Forms > Financial Status Report Short Form

Financial Status Report Short Form


A financial status report short form is generally used in business purposes to close out a grant or a cooperative agreement. The financial status report short form is sometimes even used to complete college details by the college business office. The form, in general, summarizes the details of the financial activity during the duration of the business agreement, performance of a project, or a college course. A sample financial status report short form is presented below.

Sample Financial Status Report Short Form

 

Financial Status Report

Short form

Organization to which the report is submitted:
Unique identification number of the organization:
Recipient Organization:
Complete address of the recipient organization:
Unique identification number of the recipient organization:
Final report:

  • Yes
  • No
Basis of accounting:

  • Cash
  • Accrual
Period of financial status- From:                 To:

Details of transactions

Transactions Previously reported This period Cumulative
a. Total outlays      
b. Recipient share of outlays      
c. Federal share of outlays      
d. Total unliquidated obligations      
e. Recipient share of unliquidated obligations      
f. Federal share of unliquidated obligations      
g. Total federal share      
h. Total federal funds authorized for this funding period      
i. Unobligated balance of federal funds      

 

Indirect expense a. Type of rate

  • Provisional
  • Predetermined
  • Final
  • Fixed
Rate:

Base:

Total amount:

Federal share:
Remarks: (Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation)

 

 

 

Certification

I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays and unliquidated obligations are for the purposes set forth in the award documents.

Printed name and title: ________________________

Telephone: _____________________

Signature of authorized certifying personnel: ________________

Date of report submission: ____________________

 

Category: Financial Forms

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