
Funds for Postsecondary Recipients |
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| J |
Total (Row H + I) |
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| K |
TOTAL LOCAL USES OF FUNDS (Row F + J) |
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| L |
STATE LEADERSHIP |
No information is entered on this row |
| M |
Nontraditional Training and Employment |
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| N |
State Institutions |
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| O |
Other Leadership Activities |
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| P |
TOTAL STATE LEADERSHIP (Row M + N + O) |
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| Q |
STATE ADMINISTRATION |
No information is entered on this row |
| R |
TOTAL STATE ADMINISTRATION |
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| S |
TOTAL TITLE I FUNDS (Row K + P + R) |
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| T |
* TOTAL TITLE II FUNDS * |
No information is entered on this row |
| U |
Funds for State Administration |
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| V |
Funds for Local Consortia |
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| W |
TOTAL TITLE II FUNDS (Row U + V) |
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ADDITIONAL INFORMATION: |
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XII: Certification: I understand that the use of my PIN to certify and submit this FSR is the same as certifying and signing this document. |
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Signature or PIN of an Authorized State Official: |
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Title/Agency: |