SF-272 Federal Cash Transactions Report

OMB APPROVAL NO. 0348-0003

FEDERAL CASH TRANSACTIONS REPORT
(See instructions on the back. If report is for more than one grant or
assistance agreement, attach completed Standard Form 272A.)

1. Federal sponsoring agency and organizational element to which this
report is submitted.

2. RECIPIENT ORGANIZATION

4. Federal grant or other identification
number

5. Recipient’s account number
or identifying number

6. Letter of credit number

7. Last payment voucher
number

Name:

Number
and Street

Give total number for this period
8. Payment Vouchers credited to your
account

City, State
and ZIP Code:

9. Treasury checks received
(whether or not deposited)

Period covered by this report
3. FEDERAL EMPLOYER
IDENTIFICATION NO.

FROM (month, day, year)

a. Cash on hand beginning of reporting period

TO (month, day, year)

$

b. Letter of credit withdrawals
c. Treasury check payment
d. Total receipts (Sum of lines b and c)
e. Total cash available (Sum of lines a and d)
11. STATUS OF

f. Gross disbursements

FEDERAL

g. Federal share of program income

CASH

h. Net disbursements (Line f minus line g)
i. Adjustments of prior periods

(See specific instructions on
the back)
12. THE AMOUNT
SHOWN ON LINE 11j,
ABOVE, REPRESENTS
CASH REQUIREMENTS
FOR THE ENSUING

j. Cash on hand end of period
13.

$

OTHER INFORMATION

a. Interest income

$

b. Advances to subgrantees or subcontractors

$

Days
14. REMARKS (Attach additional sheets of plain paper, if more space is required)
15.
I certify to the best of my
knowledge and belief that
this report is true in all
respects and that all
disbursements have been
made for the purpose and
conditions of the grant or
agreement.

CERTIFICATION

AUTHORIZED

Signature

Date Report Submitted

Typed or Printed Name and Title

Telephone (Area Code,
Number, Extension)

CERTIFYING
OFFICIAL

THIS SPACE FOR AGENCY USE
NSN 7540-01-016-5434
272-103

STANDARD FOR 272 (Rev. 7-2009)
Prescribed by OMB Circulars A-102 and A-110

INSTRUCTIONS
Public reporting burden for this collection of information is estimated to average 120 minutes per response, including time for reviewing instructions, 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 aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget,
Paperwork Reduction Project (0348-0004), Washington, DC 20503
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS
PROVIDED BY THE SPONSORING AGENCY.
Please type or print legibly. Items 1, 2, 8, 9, 10, 11d, 11e, 11h, and 15 are self explanatory; specific instructions for other items are as follow:
Item

Entry

Item

Entry

3

Enter Employer Identification Number (EIN) assigned by the
U.S. Internal Revenue Service or the FICE (institution) code.

11g

Enter the Federal share of program income that was required to be used
on the project or program by the terms of the grant or agreement.

4

If this report covers more than one grant or other agreement,
leave items 4 and 5 blank and provide the information on
Standard Form 272A, Report of Federal Cash Transactions Continued.

11i

Enter the amount of all adjustments pertaining to prior periods
affecting the ending balance that have not been included in any lines
above. Identify each grant or agreement for which adjustment was
made, and enter an explanation for each adjustment under “Remarks.”
Use plain sheets of paper if additional space is required.

11j

Enter the total amount of Federal cash on hand at the end of the
reporting period. This amount should include all funds on deposit,
imprest funds, and undeposited funds (line e, less line h, plus or minus
line i).

12

Enter the estimated number of days until the cash on hand, shown on
line 11j, will be expended. If more than three days cash requirements
are on hand, provide an explanation under “Remarks” as to why the
drawn down was made prematurely, or other reasons for the excess
cash. The requirement for the explanation does not apply to
prescheduled or automatic advances.

13a

Enter the amount of interest earned on advances of Federal funds but
not remitted to the Federal agency. If this includes any amount earned
and not remitted to the Federal sponsoring agency for over 60 days,
explain under “Remarks.” Do not report interest earned on advances to
States.

13b

Enter the amount of advance to secondary recipients included in item
11h.

Enter Federal grant number, agreement number, or other
identifying numbers if requested by sponsoring agency.
5

This space reserved for an account number or other identifying
number that may be assigned by the recipient.

6

Enter the letter of credit number that applies to this report. If all
advances were made by Treasury check, enter “N/A” for not
applicable and leave items 7 and 8 blank.

7

Enter the voucher number of the last letter-of-credit payment
voucher (Form TUS 5401) that was credited to your account.

11a

Enter the total amount of Federal cash on hand at the beginning
of the reporting period including all of the Federal funds on
deposit, imprest funds, and undeposited Treasury checks.

11b

Enter total amount of Federal funds received through payment
vouchers (Form TUS 5401) that were credited to your account
during the reporting period.

11c

11f

Enter the total amount of all Federal funds received during the
reporting period through Treasury checks, whether or not
deposited.
Enter the total Federal cash disbursements, made during the
reporting period, including cash received as program income.
Disbursements as used here also include the amount of advances
and payments less refunds to subgrantees or contractors; the
gross amount of direct salaries and wages, including the
employee’s share of benefits if treated as a direct cost,
interdepartmental charges for supplies and services, and the
amount to which the recipient is entitled for indirect costs.

14

In addition to providing explanations as required above, give additional
explanation deemed necessary by the recipient and for information
required by th Federal sponsoring agency in compliance with
governing legislation. Use plain sheets of paper if additional space is
required.

Standard Form 272 (Rev. 7-2009) Back