Data Collection Form for Reporting on Audits of States, Local Governments, and Non-Profit Organizations

Form SF-SAC Instructions

Data Collection Form for Reporting on Audits of States, Local Governments, and Non-Profit Organizations

OMB: 0348-0057

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06-02-2016

Instructions for Form SF-SAC,
Reporting on Audits of States, Local Governments, Indian Tribes, Institutions of Higher
Education and Nonprofit Organizations
For Fiscal Periods Beginning

on or after December 26, 2014
According to the Paperw ork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is OMB No. 0348 -0057. The
time required to complete this data collection form is estimated to average 100 hours for large auditees (i.e., auditees most likely to
administer a large number of Federal aw ards) and 20 hours for all other auditees. These amounts reflect estimates of reporting
burden on both auditees and auditors relating to the Form SF-SAC, including the time to review instructions, obtain the needed
data, and complete and review the information.
The Office of Managem ent and Budget (OMB) Title 2 U.S.
Code of Federal Regulations (CFR) Part 200, Uniform
Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards (Uniform Guidance) 2 CFR
200.512 requires auditees to subm it a com pleted Form SFSAC, along w ith one com plete reporting package, to the
Federal Audit Clearinghouse. The reporting package is defined
in 2 CFR 200.512(c). Indian Tribes and Tribal Organizations (as
defined in the Indian Self -Determination, Education and
Assistance Act (ISDEAA), 25 U.S.C 450b(l)) w hich opt not to
authorize the FAC to make the reporting package publicly
available must submit the reporting package to pass-through
entities as described in 2 CFR 200.512(b)(2); Submissions to a
pass-through entity should not include the Form SF-SAC.

CFDA extension to identif y one or more aw ard lines w hich form
the program. This w ill allow the Internet Data Entry System
(IDES) to automatically calculate the Federal Program Total and
Cluster Total (Part II, Item 1(g) and 1(h)). For more information
on Federal program determination w hen a CFDA extension is
unknow n, see 2 CFR 200.42(b).

Auditees should not submit a reporting package or Form SF-SAC
if their Uniform Guidance audit report is included in another
auditee’s report.

Additional Aw ard Identification
Part II, Item 1(c) is a field that can be used to collect other data
used to identify the aw ard w hich is not a CFDA number (e.g.,
program year, contract number, state issued numbers, etc.). If
the CFDA Extension is unknow n, this field is required.

Exam ple: The first Federal program w ith an unknow n three
digit extension w ould be U01 for all Federal aw ard lines
associated w ith that program, the second w ould be U02, and
so on. If the Federal program is part of the Research and
Development (R&D) cluster and the CFDA Three Digit
Extension is unknow n, enter “RD” in the CFDA Three Digit
Extension field.

Exam ple: If the audit of a state university’s Federal aw ards
is included in the statew ide single audit report and Form
SF-SAC, the university should not submit a reporting
package or Form SF-SAC to the Federal Audit
Clearinghouse.

Cluster Nam e
Part II, Item 1(f) w ill be used to identify w hether the aw ard is part
of a cluster of programs, and if so, the name of the cluster. For
example, Research & Development, Student Financial
Aid/Assistance, and other clusters identified in the Compliance
Supplement. The names of clusters identified by a state for
Federal aw ards that the state provides to its subrecipients can
also be entered into this item. For other clusters, this item w ill
collect the cluster name provided in the latest OMB Compliance
Supplement.

This Form SF-SAC version, dated XX-XX-2016 should be
used for audits covering fiscal periods beginning on or after
Decem ber 26, 2014, the period for w hich Subpart F of the
Uniform Guidance is first effective. For all audits that are
perform ed under OMB Circular A-133 use the appropriate
year form for Circular A-133 audits. This Form is only
available for submission on the Federal Audit Clearinghouse
(FAC) Web site https://harvester.census.gov/facw eb/.

Federal Program Total and Cluster Total
Part II, Item 1(g) and 1(h) is the total Federal aw ards expended
for each individual Federal program and cluster of programs as
required by 2 CFR 200.510(b)(3). The total Federal aw ards
expended for each Federal program w ill be auto-populated by
summing the individual aw ard lines w hich have the same CFDA
number. For clusters, the cluster total w ill also be auto-populated
by summing the individual aw ard lines w hich have the same
cluster name. These fields are added so that the data collection
form includes all data required in the SEFA.

Audit threshold for Federal expenditures is $750,000 or m ore
per year. The Uniform Guidance requires non-Federal entities
that expend $750,000 or more a year in Federal aw ards to have
an audit conducted in accordance w ith the Uniform Guidance.
The SF-SAC is not to be used by for-profit entities, foreign
public entities, or foreign organizations . These entities
should contact the Federal aw arding agency for audit report
submission instructions.

End of the Audit Period Loan Balance
Part II, Item 1(j) w ill be used to collect the loan or loan guarantee
(loan) balances outstanding at the end of the audit period for loan
programs as identified in Part II, Item 1(i), as required by 2 CFR
200.510(b)(5).

WHAT’S NEW
CFDA Three Digit Extension
Part II, Item 1(b) w ill be used to only collect three digit CFDA
extensions listed in the Catalog of Federal Domestic Assistance
(CFDA). If a valid three digit CFDA extension is unknow n, the
auditee w ill enter a “U” follow ed by a tw o digit number in the

Nam e of Pass-through Entity
Part II, Item 1(l) w ill be used to collect the name of the passthrough entity for Federal aw ards identified as not being direct in

Part II, Item 1(k). This name of the pass-through entity is required
by 2 CFR 200.510(b)(2).

The audit shall be completed and the data collection form and
reporting package shall be electronically transmitted w ithin the
earlier of 30 days after receipt of the auditor's reports, or nine
months after the end of the audit period. If the due date falls on a
Saturday, Sunday, or Federal holiday, the reporting package is
due the next business day (2 CFR 200.512(a)). The Uniform
Guidance does not permit Federal agencies or pass-through
entities to extend the due date.

Identifying Num ber Assigned by the Pass-through Entity
Part II, Item 1(m) w ill be used to collect the identifying number
assigned by the pass-through entity, if assigned, for Federal
aw ards identified as not being direct in Part II, Item 1(k). This
identifying number is required by 2 CFR 200.510(b)(2).
Federal Aw ard Passed Through to Subrecipients
Part II, Item 1(n) w ill be used to indicate if funds w ere passed
through to any subrecipients for the Federal program. Part II,
Item 1(o) w ill be used to identify the amount passed through to
subrecipients as required by 2 CFR 200.510(b)(4).

WHO TO CONTACT WITH QUESTIONS
For technical audit questions, please contact the auditee’s
Federal cognizant or oversight agency for audit. Contact
information for each Federal agency is provided in Appendix III of
the Compliance Supplement as Federal Agency Single Audit
Contacts.

Type of Auditor’s Opinion on the Financial Statem ents
Part III, Item 2(a), Financial Statement Information w as revised to
collect information w hen the financial statements are prepared in
accordance w ith a special purpose framew ork.

For questions related to a specific Federal program, please
contact the Federal agency from w hich the aw ard originated.
Contact information for each program listed in the Compliance
Supplement is provided in Appendix III of the Supplement as
Federal Agency Program Contacts.

Sum m ary Schedule of Prior Audit Findings Related to Direct
Funding
Part III, Item 3(d) is a revision to only collect data on prior audit
findings show n in the Summary Schedule of Prior Audit Findings
as data on current year audit findings is collected in Information
from the Schedule of Findings and Questioned Costs (or Part III,
Item 4, Federal Aw ard Audit Findings).

For questions concerning the Form SF-SAC submission process
or the form (e.g., how to report information on the form, reason
for rejection of a form or reporting package, and how to amend or
retract a previously accepted submission), contact the FAC at
800-253-0696 or ERD.FA C@Census.gov. Frequently Asked
Questions can be found on the IDES Web site.

Repeat Audit Findings and Prior Year Audit Finding
Reference Num bers
Part III, Item 4(m) and 4(n) w ill be used to identify w hether the
audit finding w as a repeat of an audit finding in the immediately
prior audit, and if so, any applicable prior year audit finding
reference numbers (2 CFR 200.516(b)(8) and (c)).

DESCRIPTION OF FORM
PART I: GENERAL INFORMATION
This section is completed by both the auditee and auditor.

Type of Com pliance Requirem ents
Using letters from Part 3 of the Compliance Supplement (A -N,
excluding D and K) plus P (for “Other”) the auditor must list all
type(s) of Compliance Requirements that apply to audit findings.
The Type of Compliance Requirement is the requirement the
auditor w as testing w hich generated the audit finding.

Item 1 - Fiscal Period End Date
Enter the last day of the fiscal period covered by the audit.
Item 2 - Type of Uniform Guidance Audit
Click the appropriate box. 2 CFR 200.501 of the Uniform
Guidance requires non-Federal entities that expend $750,000 or
more in a year in Federal aw ards to have a single audit
conducted except w hen they elect to have a program-specific
audit conducted in accordance w ith 2 CFR 200.507.

Auditee Certification Statem ent
Part IV, Item 1 w as revised to add specific certifications required
by the Uniform Guidance, including that the reporting package
does not include protected personally identifiable information and
to authorize the FAC to make the reporting package publicly
available on a Web site (2 CFR 200.512(b)).

Item 3 - Audit Period Covered
Mark the appropriate box. Annual audits cover 12 months and
biennial audits cover 24 months. If the audit period covered is
neither annual nor biennial, mark “Other” and provide the number
of months (excluding 12 and 24) covered in the space provided.

Auditor Statem ent
Part IV, Item 2 w as revised to update the references to the
revised form.

Item 4 - Auditee Identification Num bers
SUBMISSION TO THE FEDERAL AUDIT CLEARINGHOUSE

(a) Auditee Em ployer Identification Num ber (EIN) - Enter the
Auditee’s Employer Identification Number (EIN), the nine-digit
taxpayer identification number assigned by the Internal Revenue
Service (IRS). If the auditee w as assigned multiple EINs, enter
the primary EIN. Social Security Numbers must not be used.

Auditees are required to submit through the FAC Web site. The
only approved Form SF-SAC format is created using the Internet
Data Entry System (IDES) option on the FAC w eb site. The FAC
IDES Web site is located at:
https://harvester.census.gov/facides/. Submission instructions
are available on the IDES Web site.

(b) Are Multiple EINs Covered in this Report? - Mark the
appropriate “Yes” or “No” box to indicate if the auditee (or
components of an auditee covered by the audit) w as assigned
more than one EIN by the IRS. (e.g., a statew ide audit covers
many departments, each of w hich may have its ow n EIN.)

Revisions
The instructions for submitting revisions are available on the
IDES Web site.

(c) List the m ultiple EINs covered in this report - If Yes w as
marked for multiple EINs list the additional EIN numbers for all

Form Due Date

entities covered by the audit on the Auditee EIN Continuation
Sheet in Part I, 4(c). An EIN should be considered covered in this
report if this report is intended to satisfy the entity’s or
component’s (e.g., State Agency, sub-entity) Single Audit
requirement. Do not include separate EINs for any component
that did not receive, expend, or otherw ise administer Federal
aw ards. Do not include the primary EIN in Part I, Item 4c.

numbers for each campus listed in the original grant
applications in Item 4(f).
Item 5 - Auditee Inform ation
(a)

Note: Instructions for uploading additional EINs are included in
the on-line instructions available on the FAC IDES Web site.

Enter the auditee name associated w ith the primary EIN.
When possible, this name should match to the name
assigned to the primary EIN by the IRS.
Note: Department of Housing and Urban Development
project numbers are optional, and may be included w ith
the auditee name.

(d) Auditee Data Universal Num bering System (DUNS)
Num ber - The Data Universal Numbering System (DUNS)
number is a unique nine-digit identification sequence assigned by
Dun & Bradstreet (D&B) (available from the D&B DUNS
registration hotline at 866-705-5711). A DUNS number is
required w hen applying for a Federal grant on Grants.gov or any
other application method. All auditees w ho submit a Form SFSAC are requested, but not required to report the DUNS number
on Part I, Item 4(d) of the Form SF-SAC. For more information
go to http://fedgov.dnb.com/w ebform.

(b-e) Enter auditee contact information.
Item 6 - Prim ary Auditor Inform ation
(a-f)

(e) Are m ultiple DUNS num bers covered in this report? Mark the appropriate “Yes” or “No” box to indicate if a component
entity (e.g., State agency, sub-entity) expending Federal aw ards
is covered in the audit report.
(f) List the m ultiple DUNS num bers covered in this report - If
“Yes” is marked for multiple DUNS list the additional DUNS
numbers on the Auditee DUNS Continuation Sheet in Part I, Item
4(f). Report a DUNS number in this appendix if it identifies a
component entity (e.g., State Agency, sub-entity) of the auditee
w ith Federal aw ards expended during the fiscal period included
in the audit. Do not include separate DUNS numbers for any
component entity that did not expend or otherw ise administer
Federal aw ards. The order of the DUNS listings is not important.

Enter the name, Employer Identification Number (EIN),
and contact information of the primary auditor that
conducted the audit in accordance w ith the Uniform
Guidance. Auditors must not use any Social Security
Numbers as their EIN. To apply for an EIN, follow the
guidance of the Internal Revenue Service, located at
http://w w w.irs.gov/. The auditor name may represent a
sole practitioner, certified public accounting firm, State
auditor, etc. Where multiple audit organizations are used
to conduct the audit w ork, only the lead or coordinating
auditor shall provide its information on Page 1. The other
auditors may enter their contact information in Item 8, the
Secondary Auditors’ Contact Information Sheet.

Item 7 - Was a secondary auditor used?
Check “Yes” or “No” to indicate w hether or not multiple
auditors contributed to the audit. If “Yes”, enter the name,
Employer Identification Number (EIN), and contact
information of the secondary auditor organization(s) used
to conduct the audit w ork on the Secondary Auditors’
Contact Information Sheet.

Note: Instructions for uploading additional DUNS are included
in the on-line instructions available on the FAC IDES Web site.

Note: Only the primary auditor w ill sign the auditor
statement.

Exam ple 1: Com ponent Unit reporting: The Smith County
Sheriff’s Office applied for and expended its ow n Federal
grants using its ow n DUNS number. How ever, the Smith
County government Finance Office required the Sheriff’s
Office grants to be reported as a component of Smith
County’s Single Audit. Smith County should enter the Smith
County DUNS number as the principal DUNS number in
Item 4(d), mark Item 4(e) “Yes,” and enter the Smith County
Sheriff’s Office DUNS number in Item 4(f).

PART II: FEDERAL AWARDS
This section is completed by the auditee.
Item 1 – Federal Aw ard Expended During Fiscal Year
List each program for w hich Federal aw ards w ere expended in
the same order as show n in the Schedule of Expenditures of
Federal Aw ards in the reporting package. List individual
program s in each row .

Exam ple 2: Non-com ponent Unit reporting: The Jones
County Sheriff’s Office applied for and expended Federal
grants using its ow n DUNS number. The Jones County
Sheriff’s Office prepared and submitted an independent
Single Audit. The Jones County Sheriff’s Office should enter
its DUNS number as the principal DUNS number in Item
4(d), and mark Item 4(e) “No.”

The information to complete item 1 is obtained from the Schedule
of Expenditures of Federal Aw ards in the reporting package.
Note that Item 1 includes the required information for each
Federal program presented in the Schedule of Expenditures of
Federal Aw ards (and notes thereto), regardless of w hether audit
findings are reported.

Exam ple 3: Financial Adm inistration: A State University
system audit covers the Federal aw ard expenditures of
every campus in the system. Each University or campus in
the system applied for and expended its ow n direct Federal
grants using its ow n DUNS number. The State Board of
Education served only as a conduit for the disbursement of
Federal aw ards to each University and campus. The audit of
the State University system should list the payee’s (State
Board of Education) DUNS number as the primary DUNS
number in Item 4(d), mark Item 4(e) “Yes,” and list the DUNS

CFDA Num ber- Federal Aw arding Agency Prefix and
Extension
Most Federal programs are listed in the Catalog of Federal
Domestic Assistance (CFDA). A CFDA number consists of a tw odigit prefix, and a three-digit extension separated by a period. If
this information is unavailable, consult the Federal aw arding
agency or pass-through entity to obtain this number. The CFDA
catalog is available on the Internet at: https://w w w.cfda.gov. If the
Federal program does not have a CFDA number, follow the
specific instructions below .

select “State Cluster” from the drop-dow n menu and type in the
State Cluster name in the box provided w ithin the Internet Data
Entry System. If the name of the cluster does not appear in the
list, you can manually type in the cluster name, instead of using
the drop-dow n menu. Please notify the FAC if you discover
clusters that do not appear in the drop-dow n menu (not including
State Clusters).

(a) Federal Aw arding Agency Prefix - Enter the first tw o digits
of the CFDA number. The CFDA prefix identifies the Federal
Aw arding agency listed in Appendix I-A. If the Federal Aw arding
agency does not have a CFDA prefix, use one of the pref ixes
(noted w ith an asterisk) assigned for reporting purposes only.
(b) CFDA Three Digit Extension - The period is automatically
assumed and should not be entered on the form.

(g) Federal Program Total - The system w ill auto-generate the
total Federal aw ards expended for each individual Federal
program as required by 2 CFR 200.510(b)(3) by summing the
amount expended for all line items w ith the same CFDA Prefix
and Extension.

Program s w ith a CFDA Num ber
If the Federal program is listed in the CFDA, enter the last
three digits of the CFDA number in the CFDA Three Digit
Extension field.

(h) Cluster Total -The system w ill auto-generate the total
Federal aw ards expended for each cluster of programs as
required by 2 CFR 200.510(b)(3) by summing the amount
expended for all line items w ith the same Cluster Name.

Program s w ith No CFDA Num ber or the CFDA Num ber is
Unknow n
If the three digit CFDA extension is unknow n, the auditee w ill
enter a “U” follow ed by a tw o digit number in the CFDA
extension to identify one or more Federal aw ard lines w hich
form the program. This w ill allow the Internet Data Entry
System (IDES) to automatically calculate the Federal
Program Total and Cluster Total (Part II, Item 1(g) and 1(h)).
For more information on Federal program determination
w hen a CFDA extension is unknow n, see 2 CFR 200.42(b).

(i) Loan/Loan Guarantee - Mark either “Y” for Yes or “N” for No
if the program is a Federal loan or a Federal loan guarantee.
(j) If yes, the End of the Audit Period Outstanding Loan
Balance - Enter the loan or loan guarantee (loan) balances
outstanding at the end of the audit period for loan programs as
identified in Part II, Item 1(i), as required by 2 CFR 200.510(b)(5).
The outstanding loan balance outstanding at the end of the audit
period is the amount disclosed in the footnotes to the SEFA as
required by 200.510 (b)(5).

Exam ple: The first Federal program w ith an unknow n
three digit extension w ould be U01 for all aw ard lines
associated w ith that program, the second w ould be U02,
and so on.

(k) Direct Aw ard - Mark either “Y” for Yes or “N” for No to
indicate if the aw ard w as received directly from a Federal
aw arding agency. When an aw ard consists of both direct and
indirect (i.e., received as a subrecipient from a pass-through
entity) funds, list the direct expenditure detail on one line and the
indirect expenditure detail on a second line. When a single audit
reporting entity receives direct aw ards and transfers them to
another part of the same single audit reporting entity, these
aw ards should still be reported as direct (e.g., transfers w ithin the
single audit reporting entity do not create a pass-through
entity/subrecipient relationship).

Note: The tw o digit number can start over for each
Federal Agency or continue throughout the remainder of
the data collection form.
Program s that are part of the R&D Cluster and the CFDA
Num ber is Unknow n
If the Federal program is part of the Research and
Development (R&D) cluster and the CFDA Number is
unknow n, enter “RD” in the CFDA Three Digit Extension
field.

(l) If no, list Nam e of Pass-through Entity - Enter the name of
the pass-through entity for aw ard lines identified as not being
direct in Part II, Item 1(k). This name of the pass-through entity is
required by 2 CFR 200.510(b)(2).If a program has multiple passthrough entities, the data collection form w ill accept multiple
names for each pass-through entity.

(c) Additional Aw ard Identification - Part II, Item 1(c) is a
required field if Item 1(b) is unknow n. If Item 1(b) has a valid
CFDA Extension, then Item 1(c) is optional. Enter other data
used to identify the aw ard w hich is not a CFDA number (e.g.,
program year, contract number, state issued numbers, etc.).

(m ) If no, List Identifying Num ber Assigned by the Passthrough Entity, if assigned - Enter the identifying number
assigned by the pass-through entity, if assigned, for aw ard lines
identified as not being direct in Part II, Item 1(k). This number is
required by 2 CFR 200.510(b)(2). If a program has multiple passthrough aw ard numbers, the data collection form w ill accept
multiple identifying numbers assigned by the multiple pass through entities. If there is not an identifying number assigned by
the pass-through entity, enter “N/A” in this field.

(d) Nam e of Federal Program - Enter the name of the Federal
program as show n in the CFDA. If the program is not listed in the
CFDA, a description of the aw ard recognizable by the Federal
aw arding agency or pass-through entity should be entered. If a
valid CFDA Three Digit Extension is entered into Part II, Item
1(b), the system w ill auto-generate the Name of the Federal
Program w ith the name listed in the CFDA for the CFDA Number.
(e) Am ount Expended - Enter the amount of expenditures
included in the Schedule of Expenditures of Federal Aw ards in
the reporting package for each Federal aw ard. The SEFA must
include the total Federal aw ards expended as determined in
accordance w ith 2 CFR 200.502. Round to the nearest w hole
dollar.

(n) Federal Aw ard Passed Through to Subrecipients - Mark
either “Y” for Yes or “N” for No to indicate if funds w ere passed
through to any subricipients for the Federal program.
(o) If yes, Provide Am ount Passed Through –Enter the
amount passed through to subrecipients as required by 2 CFR
200.510(b)(4). This amount is also included in the amount
entered in Part II, Item 1(e). If multiple lines are entered for a
Federal program, then the amount passed through to

(f) Cluster Nam e – Select the name of the cluster of programs
from the drop-dow n menu. If the program is not part of a cluster,
select “N/A” for no cluster. If the program is part of a state cluster,

subrecipients should only be the amount relevant to that specific
line on the data collection form.

If the financial statements w ere not prepared in accordance w ith
GAAP but w ere prepared in accordance w ith a special purpose
framew ork, mark “Financial statements w ere not prepared in
accordance w ith GAAP but w ere prepared in accordance w ith a
special purpose framew ork.” (Reference AU-C Section 800,
“Special Considerations – Audits of Financial Statements
Prepared in Accordance With Special Purpose Framew ork,” for
additional information.)

PART III: INFORMATION FROM THE SCHEDUL E OF
FINDINGS AND QUESTIONED COSTS
This section is completed by the auditor.
All information for this section should be obtained from the
opinions on the financial statements and reports in accordance
w ith the Generally Accepted Government Auditing Standards
(GAGAS) related to the financial statement audit.

Complete Items (ii), (iii), and (iv) only if the statements w ere
prepared in accordance w ith a special purpose framew ork.
(ii) What w as the special purpose fram ework ? - Mark the
applicable special purpose framew ork that w as used as the basis
of accounting using the definitions in AU-C Section 800.

Item 1 - Major Program Inform ation and Audit Findings
The information to complete columns (a), (b), and (c) is obtained
from the Schedule of Findings and Questioned Costs prepared
by the auditor.

(iii) Was the special purpose framework used a basis
accounting required by state law or tribal law ? - Mark either
“Yes” or “No” as applicable. Mark “No” if the special-purpose
framew ork w as permitted by state law but not required. The
response to this question w ill affect w hether an entity can qualify
as a low -risk auditee in the tw o subsequent audit periods (see 2
CFR 200.520(b).

(a) Major program - Mark either “Y” for Yes or “N” for No to
indicate if the Federal program is a major program, as defined in
2 CFR 200.518.
(b) If yes, type of audit report on Major Program - If Part III,
Item 1(a) is marked “Y” for Yes, enter one letter (U, Q, A, or D)
corresponding to the type of audit report on the major program.
Enter either “U” for Unmodified opinion, “Q” for Qualified opinion,
“A” for Adverse opinion, or “D” for Disclaimer of opinion. For
clusters of programs, the type of audit report must apply to the
cluster as a w hole. Therefore, all programs in a cluster should
share the same type of audit report and each line should be filled
in completely.

(iv) What w as the auditor’s opinion on the special purpose
fram ework? - Select any combination of “Unmodified opinion” or
any combination of “Qualified opinion”, “Adverse opinion”, or
“Disclaimer of opinion”, as applicable.
(b) Is a “going concern” em phasis-of-matter paragraph
included in the auditor’s report? - Mark either “Yes” or “No” to
indicate the existence of a “going concern” emphasis-of-matter
paragraph in the auditor’s report.

Note: If tw o or more lines are listed for the same CFDA
number, all aw ard lines should have the same major program
determination and type of audit report on major program. If the
program is not a major program, leave the “Type of Audit
Report” blank.

(c) Is a significant deficiency disclosed? - Mark either “Yes” or
“No” to indicate the disclosure of a “significant deficiency.”
(d) Is a m aterial w eakness disclosed? - Mark either “Yes” or
“No” to indicate the disclosure of a “material w eakness”.

(c) Num ber of Audit Findings - Indicate the number of audit
findings on the Federal program. If there are no findings the
auditor should put “0” (zero).

(e) Is a m aterial noncom pliance disclosed? - Mark either “Yes”
or “No” to indicate the disclosure of a “material noncompliance.”

Item 2 - Financial Statem ents
Item 3 - Federal Program s
(a) Financial Statem ent Information (a) Does the auditor’s report include a statem ent that the
auditee’s financial statem ents include departments,
agencies, or other organizational units expending $750,000
or m ore in Federal aw ards that have separate Uniform
Guidance audits w hich are not included in this audit (AICPA
Audit Guide.) - According to AICPA Audit Guide “Government
Auditing Standards and Single Audits audit guide,” if the audit of
Federal aw ards did not encompass the entirety of the auditee’s
operations expending Federal aw ards, the operations that are not
included should be identified in a separate paragraph follow ing
the first paragraph of the report on major programs. In Part III,
Item 3(a), mark either “Yes” or “No” to indicate the presence of
such a paragraph for any departments, agencies, or other
organizational units not included in the audit, w hich expended
$750,000, or more in Federal aw ards during the fiscal period.

(i) What w ere the results of the auditor's determination of
w hether the financial statem ents of the auditee w ere
prepared in accordance w ith generally accepted accounting
principles (GAAP)? - If the financial statements w ere prepared
in accordance w ith generally accepted accounting principles
(GAAP), select any combination of “Unmodified opinion”,
“Qualified opinion”, “Adverse opinion”, or “Disclaimer of Opinion”,
as applicable.
Audits of state and local governments prepared in accordance
w ith GAAP often result in the auditor providing multiple opinions
on various opinion units w ithin the financial statements. In
situations w here there are unmodified opinions on some opinion
units and modified opinions on others, multiple boxes should be
checked in response to this question. For example, if the financial
statements for an auditee include a qualified opinion for one
opinion unit, a disclaimer of opinion for a second opinion unit,
and unmodified opinion on the remaining opinion units, then mark
“Qualified Opinion” and “Disclaimer of Opinion.” “Unmodified
Opinion” is marked only w hen an unmodified opinion applies on
the financial statements as a w hole or w hen unmodified opinions
are provided on all opinion units.

(b) What is the dollar threshold to distinguish Type A and
Type B program s? - Enter the dollar threshold used to
distinguish betw een Type A and Type B programs, as described
in 2 CFR 200.518(b)(1), or 2 CFR 200.518(b)(3) w hen a
recalculation of the Type A threshold is required for large loan or
loan guarantees. The dollar threshold must be $750,000 or
higher. Round to the nearest w hole dollar.

Deficiency or Neither. Mark “Y” for Yes or “N” for No for each
audit finding in each column.

(c) Did the auditee qualify as a low -risk auditee? - Mark either
“Yes” or “No” to indicate if the auditee qualifies as a low -risk
auditee under 2 CFR 200.520 at the beginning of the audit
period.

(k) Other Audit Findings - Other Audit Findings can be marked
“Y” for Yes if there are no Compliance Audit Findings or Internal
Control Audit Findings. If the auditor marked “N” in all four
columns (g), (h), (i), and (j), (indicating there are no compliance
audit findings or internal control audit findings) mark “Y” for Yes
to indicate Other Audit Findings.

(d) Indicate w hich Federal agency(ies) have prior audit
findings show n in the Sum m ary Schedule of Prior Audit
Findings related to direct funding. - Mark (X) the Federal
agency(ies) only if the Summary Schedule of Prior Audit Findings
reports the status of any audit findings relating to direct Federal
aw ards expended.

If the auditor marked “Y” in any columns (g), (h), (i), or (j),
indicating compliance audit findings or internal control audit
findings, mark “N” for No.

Item 4 - Federal Aw ard Audit Findings
The information on Part III, Item 4 directly corresponds to the
number of findings indicated in column (c) in Part III, Item 1. For
each finding noted on Part III, Item 1(c) the details w ill be entered
on Part III, Item 4. If Part III, item 1(c) “Number of Audit Findings”
is 0 (zero), no information w ill appear for that Federal Aw ard in
Part III, Item 4.

The chart below shows the nine different possible combinations
of findings for columns (g) through (k).

(g)

Row Num ber from Part II, Item 1 – This number allow s you to
trace back to CFDA line on the SEFA.

(h)

(i)

(j)

(k)

Compliance Internal Control
Audit Findings Audit Findings

Other Audit Findings

Significant Deficiency

Material Weakness

(b) CFDA Three Digit Extension - The CFDA extension as
show n in Part II, Item 1(b) w ill be auto-generated w hen the
“Number of Audit Findings” in Part III, Item 1(c) is greater than
zero.

Other Matters

Modified Opinion

(a) Federal Aw arding Agency Prefix - The first tw o digits of the
CFDA number as show n in Part II, Item 1(a) w ill be autogenerated w hen the “Number of Audit Findings” in Part III, Item
1(c) is greater than zero.

(Y/N ) (Y/N ) (Y/N ) (Y/N ) (Y/N )

1
2
3
4
5
6
7
8
9

(c) Additional Aw ard Identification - The Additional Aw ard
Identification as show n in Part II, Item 1(c) w ill be auto-generated
w hen the “Number of Audit Findings” in Part II, Item 1(c) is
greater than zero.
(d) Nam e of Federal Program - The name of the Federal
program as show n in Part II, Item 1(d) w ill be auto-generated
w hen the “Number of Audit Findings” in Part III, Item 1(c) is
greater than zero.
(e) Audit Finding Reference Num bers - The required format for
the audit finding reference numbers is the four digit audit year
(Part I, Item 1), a hyphen and a three digit number (e.g., 2016001, 2016-002…2016-999). Audit finding reference numbers on
the Form SF-SAC should match those reported in the Schedule
of Findings and Questioned Costs and applicable auditor’s
reports.

Y
Y
Y
N
N
N
N
N
N

N
N
N
Y
Y
Y
N
N
N

N
Y
N
N
Y
N
Y
N
N

N
N
Y
N
N
Y
N
Y
N

N
N
N
N
N
N
N
N
Y

(l) Questioned Costs - For each audit finding, the auditor w ill
report if there w ere any Questioned Costs related to that audit
finding. If questioned costs exist but the amount cannot be
determined, the auditor must mark “Y” for “Yes.”
(m ) Repeat Audit Finding from Prior Year - Mark either “Y” for
Yes or “N” for No to identify w hether the audit finding w as a
repeat of an audit finding in the immediate prior audit.

(f) Type of Com pliance Requirem ents - Using letters from Part
3 of the Compliance Supplement (A-N, excluding D and K) plus P
(for “Other”) the auditor must list all type(s) of Compliance
Requirements that apply to audit findings. The Type of
Compliance Requirement is the requirement the auditor w as
testing w hich generated the audit finding.

(n) If yes, provide Prior Year Audit Finding Reference
Num bers - If column (m) is marked “Y”, enter all applicable audit
finding reference numbers from the immediate prior audit (2 CFR
200.516(b)(8) and (c)).

(g) and (h) Com pliance Audit Findings -. Mark w hether the
auditor identified the audit finding in the Report on Compliance
for Each Major Federal Program as the basis for a Modified
Opinion or Other Matters or neither. Mark “Y” for Yes for “N” for
No for each audit finding in each column.

PART IV: CERTIFICATIONS
Item 1 - Auditee Certification Statem ent
A senior representative of the auditee (e.g., state controller,
director of finance, chief executive officer, chief financial officer)
electronically “signs” the certification statement below as required
by 2 CFR 200.512(b).

(i) and (j) Internal Control Audit Findings - Mark w hether the
auditor identified the audit finding in the Report on Internal
Control over Compliance as a Material Weakness or Significant

This is to certify that, to the best of my know ledge and belief
the follow ing is true and correct, the auditee has:

Assistance Act (ISDEAA), 25 U.S.C 450b(l)) and opts
not to authorize the Federal Audit Clearinghouse to
make the reporting package publicly available (tribes
selecting this option must submit the reporting package
to pass-through entities as described in 2 CFR
200.512(b)(2));

ensured that the reporting package does not include
protected personally identifiable information (Protected
PII) (2 CFR 200.79 and 2 CFR 200.82), or if it does, the
Federal Audit Clearinghouse is authorized to publicly
post all information contained in this Form SF-SAC and
the audit report;

ensured that the Form SF-SAC and reporting package
does not include protected personally identifiable
information (Protected PII) (2 CFR 200.79 and 2 CFR
200.82), or if it does, the Federal Audit Clearinghouse is
authorized to publicly post all information contained in
the Form SF-SAC;

ensured that the Form SF-SAC and reporting package
does not include business identifiable information (BII)
as defined below *, or if it does, the Federal Audit
Clearinghouse is authorized to publicly post all
information contained in this Form SF-SAC and the
audit report
complied w ith the requirements of 2 CFR Part 200
Subpart F specific to the auditee;

prepared the data in this form in accordance w ith 2 CFR
Part 200 and the accompanying instructions to this form;

complied w ith the requirements of 2 CFR Part 200
Subpart F specific to the auditee;

included all information required to be reported in this
form in its entirety and such information is accurate and
complete;

prepared the data in this form in accordance w ith 2 CFR
Part 200 and the accompanying instructions to this form;
included all information required to be reported in this
form in its entirety and such information is accurate and
complete;

engaged an auditor to perform an audit in accordance
w ith 2 CFR Part 200. for the period described in Part I,
Items 1 and 3;

engaged an auditor to perform an audit in accordance
w ith 2 CFR Part 200.500 for the period described in Part
I, Items 1 and 3;

ensured the auditor has completed such audit and
issued the signed audit report required by 200.515
w hich states that the audit has conducted in accordance
w ith the audit requirements of the Uniform Guidance;
and

authorized the FAC to make the reporting package
publicly available on a Web site
*BII consists of information defined in the Freedom of Information
Act (FOIA) as “trade secrets and commercial or financial
information obtained from a person [that is] privileged or
confidential.” (5 U.S.C.552(b)(4)). This information is exempt
from automatic release under the (b)(4) FOIA exemption.
“Commercial” is not confined to records that reveal “basic
commercial operations” but includes any records or information in
which the submitter has a commercial interest, and can include
information submitted by a nonprofit entity. Additional examples
of BII will be included on the FAC’s Frequently Asked Questions
and on the certification page within the IDES.

authorized the FAC to make the Form SF-SAC publicly
available on a Web site
*BII consists of information defined in the Freedom of Information
Act (FOIA) as “trade secrets and commercial or financial
information obtained from a person [that is] privileged or
confidential.” (5 U.S.C.552(b)(4)). This information is exempt
from automatic release under the (b)(4) FOIA exemption.
“Commercial” is not confined to records that reveal “basic
commercial operations” but includes any records or information in
which the submitter has a commercial interest, and can include
information submitted by a nonprofit entity. Additional examples
of BII will be included on the FAC’s Frequently Asked Questions
and on the certification page within the IDES

Com plete the Indian Tribe or Tribal Organization Auditee
Certification Statem ent only if the checkbox “Qualified as an
Indian Tribe or Tribal Organization” is checked from the
Subm ission Criteria Check Page in the Internet Data Entry
System (IDES).

Item 2 - Auditor Statem ent
The auditor must electronically “sign” the follow ing statement on
the form:

Item 1 - Auditee Certification Statem ent
A senior representative of the auditee (e.g., state controller,
director of finance, chief executive officer, chief financial officer)
electronically “signs” the certification statement below as required
by 2 CFR 200.512(b).
This is to certify that, to the best of my know ledge and belief
the follow ing is true and correct, the auditee has:

The data elements and information included in this form
are limited to those prescribed by the Uniform Guidance.
The information in Part II of this form is the responsibility
of the auditee and is based on information included in the
reporting package required by the Uniform Guidance. The
information included in Part III of this form, except for Part
III Item 2(a)(iii), Item 3(d), and Items 4(a) – (d) (w hen there
are audit findings), w as transferred by the auditor from the
auditor's report(s) for the period described in Part I, Items

qualified as an Indian Tribe or Tribal Organization (as
defined in the Indian Self-Determination, Education and

1 and 3, and is not a substitute for such reports. The
auditor has not performed any auditing procedures since
the date of the auditor's report(s) or any additional auditing
procedures in connection w ith the completion of this form.
A copy of the reporting package required by the Uniform
Guidance, w hich includes the complete auditor’s report(s),
is required to be made available by the FAC on the FAC
w eb site. It is also available in its entirety from the auditee
at the address identified in Part I of this form and on the
FAC w eb site.

APPENDIX I-A
Federal Audit Clearinghouse Federal Agency Two-Digit Prefix List
(Alphabetic Order)
01*

African Development Foundation

61*

International Trade Commission

U. S. Agency for International Development

Japan – U.S. Friendship Commission

Department of Agriculture

Department of Justice

Appalachian Regional Commission

Department of Labor

Architectural & Transportation Barriers

09*

Legal Services Corporation

Compliance Board

Library of Congress

Central Intelligence Agency

99*

Miscellaneous

Department of Commerce

National Aeronautics & Space Administration

Commission on Civil Rights

National Archives & Records Administration

Commodity Futures Trading Commission

National Council on Disability

Consumer Product Safety Commission

National Credit Union Administration

Corporation for National and Community Service

National Foundation on the Arts and the

Department of Defense

Delta Regional Authority

National Gallery of Art

Denali Commission

National Labor Relations Board

Department of Education

National Science Foundation

Election Assistance Commission

Nuclear Regulatory Commission

Department of Energy

07*

Office of National Drug Control Policy

Environmental Protection Agency

Office of Personnel Management

Equal Employment Opportunity Commission

Overseas Private Investment Corporation

Federal Communications Commission

08*

Peace Corps

Federal Maritime Commission

Pension Benefit Guaranty Corporation

Federal Mediation and Conciliation Service

Railroad Retirement Board

Federal Reserve System

Scholarship Foundations

Federal Trade Commission

Securities and Exchange Commission

General Services Administration

Small Business Administration

Government Printing Office

Smithsonian Institution

Department of Health and Human Services

Social Security Administration

Department of Homeland Security

Department of State

Department of Housing and Urban Development

Tennessee Valley Authority

United States Institute of Peace

Department of Transportation

04*

Inter-American Foundation

Department of the Treasury

Department of the Interior

Department of Veterans Affairs

Humanities

* Note: These prefixes are not assigned by the Catalog of Federal Domestic Assistance,
and are only used for OMB Uniform Guidance reporting purposes only.

APPENDIX I-B
Federal Audit Clearinghouse Federal Agency Two-Digit Prefix List
(Numeric Order)
01*