Form ADD-02B Financial Status Report

Financial Status Report

State Councils on Developmental Disabilities

ADD-02B

Within the On-Line Data Collection (OLDC) System

Administration for Children and Families

Department of Health & Human Services

On-Line Data Collection Department of Health & Human Services
OMB Clearance No.: 0980-0212 Expiration Date: xx/xx/xxxx ADD-02B
Report Information
1. Designated State Agency: Dept. of Health & Social Services			2. State: Alaska
3. Grant Document Number:0901AKBS02			4. Fiscal Year:2009
5. Council is its own Designated State Agency: Yes No			6. Total Federal Award:$198,795
7. Reporting Period:10/01/2008    To:09/30/2009
8. Original Revised Final
Expenditures
9. Budget Category		Cumulative Expenditures		Unliquidated Obligations		Unobligated Estimates
a. Goal Activities, undertaken by Council/staff		$0		$0		$0
b. Goal Activities, Poverty Area		$0		$0		$0
c. Goal Activities, Other		$0		$0		$0
d. General Management		$0		$0		$0
e. Functions of Designated State Agency (FDSA), Federal Participation		$0
f. Total Federal (a. through e.)		$0		$0		$0
g. State Match (including FDSA + Prog.Inc.)		$0		$0		$0
h. Functions of Designated State Agency (FDSA), State Participation, reporting year		$0
i. Functions of Designated State Agency (FDSA), State Participation, previous year		$0
j. Program Income (including used as match)*		$0		$0		$0
Remarks and Signature
10. Remarks	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.
	Signature Name				Signature Date ___/___/______
	Signature Title
	Signature
* Program Income expenditures are reported for the current period only, not cummulatively. Please report unobligated balance of Program Income under Unobligated Estimates.
Submit Date: ___/___/______
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 5.1 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

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Notes regarding the ADD-02B form in the On-Line Data Collection (OLDC) system:

• Within the OLDC system, a user accessing the ADD-02B form must first select the State, and then they select the Fiscal Year of award, and the Reporting Period in order to “Select Form” shown here. Based on these selections, the OLDC system inserts some information automatically (shown in blue). The selection options are limited, based on the authorizations of the user’s OLDC account, so that they cannot accidentally enter data in a form for a different State or for a fiscal year or reporting period in the future.

• Form information and data in blue are provided/calculated by the system automatically.

• The blue buttons at the top of the report are for going to different parts of the OLDC system:

  • OLDC Home ... the first page visited in OLDC when accessing it.

  • Select State ... the page where a user selects their State.

  • Select Form ... the page where the user selects the reporting period.

  • End OLDC ... permits the user to sign out of the system.

• The blue buttons at the bottom of the report are for report manipulations:

  • Save Form ... saves the data as it is currently showing in the form.

  • Validate Form ... the data entry staff indicate that the report is completed

  • Click to Sign ... this button embedded within the form, near the bottom, permits the authorized official the opportunity to electronically sign and thus to legally certify the accuracy of the data.

  • Submit Form ... the authorized official sends the report to the federal reviewers.