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19 <br /> FEDERAL FINANCIAL REPORT <br /> (Follow form instructions) <br /> 1. Federal Agency and Organizational Element 2. Federal Grant or Other Identifying Number Assigned by Federal Agency Page of <br /> to Which Report is Submitted (To report multiple grants,use FFR Attachment) <br /> , pages <br /> 3. Recipient Organization(Name and complete address Including Zip code) <br /> 4a. DUNS Number 4b. EIN 5. Recipient Account Number or Identifying Number 6. Report Type 7. Basis of Accounting <br /> (To report multiple grants,use FFR Attachment) r Quarterly <br /> C Semi-Annual <br /> r Annual <br /> 0 Final t'l Cash El Accrual <br /> 8. Project"Grant Period g. Reporting Period End Date <br /> From: (Month,Day,Year) 1To: (Month,Day,Year) (Month,Day,Year) <br /> 10. Transactions <br /> Cumulative <br /> (Use lines a-c for single or multiple grant reporting) <br /> Federal Cash (To report multiple grants,also use FFR Attachment): <br /> a. Cash Receipts <br /> b. Cash Disbursements <br /> c. Cash on Fland(line a minus b) <br /> (Use lines d-o for single grant reporting) <br /> Federal Expenditures and Unobligated Balance: <br /> d. Total Federal funds authorized <br /> e. Federal share of expenditures <br /> f. Federal share of untiquidated obligations <br /> g. Total Federal share(sum of lines a and f) <br /> h. Unobligaled balance of Federal funds(line d minus g) <br /> Recipient Share: <br /> i. Total recipient share required <br /> j. Recipient share of expenditures <br /> k. Remaining recipient share to be provided One t minus j) <br /> Program Income: <br /> 1. Total Federal program Income caned <br /> m. Program income expended in accordance with the deduction alternative <br /> n. Program income expended in accordance with the addition alternative <br /> o. Unexpended program income(line I minus line m or line n) <br /> a. Type b.Rate c.Period From Period To d.Base e. Amount Charged f.Federal Share <br /> 11.Indirect <br /> Expense <br /> g.Totals: <br /> 12. Remarks: Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation: <br /> 13. Certification: By signing this report,1 certify that it is true,complete,and accurate to the best of my knowledge, l am aware that <br /> any false,fictitious,or fraudulent information may subject me to criminal,civil,or administrative penalities. (U.S.Code,Title 18,Section 1001) <br /> a. Typed or Printed Name and Title of Authorized Certifying Official c. Telephone(Area code,number and extension) <br /> d. Email address <br /> b. Signature of Authorized Certifying Official e. Hate Report Submitted (Month,Day,Year) <br /> 14.A efCN user>::: <br /> Standard Fenn 425 <br /> ❑Mg Approve!Number:5348-DO51 <br /> Expiration Oats'1013112d11 <br /> Paperwork Burden Statement <br /> According to the Paperwork Reduction Act,as amended,no persons are required to respond tea collection of information unless it displays a valid OMB Control Number.The valid OMB control <br /> number for this information collection is 0348.0061. Public reporting burden for this collection of information is estimated to average 1.5 hours per response,including time for reviewing instructions, <br /> searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.Send comments regarding the burden estimate or any other <br /> aspect of this collection of information,including suggestions for reducing this burden.to the Office of Management and Budget,Paperwork Reduction Project(0348-0060),Washington,DC 20503. <br />