Endowment Activity and Challenge Grant Program

INSTRUCTIONS FOR COMPLETION OF THE FINANCIAL REPORT

FOR TITLE III PART A, TITLE III PART B AND TITLE V PROGRAMS ENDOWMENT ACTIVITY AND TITLE III PART C ENDOWMENT CHALLENGE GRANT PROGRAM

Please use the following link to access the Financial Report for Title III Part A, Title III Part B and Title V Program Endowment Activities and Title III Part C Endowment Challenge Grant Program:

http://webprod.cbmiweb.com/endowfsr/

 

Please use this electronic form to enter your institution’s financial data. It is highly recommended that a hard copy be utilized for draft purposes, prior to entering the data into the system. A hard copy has been provided to you along with the pin number to access the electronic reporting form. A hard copy may also be printed from the Web. In addition, you may utilize your pin to save your submission and access it at a later time. However, once the reporting form is submitted electronically, it will NOT be accessible for any modifications. All submissions will be time and date stamped. Please pay careful attention to the last section regarding the certification requirement. The certification requirement states that all signature pages must be faxed in to the fax number provided. Your financial report will NOT be considered complete without this certification form.

Please enter the name, address, city, state, and zip code of your institution. Also, enter the name, telephone number, fax number, and email address of the “contact person” for the grant program at your institution. The contact person is responsible for the administration and management of your institution’s Title III Part A, Title III Part B and Title V Program Endowment activities and Title III Part C Endowment Challenge Grant Program.

Please follow the remaining instructions below that correspond numerically with the electronic form:

1. PR Award Number

Title III Part A, Title III Part B and Title V Program Endowment Activity only: Enter the Project Award Number (P031G_ _ _ _ _)

Title III Part C only: Enter the Grant Number (GOO _ _ _ _ _ _ _). Grants awarded since 1987 have only a Project Award (PR/Award) Number.

2. Endowment Fund Corpus

Title III Part C only: Enter the amount of the original Endowment Fund Corpus. The “Endowment Fund Corpus” is the Federal grant amount plus the institution’s matching amount.

Title III Part A & B and Title V Program Endowment Activity only: Institution match plus Federal dollars drawn down and invested. This amount may change from year to year if you elected to use federal funds for endowment building more than one year of your five year grant period and added to the original corpus rather than creating a different account for each drawdown. For example, if in year one you raised and matched $50,000 of Federal funds, and you invested $100,000 to form the endowment corpus, then in year two you elected to raise and match $25,000 of Federal funds for a total of $50,000 and decided to add this $50,000 to the original $100,000, your corpus then changes from $100,000 to $150,000. However, if you have chosen to develop a separate endowment corpus for each year, you will report on each individual investment.

3. Report Number

Enter the report number for which this financial report is being submitted. (For example, the first financial report you submit would be Report Number 1 of 20. The last report you submit would be No. 20 of 20.)

4. Investment Distribution

Enter the type of savings account or security, the amount invested, and the financial institution(s) managing your Endowment Fund Corpus (Section 628.43 of the program regulations).

AFTER THE FIRST YEAR, THE AMOUNT OF MONEY REPORTED TO BE INVESTED SHOULD BE THE ‘CORPUS’ PLUS ALL THE UNSPENT OR UNUSED ENDOWMENT FUND INCOME. THIS FIGURE SHOULD BE THE AMOUNT AT THE BEGINNING OF THE INVESTMENT PERIOD. THIS INVESTMENT PERIOD IS FOR THE 12-MONTH PERIOD BEGINNING 10/01/2006 – 09/30/2007.

Examples of investment entities include but not limited to are:

1. A federally insured bank savings account;

2. A comparable interest bearing account;

3. Money Market fund;

4. Certificates of Deposit;

5. Mutual funds;

6. Stocks

7. Bonds; and

8. Other (If not listed in A through G above, please enter the type of investment account.)

5. Income Earned

1. Enter the amount of the Endowment Fund Income earned only for the 12- month period covered by this financial report.

2. Enter the cumulative (aggregate) amount of the Endowment Fund Income earned since the initial investment of your endowment fund corpus.

6. Income Used

In the appropriate spaces, enter the amount for the reporting year and aggregate amounts of the Endowment fund income which you expended for any of the following categories:

1. Operations and maintenance – Includes expenditures established to provide services and maintenance related to campus grounds and facilities, including utilities, property insurance, fire protection, janitorial services, and similar items.

2. Administration – Includes expenditures for activities carried out to provide for the day-to-day functioning as well as the long-range viability of the institution as an operating organization. This also includes costs for general executive and administrative offices and other expenses of a general character which do not relate solely to (l) instruction, (2) organized research, or (3) other institutional activities.

3. Academic and support personnel – Includes expenditures for all faculty and academic administrators.

4. Construction and renovation – Includes expenditures for renewal and replacement of the campus grounds and facilities.

5. Community and student services programs and technical assistance – Includes expenditures for activities that primarily provide services beneficial to groups outside the institution. Included in this category are conferences, institutes, programs, advertising, consulting, and

similar services to particular sectors of the community. Also included are expenditures for counselors, career guidance and placement personnel as well as expenditures connected with auxiliary programs, student aid administration, student activities, cultural events, student newspaper, intramural athletics, student organizations, student aid administration and student health services.

Further included are expenditures for activities of specific professional or technical groups such as conferences, workshops, or meetings where specific and practical advice is given to a group of lawyers, doctors, business executives, etc.

6. Other – Includes expenditures for education-related activities not

included in the categories above. Indicate in the space provided the nature of the expenditure.

7. Certification

This financial report must be signed by the President or Chief Executive Officer of the institution certifying that all information is correct to the best of his/her knowledge. After completing the signature page, please fax it to the attention of your program contact at fax number: (202) 502-7861.

IMPORTANT NOTE:

If your institution has been awarded more than one Endowment grant, report each separately by submitting financial reports with the respective project award and/or grant numbers.

FORM APPROVED

OMB No. 1840-0564

Expiration Date:

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1840-0564. The time required to complete this information collection is estimated to average 3 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.

If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to:

Institutional Development and Undergraduate Education Service, Title III Part A: Dr. Darlene Collins; Title III Part B: Karen Johnson; Title III Part C: Sara Qadir; Title V: Josephine Hamilton at the U. S. Department of Education, 1990 K Street, N.W., Washington, D.C. 20006.

U.S. DEPARTMENT OF EDUCATION

OFFICE OF POSTSECONDARY EDUCATION

WASHINGTON, D.C. 20006

FINANCIAL REPORT FOR THE TITLE III PART A, TITLE III PART B AND TITLE V PROGRAM ENDOWMENT ACTIVITY AND TITLE III PART C ENDOWMENT CHALLENGE GRANT PROGRAM

Authority: Title III, Part C, Higher Education Act of 1965, As Amended,

20 U.S.C. 1065

CFDA No. 84.031

NAME OF INSTITUTION:_________________________________________________

ADDRESS :_________________________________________________

CITY AND STATE :_________________________ZIP CODE_______________

CONTACT PERSON :_________________________________________________

TELEPHONE NUMBER :_______________________FAX:______________________

EMAIL : _________________________________________________

1. (a) Enter the PR/AWARD Number: P031__ _ _ _ _.

(b) Enter the Grant Number: GOO_ _ _ _ _ _ _.

2. Enter the amount of the institution’s original “Endowment Fund Corpus”: $___________

3. Report Number _____ of 20

4. INVESTMENT DISTRIBUTION “FOR CORPUS ONLY”

Name of

TYPE OF SAVINGS ACCOUNT Financial

OR SECURITY Amount Institution

________________________ $___________________ ________________

________________________ $___________________ ________________

________________________ $___________________ ________________

________________________ $___________________ ________________

________________________ $___________________ ________________

________________________ $___________________ ________________

TOTAL INVESTED: $___________________

5. INCOME EARNED

a. Enter the amount of the Endowment Fund Income Earned only for the 12-month period covered by this financial report. $________________

b. Enter the cumulative (aggregate) amount of all Endowment funds earned to date.

$________________

6. INCOME USED

Enter in the appropriate space(s) the amount of Endowment Fund Income Used, both for the 12-month period covered by this report, and in the aggregate, for the following purposes:

CURRENT AGGREGATE

a) Operations and maintenance: $______________ $_____________

b) Administration: $______________ $_____________

c) Academic and support personnel: $______________ $_____________

d) Construction and renovation: $______________ $_____________

5. Community and student services

programs and technical

assistance $______________ $_____________

f) Other: (Please specify below) $______________ $_____________

___________________________ $______________ $_____________

___________________________ $______________ $_____________

============== ===============

Total Endowment Fund Income

Used; Current/Aggregate $______________ $_____________

7. CERTIFICATION

I certify that:

-No part of the endowment fund corpus has been invested in real estate (Section 628.43 of the regulations);

-No part of the endowment fund corpus has been withdrawn and/or expended (Section 628.44 of the regulations);

-Not more than fifty percent of aggregate endowment fund income has been withdrawn and/or expended (Section 628.45 of the regulations).

President (or Chief Executive Officer):

_________________________________ ______________________

(Signature) (Date)

(Type Name)

(Title)

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form is subject to penalties that may include fines and/or imprisonment under the United States Criminal Code.

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