Objective Progress Report (OPR)

Administration for Native Americans

Objective Progress Report

					Page:      	of Pages	     
1.Grantee Name      		2. Grant Number      			3a. DUNS Number      
					3b. EIN      
4. Recipient Organization (Name and complete address including zip code)      					5. SF269 Long Form Attached? Yes No
6. Project Period			7. Reporting Period End Date		8. Final Report? Yes No
Start Date: (Month, Day, Year)      	End Date: (Month, Day, Year)      		(Month, Day, Year)      		9. Report Frequency
					quarterly other (If other, describe:      )
10. Performance Narrative (attach performance narrative as instructed by the awarding Federal Agency) Project Title:      Report prepared by: Name:       Date:      
11. Other Attachments:      
12. Certification: I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents.
13a. Typed or Printed Name and Title of Authorized Certifying Official      				13c. Telephone (area code, number and extension)      
				13d. Email Address      
13b. Signature of Authorized Certifying Official      				13e. Date Report Submitted (Month, Day, Year )      
				14. Agency use only

Objective Work Plan Update

1. Have any changes been made to the Objective Work Plan (OWP)? Yes No

If Yes, please explain.      

If Yes, did you receive ANA’s approval for these changes? Yes No

2. Please complete the tables below and include all objectives and activities from your approved OWP. If you require more space, attach additional sheets and follow the same format.

GOAL:      

OBJECTIVE 1:      

Describe how each activity was accomplished

Activity (or what prevented activity from being completed) Status

     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      

OBJECTIVE 2:      

Describe how each activity was accomplished

Activity (or what prevented activity from being completed) Status

     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      

OBJECTIVE 3:      

Describe how each activity was accomplished

Activity (or what prevented activity from being completed) Status

     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      

OBJECTIVE 4:      

Describe how each activity was accomplished

Activity (or what prevented activity from being completed) Status

     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      

OBJECTIVE 5:      

Describe how each activity was accomplished

Activity (or what prevented activity from being completed) Status

     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      

OBJECTIVE 6:      

Describe how each activity was accomplished

Activity (or what prevented activity from being completed) Status

     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      
     	     	Completed Ongoing N/A this quarter Not Completed (if not completed, include expected completion date: dd/mm/yr)      

IMPACT/PERFORMANCE INDICATORS

3. Please list all impact/performance indicators for this project and provide details in the table below.

Note: If your grant started prior to 2004, please check here □ and skip to #3.

Total # and/or $ for this Total # and/or $ since

Impact/performance indicators Initial Target # and/or $ reporting period beginning of project

1. Resources Leveraged	     	     	     
2. Partnerships Formed	     	     	     
3.      	     	     	     
4.      	     	     	     
5.      	     	     	     

PARTNERSHIPS

4. Please list any partnerships formed during this reporting period:

Brief description of partnership and

Partnering agency/organization/tribe Type of Partnership how it is benefiting the project

     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     
     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     
     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     
     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     
     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     
     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     
     	Local Regional State National Federal International Faith-Based Philanthropic Tribal Other      	     

LEVERAGED RESOURCES

5. Please list any resources leveraged during this reporting period that are over and above the non-federal share match (e.g., other grants secured as a result of this project, donated meeting space/equipment/advertising, volunteer hours, etc.).

Source Federal or Non-Federal Dollar Value

     	     	     
     	     	     
     	     	     

NATIVE AMERICAN YOUTH AND ELDER OPPORTUNITIES

6. During this reporting period, did this project provide any opportunities or activities for Native American youth or elders? Yes No NA

If Yes, please list activity and provide details below:

# of Youth # of Elders Was this an inter-

Activity Participating Participating Description generational activity?

     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     

JOBS

7. Please list all jobs created during this reporting period as a direct result of this award (i.e., salaries/consultant fees paid through ANA funding or in-kind) and complete the following table:

Position Title Name Full or Part Time Hours per Month Federal or In-Kind

     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     

8. Were any jobs created in the community during this reporting period as a result of this project (e.g., through businesses and/or services resulting from this project but whose salaries were not paid with ANA funds)? Yes No

If Yes, please list below:

Position Title Full or Part Time Hours per Month

     	     	     
     	     	     
     	     	     
     	     	     
     	     	     

PROJECT PERSONNEL

9. Have you hired all key personnel, as outlined in the grant application? Yes No

If No, please list vacant positions and explain:      

10. Did you have any changes or turnover in key personnel, consultants or contractors during this reporting period? Yes No

If Yes, please list affected positions and explain:      

FINANCIAL

11. What were your forecasted cash needs for this reporting period (from the Form 424A)? What were your actual expenditures?

Please list in the table below:

	1st Quarter		2nd Quarter		3rd Quarter		4th Quarter
	Forecasted	Actual	Forecasted	Actual	Forecasted	Actual	Forecasted	Actual
Federal	     	     	     	     	     	     	     	     
Non-Federal	     	     	     	     	     	     	     	     

12. Did you access funds through the Division of Payment Management (DPM) during this reporting period? Yes No

If No, please explain:      

13. Did you revise your budget during this reporting period? Yes No

If Yes, was it approved by ANA? Yes No

If a revision was made, please explain:      

14. Have you met your Non-Federal Share of the project costs for this reporting period? Yes No

If No, please explain.      

OTHER

15. Please describe any challenges you encountered on this project during this reporting period and include how you overcame (or plan to overcome) them:      

16. ANA is committed to assisting you in the successful implementation of your project and offers free training and technical assistance. Are you in need of any training or technical assistance to carry out your project objectives? Yes No

If Yes, what type of assistance would you like: Electronic On-site Other      

Please explain:      

17. Do you expect to complete your project objectives and activities by the project end date? Yes No

If No, please explain:      

18. Please include any other information you would like to share with ANA regarding your project here:      

OMB Control Number XXXX-XXXX