Form OSM-47 Budget Information Report

U.S. DEPARTMENT OF THE INTERIOR

OMB Control No. 1029-0059

Office of S urface Mining Reclamation and Enforcement

Exp. Date: 7/31/2021

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A. Program
E. Budget Period (Month, Day, Year)
B. Grantee
Beginning Date
C. Grant Program
Ending Date
D. Rate of Federal Sharing (%)

F. Mark 'X' in Appropriate Box
(
) New Budget
(
) Revised Budget (Enter Grant Number)
(
) Grant Number

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TOTAL
(a)

(b)

(c)

(d)

(e)

(f)

(g)

1. Personnel
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$0.00

2. Fringe Benefit

$0.00

3. Travel
4. Equipment
5. Supplies
6. Contractural

$0.00
$0.00
$0.00

$0.00

7. Construction

$0.00

8. Other
$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

10. Indirect Charges
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$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

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13. Federal Share

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14. Program Income

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15. Detail on Indirect Cost
Type of Rate (mark 'X' in Box)
Rate________%

$0.00

 

12. Non-Federal Share

E. Signature of Authorizing Official

Excel

$0.00

9. Total Direct Charges

$0.00

$0.00

$0.00

(
) Predetermined
Total Amount _______________
F. Name and Title (type or print)

(
) Provisional
Base _________

(

) Final

G. Telephone Number (Area Code, Number
and Extension)

(

) Fixed

H. Date Report Submitted

OSM-47 (8/97)

The Paperwork Reduction Act of 1995 (44 U.S.C. 3501) requires us to inform you that: Federal Agencies 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. This information is being collected to review, administer and evaluate the
States/Tribes grants for program development and administration and enforcement to meet the requirements of the Surface Mining Control Reclamation and Enforcement
Act. The obligation to respond is required to obtain a benefit. Public reporting burden for this form is estimated to average 1 hours per response, including time for
reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this
form to the Information Collection Clearance Officer, Office of Surface Mining Reclamation and Enforcement, 1849 C Street, NW, Room 4559, Washington, DC 20240.