Form 10-915 Amendment to UPAAR Grant Agreement

OMB Control No. 1024-0048
Expires: XX/XX/2016

UNITED STATES DEPARTMENT OF THE INTERIOR
NATIONAL PARK SERVICE
URBAN PARK AND RECREATION RECOVERY PROGRAM GRANT
AMENDMENT TO UPARR GRANT AGREEMENT
JURISDICTION:
GRANT AGREEMENT NO.

AMENDMENT NO.

STATE

PROJECT TITLE:

THIS AMENDMENT TO GRANT Agreement No. _____________________ is hereby made and agreed upon by the
United States of America, acting through the Director of the National Park Service pursuant to Title X, Urban Park and
Recreation Recovery Program, 16 USC 2501, 92 Stat. 3538 (1978).
The GRANTEE and the United States, in mutual consideration of the promises made herein and in the agreement of
which this is an amendment do promise as follows:
That the above mentioned agreement is amended by adding the following:

In all other respects the agreement of which this is an amendment, and the plans and specifications relevant thereto, shall
remain in full force and effect. In witness whereof the parties hereto have executed this amendment as of the date
entered below:
UNITED STATES OF AMERICA

GRANTEE

BY ________________________________________
(Signature)

____________________________________________
(Government Name)

________________________________________
(Title)
National Park Service

BY ____________________________________________
(Signature)

________________________________________
(Date)

___________________________________________
(Name)
___________________________________________
(Title)
NPS Form 10-915

Paperwork Reduction Act Statement. We collect this information under the authority of the Urban Park and Recreation Recovery
(UPARR) Act (16 U.S.C. 2501 et seq.). We use this information to document changes made to the original grant agreement. Your
response is required to obtain or retain a benefit. We estimate that it will take you approximately 1 hour to complete this form. This
estimate includes time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form.
You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National
Park Service, 1849 C Street, NW. (2601), Washington, DC 20240. We may not collect or sponsor and you are not required to respond
to a collection of information unless it displays a currently valid OMB control number.