Download:
docx |
pdf
OMB
No 1845-0030 Expires: Under Review
Public
Burden Statement
According
to the Paperwork Reduction Act of 1995, no persons are required to
respond to a collection of information unless such collection
displays a valid OMB control number. The valid OMB control number
for this information collection is 1845-0030. Public reporting
burden for this collection of information is estimated to average 24
hours 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.
Responding to this collection is mandatory in accordance with 34 CFR
674.19 (Federal Perkins Loan), 34 CFR 675.19 (Federal Work-Study),
and 34 CFR 676.19 and 20 U.S.C. 1094 (Federal Supplemental
Educational Opportunity Grant). If you have comments or concerns
regarding the status of your individual submission of this form,
please contact the FSA Partner and School Relations Center directly
at 1-800-848-0978 or email CODSupport@ed.gov.
Fiscal Operations Report and Application to
Participate (FISAP)
Report:
Award Year July 1, 2022 through June 30, 2023; Application: Award
Year July 1, 2024 through June 30, 2025
Part I. Identifying Information, Certification
and Warning
Section A. Identifying Information
1(a) Name and address of school
________________________________________________________________________________________________________________________________________________________________________________________________________
2. OPEID Number _____________________
3. Type of school (select one)
__
3.1 public
__
3.2 private/non-profit
__
3.3 proprietary
(Select
one if
proprietary)
__
(a) art
__
(b) business
__
(c) cosmetology
__
(d) trade and technical
__
(e) other
1(b) Mailing address (if different from 1(a))
________________________________________________________________________________________________________________________________________________________________________________________________________
4. Length/type of longest program (select one)
__
4.1 less than 1 year
__
4.2 1 year but less than 2 years
__
4.3 2 years but less than 3 years
__
4.4 3 years but less than 4 years
__
4.5 4 years (no higher than a baccalaureate degree)
__
4.6 5 years or more
__
4.7 post-baccalaureate only
5. Additional Instititutions
If the data
reported on this form applies to more than one eligible institution
you must identify all institutions for which this form is
applicable. The OPEID and individual amount(s) of 2022–23
FSEOG and FWS authorizations allocated to each institution must be
provided. See instructions.
This FISAP includes data for more than one
eligible institution. __ yes __ no
If yes, list the following for each eligible
institution (not all institutions may show here; see instructions
for how to obtain a complete list):
OPEID ______________ 2022–23
FSEOG $______________
2022–23 FWS $______________
6. Financial Aid Administrator
Name
_____________________________ Telephone
No. ______________
Email address
_____________________________ Fax
No.
______________
7. Name and address of private financial aid
consultant firm, if any
Name
_____________________________________________
Address
1_____________________________________________
Address
2_____________________________________________
City ____________________ State
______ Zip ____________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Section B. Certification and Warning
Applicants must review the requirements for
certification regarding lobbying included in the regulations cited
below before completing this form. Applicants must sign this form to
comply with the certification requirements under 34 CFR Part 82, “New
Restrictions on Lobbying.” This certification is a material
representation of fact upon which the Department of Education relies
when it makes a grant or enters into a cooperative agreement.
As required by Section 1352, Title 31 of the U.S.
Code, and implemented at 34 CFR Part 82, for persons entering into a
Federal contract, grant or cooperative agreement over $100,000, as
defined at 34 CFR Part 82, Sections 82.105 and 82.110, the applicant
certifies that:
(a) No Federal appropriated funds have been paid
or will be paid, by or on behalf of the undersigned, to any person
for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the making
of any Federal grant, the entering into of any cooperative agreement,
and the extension, continuation, renewal, amendment, or modification
of any Federal grant or cooperative agreement;
(b) If any funds other than Federal appropriated
funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal
grant or cooperative agreement, the undersigned shall complete and
submit Standard Form-LLL, “Disclosure Form to Report Lobbying,”
in accordance with its instructions; and
(c) The undersigned shall require that the
language of this certification be included in the award documents for
all subawards at all tiers (including subgrants and contracts under
grants and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
As the duly authorized representative of the
applicant, I hereby certify that the applicant will comply with the
above certification. I further certify that the information contained
in this electronic FISAP is in compliance with governing legislation
and regulations and is true and accurate. I understand that all
information associated with this FISAP is subject to audit and
program review by representatives of the Secretary of Education.
WARNING: If you purposely give false or misleading
information, you may be fined up to $20,000, sent to prison, or both.
8. Chief Executive Officer (e.g. President,
Chancellor, Director, Owner)
Important: ONLY the school’s CEO is
authorized to sign the FISAP.
Signature
_________________________________ Date
signed _______________
Name
____________________________________ Telephone
No. ____________
Title
_____________________________________ Fax
No. _________________
E-mail
address _____________________________
The CEO must provide an original signature on the
printed form that must be mailed or hand delivered by the September
29, 2023 deadline date.
-
Standard
Mail:
U.S.
Department of Education
P.O.
Box 1130
Fairfax,
VA 22038
|
Overnight
Mail/Courier:
U.S.
Department of Education
4050
Legato Road, #1100
Fairfax,
VA 22033
|
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part II. Application to Participate for Award
Year July 1, 2024 through June 30, 2025
Section A. Request for Funds for the 2024–25
Award Year
1. Federal Perkins Loan Level of Expenditures $
__N/A____
2. Federal Perkins Loan Federal Capital
Contribution $ __N/A____
3. FSEOG federal funds $ _________
4. FWS federal funds $ _________
Section B. Federal Perkins Loan Program
Liquidation Request
(Refer to FISAP Instructions for a more detailed
explanation of this Section and field.)
5. My school wishes to liquidate its Federal
Perkins Loan Program portfolio. __
yes __
no
Section C. Waiver Request for the Underuse of
Funds
My school has returned more than 10 percent of its
FSEOG or FWS allocation for the 2022–23 award year.
6. My school wishes to apply for a waiver of the
penalty for the underuse of funds and will provide, on the FISAP
Validation screen, a thorough detailed written explanation of the
circumstances. __
yes __
no
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part II. Application to Participate for Award
Year July 1, 2024 through June 30, 2025
Section D. Information on Enrollment
My school’s calendar is __Traditional
__Non-Traditional
Schools with a traditional calendar that had
2022–23 enrollment, fill in Field 7.
7. Total number
students, 2022–23 (a) Undergraduate ____________ (b)
Graduate/Professional ____________
Schools with a traditional calendar that did not
have 2022–23 enrollment, fill in Field 8.
8. Estimated
number students, 2023–24 (a) Undergraduate ____________ (b)
Graduate/Professional ____________
Schools with a non-traditional calendar that had
2022–23 enrollment, fill in fields 9 through 20.
Undergraduate Undergraduate Graduate/Professional Graduate/Professional
Continuing
Students New Starts Continuing Students New Starts
(a) (b) (c) (d)
9. July 1,
2022 ____________ ____________ ____________ ____________
10. August
1 ____________ ____________ ____________ ____________
11. September
1 ____________ ____________ ____________ ____________
12. October
1 ____________ ____________ ____________ ____________
13. November
1 ____________ ____________ ____________ ____________
14. December
1 ____________ ____________ ____________ ____________
15. January 1,
2023 ____________ ____________ ____________ ____________
16. February
1 ____________ ____________ ____________ ____________
17. March
1 ____________ ____________ ____________ ____________
18. April
1 ____________ ____________ ____________ ____________
19. May
1 ____________ ____________ ____________ ____________
20. June
1 ____________ ____________ ____________ ____________
21.
TOTAL ____________ ____________ ____________ ____________
Section E. Assessments and Expenditures
Undergraduate
(a) Graduate/Professional (b)
22. Total tuition and fees for the award year
July 1, 2022 to June 30, 2023 $____________ $____________
23.
Total Federal Pell Grants expenditures for the 2022–23 award
year $____________
24.
Total expended for state grants and scholarships made to
undergraduates for the award year July 1, 2022 to
June 30, 2023 $__N/A_______
Section F. Information on Eligible Aid Applicants
Enrolled in Your School for Award Year 2022–23
Dependent
Undergraduate Independent Undergraduate Independent
Without
Baccalaureate/ With Baccalaureate Without Baccalaureate/ With
Baccalaureate/ Graduate/
1st Prof.
Degree (a) 1st Prof. Degree (b) 1st Prof
Degree (c) 1st Prof. Degree (d) Professional (e)
25. Students with an
“Automatic” Zero
EFC ____________ ____________ ____________ ____________ ____________
Taxable
and Untaxed Income Taxable
and Untaxed Income
26. $0 - $2,999 _________ _________ $0 -
$999 _________ _________ _________
27. $3,000 - $5,999 _________ _________ $1,000 -
$1,999 _________ _________ _________
28. $6,000 - $8,999 _________ _________ $2,000 -
$2,999 _________ _________ _________
29. $9,000 - $11,999 _________ _________ $3,000 -
$3,999 _________ _________ _________
30. $12,000 - $14,999 _________ _________ $4,000
- $4,999 _________ _________ _________
31. $15,000 - $17,999 _________ _________ $5,000
- $5,999 _________ _________ _________
32. $18,000 - $23,999 _________ _________ $6,000
- $7,999 _________ _________ _________
33. $24,000 - $29,999 _________ _________ $8,000
- $9,999 _________ _________ _________
34. $30,000 - $35,999
_________ _________ $10,000 - $11,999 _________ _________ _________
35. $36,000 - $41,999 _________ _________ $12,000
- $13,999 _________ _________ _________
36. $42,000 - $47,999 _________ _________ $14,000
- $15,999 _________ _________ _________
37. $48,000 - $53,999 _________ _________ $16,000
- $17,999 _________ _________ _________
38. $54,000 - $59,999 _________ _________ $18,000
- $19,999 _________ _________ _________
39. $60,000 and over _________ _________ $20,000
and over _________ _________ _________
40.
TOTAL _________ _________ TOTAL _________ _________ _________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part III. Federal Perkins Loan Program for Award
Year July 1, 2022 through June 30, 2023
Section A. Fiscal Report (Cumulative) as of June
30, 2023
Field
Item Amount Number
of Borrowers Debit Balances Credit Balances
(a) (b) (c) (d)
1.1. Cash on hand and in depository as of
6/30/2023 $__________
1.2. Cash on hand and in depository as of
10/31/2023 $__________
2. Funds receivable from federal
government $__N/A_____
3. Funds receivable from
school $__N/A_____
4. Funds advanced to
students __________ $__________
5. Loan principal
collected __________ $__________
6. Loan principal assigned to and accepted by the
United
States __________ $__________
Loan principal canceled for the following
categories:
7. teaching/military service (applies to loans
made prior to
07/01/1972) __________ $__________
8. certain subject matter teaching service (math,
science, foreign languages, bilingual education)
__________ $__________
9. all other authorized pre-K or K-12 teaching
service __________ $__________
10. military service (applies to loans made
07/01/1972 and after) __________ $__________
11. volunteer
service __________ $__________
12. law enforcement and corrections officer
service __________ $__________
13. child/family/early intervention
service __________ $__________
14. nurse/medical technician
service __________ $__________
15. pre-K or child care program staff member
service __________ $__________
16. service as an attorney in a public defender
organization __________ $__________
17. fire fighter
service __________ $__________
18. Tribal College or University faculty
service __________ $__________
19. librarian
service __________ $__________
20. speech-language pathology
service __________ $__________
21.
death/disability __________ $__________
22. disability based on VA
determination __________ $__________
23. bankruptcy __________ $__________
24. surviving spouses of public service
victims of 9-11
terrorist attacks __________ $__________
25. loans discharged due to closed
schools __________ $__________
26. Loan principal adjustments –
other __________ $__________
27. Federal Capital
Contributions $__________
28.1 Repayments of
fund capital to federal
government
$__________
28.2 Service cancelation reimbursement received
on or after
07/01/2019 $__________
28.3
Total FCC offset (repayments of FCC + amount
retained by school as
reimbursement for cancellations) $__________
29.1.
Short-term loans to the Fund $__________
29.2. ICC deposited to the Fund $__________
29.3. Institutional Capital
Contributions $__________
30.1. Repayment of short-term loans to the
fund $__________
30.2. Repayments of excess/liquidated fund
capital
to
Institution $__________
30.3. Repayments of fund capital to
school $__________
31. Interest income on loans $__________
32. Other income $__________
33. Reimbursements to the Fund through 06/30/2009
of amounts canceled on loans made 07/01/1972 and
after $__________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part III. Federal Perkins Loan Program for
Award Year July 1, 2022 through June 30, 2023
Section A. Fiscal Report (Cumulative) as of June
30, 2023
Field
Item Amount Number
of Borrowers Debit Balances
Credit
Balances
(a)
(b) (c) (d)
34.1. Administrative cost
allowance $__________
34.2. Collection costs $__________
34.3. Administrative cost allowance and
collection costs (control) $__________
Cost of loan principal and interest canceled for
the following categories:
35. teaching/military service (applies to loans
made prior to 07/01/1972) $__________
36. certain subject matter teaching service
(math, science, foreign languages, bilingual
education) $__________
37. all other authorized pre-K or K-12 teaching
service (applies to loans made 07/01/1972 and after)
$__________
38. military service (applies to loans made
07/01/1972 and after) $__________
39. volunteer service in the Peace Corps or under
the Domestic Volunteer Service Act of 1973 $__________
40. law enforcement and corrections officer
service $__________
41. child/family/early intervention
service $__________
42. nurse/medical technician
service $__________
43. pre-K or child care program staff member
service $__________
44. service as an attorney in a public defender
organization $__________
45. fire fighter service $__________
46. Tribal College or University faculty
service $__________
47. librarian service $__________
48. speech-language pathology
service $__________
49. death/disability $__________
50. VA disability
determination $__________
51. bankruptcy $__________
52. surviving spouses of public service victims
of 9-11 terrorist attacks $__________
53. Cost of loan principal and interest assigned
to and accepted by the United States $__________
54. Cost of loan principal and interest canceled
for loans discharged due to closed schools $__________
55. Other costs or losses $__________
56. Balancing Adjustments
(Debits) $__________
57. Balancing Adjustments
(Credits) $__________
58. Total debits and credits (Sum of fields 1.1
through 57) $__________ $__________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part III. Federal Perkins Loan Program for Award
Year July 1, 2022 through June 30, 2023
Section B. Annual Activity During the 2022–23
Award Year (July 1, 2022 through June 30, 2023)
Number
of Borrowers Amount
(a)
(b)
1. Final adjusted Federal Capital Contribution
(FCC) authorization $__N/A______
2. FWS funds transferred to the Fund
+ $__N/A______
3. FCC transferred to:
(a) FSEOG - $__N/A______
(b) FWS - $__N/A______
4. Total federal funds available for the 2022–23
award year (fields 1 + 2 – 3(a) – 3(b)) $__N/A______
5. The unexpended amount of final adjusted
authorized FCC for award year 2022–23
that was NOT requested from G5 by June 30, 2023.
This amount will be reduced
from your total award amount next
spring (see instructions). $__N/A______
6.
Institutional Capital Contribution (ICC) deposited into the Fund
between July 1, 2022 and June 30, 2023 $__N/A______
7. Loans advanced to students from the Fund
during the 2022–23 award year
(minus 2022–23 award year refunds)
$__N/A______
8. Administrative cost allowance claimed
for the 2022–23 award year (see
instructions) $__N/A______
9.1 Total principal repaid by borrowers
from all sources during the 2022–23 award year __________
$__________
9.2 Total interest repaid by borrowers from all
sources during the 2022–23 award year
__________ $__________
10. Total principal repaid by borrowers from all
sources during the 2022–23 award
year for loans in default for more than 2
years but not more than 5 years __________
$__________
11. Total principal repaid by borrowers
from all sources during the 2022–23 award
year for loans in default for more than 5
years __________
$__________
12. Annual servicing costs paid with
institutional funds during the 2022–23 award
year for non-defaulted loans (do not include
collection costs included in Section A, field 34.2) $__________
13. Amount of loan service cancellation
reimbursement your institution received during the
2022–23 award year, if applicable
(do not include this amount in Section A, field 33) $__________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part III. Federal Perkins Loan Program for Award
Year July 1, 2022 through June 30, 2023
Section C. Cumulative Repayment Information as of
June 30, 2023
Status of Borrowers as of June 30,
2023 Amount Number of Amount Lent Principal Amount
Borrowers Outstanding
(a) (b) (c) (d)
1.1. Borrowers whose loans are fully
retired __________ $__________
1.2. Loans that have been
purchased $__________
2. Borrowers whose loans were assigned to
and officially accepted
by the U.S. Department of Education as of June
30, 2023
(Note: Field 2 equals the sum of Field 2.1 plus
Field 2.2.) __________ $__________ $__________
2.1. Assignments due to default or
liquidation __________ $__________ $__________
2.2. Assignments due to total and permanent
disability discharge __________ $__________ $__________
3. Total borrowers not in repayment
status __________
$__________
4. Borrowers on schedule in repayment
status __________ $__________
5.1. In default less than 240 days (monthly
installments) or less than
270 days (other installments) __________
$__________
$__________
5.2. In default 240 days or more (monthly
installments) or 270 days
or more (other installments), up to 2 years
__________
$__________
$__________
5.3. In default more than 2 years but not
more than 5 years __________
$__________
$__________
5.4. In default more than 5 years
__________
$__________
$__________
Cohort Default Rate (Sections D and E)
Schools with fewer than 30 borrowers who entered
repayment in the 2021–22 award year should skip to Section E.
Section D. Schools with 30 or More Borrowers Who
Entered Repayment in the 2021–22 Award Year
1.1. Number of borrowers who entered repayment in
2021–22 __________
1.2. Number of borrowers from Field 1.1 above
with loans in default by June 30, 2023 __________
1.3. Cohort default rate ((Field 1.2 / Field 1.1)
x 100) __________
Section E. Schools with Fewer than 30
Borrowers Who Entered Repayment in the 2021–22 Award Year
2.1. Number of borrowers who entered repayment
in: 2.2. Number of borrowers with loans in default by:
(a) 2019–20 (07/01/2019-06/30/2020)
__________ (a)
June 30, 2021 (those in 2.1(a) only) __________
(b) 2020–21
(07/01/2020-06/30/2021) __________ (b)
June 30, 2022 (those in 2.1(b) only) __________
(c) 2021–22
(07/01/2021-06/30/2022) __________ (c)
June 30, 2023 (those in 2.1(c) only) __________
2.3. Total number of borrowers who entered
repayment during the three years above (fields 2.1(a) + 2.1(b) +
2.1(c)) __________
2.4. Total number of borrowers with loans in
default during the three years above (fields 2.2(a) + 2.2(b) +
2.2(c)) __________
2.5. Cohort default rate ((Field 2.4 / Field 2.3)
x 100) __________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part III. Federal Perkins Loan Program for Award
Year July 1, 2022 through June 30, 2023
Section F. Capital Contributions to the Perkins
Fund
Total Federal capital contributions (FCC)
made to the Fund (from Section A, Field 27) $__________
1.1 Total FCC offset
(from Section A, Field 28.3) $__________
Total net FCC (field 1 – field
1.1) $__________
Total institutional capital contributions
(ICC) made to the Fund (from Section A, Field 29.3) $__________
2.1 Total repayments
of fund capital to school (from Section A, Field 30.3) $__________
2.2 Total net ICC
(field 2 – field 2.1) $__________
Total net capital contributions made to the
Fund (net FCC field 1.2 + net ICC field 2.2) $__________
Federal share percentage of total net
capital contributions (field 1.2 divided by field 3) __________%
Institutional share percentage of total net
capital contributions (field 2.2 divided by field 3) __________%
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part IV. Federal Supplemental Educational
Opportunity Grant (FSEOG) Program for Award Year July 1, 2022
through June 30, 2023
Section A. Federal Funds Authorized for FSEOG
1. Final adjusted FSEOG authorization (as of
10/1/2023) $____________
Section B. Federal Funds Available for FSEOG
Expenditures
2. FWS funds transferred to and spent in
FSEOG + $____________
3. Federal Perkins Federal Capital
Contribution funds transferred to and spent in
FSEOG + $__N/A________
4. FSEOG funds
transferred to and spent in FWS -
$____________
5. 2023–24 FSEOG funds carried back
and spent in 2022–23 + $____________
6. Additional 2023–24 FSEOG funds
carried back and spent for 2023 summer enrollment + $____________
7. 2021–22 funds carried forward
and spent in 2022–23 + $____________
8. 2022–23 funds carried forward to
be spent in 2023–24 -
$____________
9. 2022–23 funds carried back and
spent in 2021–22 -
$____________
10. Additional 2022–23 funds
carried back and spent for 2022 summer enrollment -
$____________
11. Total federal funds available for
2022–23 FSEOG
(fields 1 + 2 + 3 + 5 + 6 + 7) minus
(fields 4 + 8 + 9 + 10) $____________
Section C. Funds to FSEOG Recipients
12. Total funds to FSEOG recipients (fields 13
+ 14) $____________
13. Nonfederal share of funds to FSEOG
recipients (25 percent of Field 12) $____________
(a) Cash outlay contributed
$____________
(b) Other resources designated
$____________
Section D. Federal Funds Spent for FSEOG Program
14. Federal share of funds to FSEOG recipients
(75 percent of Field 12) $____________
15. Administrative cost allowance claimed
(see instructions) $____________
16. Federal funds spent for FSEOG (fields
14 + 15) $____________
Section E. Use of FSEOG Authorization
17. Expended FSEOG authorization (fields 4 + 8
+ 9 + 10 + 16) minus (fields 2 + 3 + 5 + 6 + 7) $____________
18.
Unexpended FSEOG authorization (Field 1 - Field 17) (cannot be
negative) $____________
Section F. Information about FSEOG
Disaster-Affected Students
19. Number of disaster-affected students who
received FSEOG funds ____________
20. Federal Share of FSEOG funds to
disaster-affected students $____________
21. Total FSEOG Funds to
disaster-affected students $____________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part V. Federal Work-Study (FWS) Program for
Award Year July 1, 2022 through June 30, 2023
Section A. Federal Funds Authorized for FWS
1. Final adjusted FWS authorization (as of
10/1/2023) $____________
Section B. Federal Funds Available for FWS
Expenditures
2. Federal Perkins Federal Capital Contribution
funds transferred to and spent in FWS + $____________
3. FSEOG funds transferred to and spent
in FWS + $____________
4. FWS funds transferred to and spent in:
(a) FSEOG - $____________
(b) Federal Perkins Loan Program
- $__N/A________
(c) Work Colleges
Program - $____________
5. 2023–24 FWS funds carried back
and spent in 2022–23 + $____________
6. Additional 2023–24 FWS funds
carried back and spent for 2023 summer employment + $____________
7. 2021–22 funds carried forward
and spent in 2022–23 + $____________
8. 2022–23 funds carried forward to
be spent in 2023–24 - $____________
9. 2022–23 funds carried back and
spent in 2021–22 - $____________
10. Additional 2022–23 funds
carried back and spent for 2022 summer employment - $____________
11. Total
federal funds available for 2022–23 FWS
(fields 1 + 2 + 3 + 5 + 6 + 7) minus (fields 4(a)
+ 4(b) + 4(c) + 8 + 9 + 10) $____________
Section C. Total Compensation for FWS
12. Total earned compensation for FWS Program
$____________
(a) On-campus earned
compensation $____________
(b) Off-campus earned
compensation for public or private non-profit agencies,
excluding amounts reported in Field 12(c)
$____________
(c) Off-campus earned
compensation for agencies that were unable to pay
regular nonfederal share and had a federal share
up to 90 percent $____________
(d) Off-campus earned
compensation for private for-profit organizations $____________
13. Total institutional share of earned
compensation (see instructions) $____________
Section D. Funds Spent from Federal Share
of FWS
14. Total federal share of FWS earned
compensation $____________
(a) Federal share paid at a rate up to 75
percent $____________
(b) Federal share paid at a rate up to 100
percent for waivers of
nonfederal share $____________
(c) Federal share paid at a rate up to 90
percent for agencies that were
unable to pay regular nonfederal
share $____________
(d) Federal share paid at a rate up to 50
percent for off-campus, private
for-profit
organizations $____________
15. Administrative cost allowance claimed
(see instructions)
$____________
16.
Federal share of Job Location and Development (JLD) Program
expenditures $____________
17. Total federal funds spent for FWS
(fields 14 + 15 + 16) $____________
Name of School
_____________________________________________________
OPEID
Number _________ State _______
Part V. Federal Work-Study (FWS) Program for
Award Year July 1, 2022 through June 30, 2023
Section E. Use of FWS Authorization
18. Expended FWS authorization (fields 4(a) +
4(b) + 4(c) + 8 + 9 + 10 + 17) minus (fields 2 + 3 + 5 + 6 +
7) $____________
19. Unexpended FWS authorization (Field 1 -
Field 18) $____________
Section F. Information About the Job Location and
Development (JLD) Program
20. Total expenditures for the JLD
Program $____________
21. Institutional expenditures for the JLD
Program (see instructions) $____________
22. Number of students for whom jobs were
located or developed ____________
23. Total
earnings of the students in Field 22 above $____________
Section G. Information About FWS Students
Employed in Community Service Activities
24. Number of students in community service
employment ____________
25.
Federal share of community service earned
compensation $____________
26. Nonfederal share of community service
earned compensation $____________
Section H. Information About FWS Students
Employed as Reading Tutors of Children or Employed in Family Literacy
Activities
27. Number of FWS students employed as reading
tutors of children or employed in family literacy
activities ____________
28. Federal share of earned compensation
for FWS students employed as reading tutors of children or employed
in family literacy
activities $____________
(a) Amount of the
federal share in Field 28 spent on community service
employment $____________
29. Total earned compensation for FWS
students employed as reading tutors of children or employed in family
literacy activities
$____________
Section I.Information About FWS Students Employed
as Mathematics Tutors of Children
30. Number of FWS students employed as
mathematics tutors of children ____________
31. Federal share of earned compensation
for FWS students employed as mathematics tutors of
children $____________
32. Total earned compensation for FWS
students employed as mathematics tutors of children $____________
Section J. Information About FWS Students
in Civic Education and Participation Activities
33. Number of students in civic education and
participation activities ____________
34. Federal share spent for students in
civic education and participation activities $____________
35. Total spent for students in civic
education and participation activities $____________
Section K. Information About FWS
Disaster-Affected Students
36. Number of disaster-affected students
receiving FWS funds ____________
37.
Federal share of funds to disaster-affected
students $____________
38. Total funds to disaster-affected
students $____________
Name
of School _____________________________________________________
OPEID
Number _________ State _______
Part VI. Program Summary for Award Year July 1,
2022 through June 30, 2023
Section A. Distribution of Program Recipients and
Expenditures by Type of Student
Taxable
and Untaxed
Federal
Perkins Loan FSEOG FWS
Unduplicated
Income
Category
Recipients Funds Recipients Funds
Recipients Funds Recipients
Student
Type
(a) (b) (c)
(d) (e) (f) (g)
Undergraduate
Dependent
1. $0 -
$5,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
2. $6,000 -
$11,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
3. $12,000
- $23,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
4. $24,000
- $29,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
5. $30,000
- $41,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
6. $42,000
- $59,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
7. $60,000
- $69,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
8. $70,000
- $79,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
9. $80,000
- $89,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
10. $90,000
- $99,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
11.
$100,000 and over ___N/A_
___N/A_ ________ ________ ________ ________ ________
Undergraduate
Independent
12. $0 -
$1,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
13. $2,000
- $3,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
14. $4,000
- $7,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
15. $8,000
- $11,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
16. $12,000
- $15,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
17. $16,000
- $19,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
18. $20,000
- $24,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
19. $25,000
- $29,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
20. $30,000
- $34,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
21. $35,000
- $39,999 ___N/A_
___N/A_ ________ ________ ________ ________ ________
22. $40,000
and over ___N/A_
___N/A_ ________ ________ ________ ________ ________
23.
Graduate/Professional ___N/A_
___N/A_ ________ ________ ________ ________ ________
24. TOTAL
(fields 1-23) ___N/A_
___N/A_ ________ ________ ________ ________ ________
25. Total less-than-full-time
students
(from
fields 1-23) ___N/A_
___N/A_ ________ ________ ________ ________ ________
26. Total “Automatic” Zero
EFC students
(from
fields 1-23) ___N/A_
___N/A_ ________ ________ ________ ________ ________
Name
of School
_____________________________________________________
OPEID
Number
_________ State
_______
Part VI. Program Summary for Award Year July 1,
2022 through June 30, 2023
Section B. Calculating the Administrative Cost
Allowance
Step 1. Calculate the amount spent in 2022–23
on which the administrative cost allowance is based.
1. Total compensation in FWS (amount from Part V,
Section C, Field 12) $____________
2.
Amount of Federal Perkins Loan funds advanced to students (amount
from Part III, Section B, Field 7) + $__N/A_______
3.
Total funds to FSEOG recipients (amount from Part IV, Section C,
Field 12) + $____________
4.
Total amount spent (fields 1 + 2 + 3) $____________
Step 2. Calculate the administrative cost
allowance.
Schools whose total amount spent was
$2,750,000 or less:
5. Enter total amount spent (Field
4) $____________
6. Multiply x 0.05
7. Total administrative cost allowance—go
to Step 3 $____________
Schools whose total amount spent was more
than $2,750,000 but less than $5,500,000:
8. Enter total amount spent (Field
4) $____________
9. Subtract - $ 2,750,000
10. Expenditures over $2,750,000 (Field 8 - Field
9) $____________
11. Multiply x 0.04
12. Administrative cost allowance on expenditures
over $2,750,000 (Field 10 x Field 11) $____________
13. Add administrative cost allowance on
expenditures of $2,750,000 ($2.75 million x .05) + $ 137,500
14. Total administrative cost allowance (Field 12
+ Field 13)—go to Step 3 $____________
Schools whose total amount spent was $5,500,000 or
more:
15. Enter total amount spent (Field
4) $____________
16. Subtract - $ 5,499,999
17. Expenditures of $5,500,000 or more (Field 15
- Field 16) $____________
18. Multiply x 0.03
19. Administrative cost allowance on expenditures
of $5,500,000 or more (Field 17 x Field 18) $____________
20. Add administrative cost allowance on
expenditures less than $5,500,000
(($2.75 million x .05)
+ Field 12) + $ 247,500
21. Total administrative cost allowance (Field 19
+ Field 20)—go to Step 3 $____________
Step 3. Decide how much administrative cost
allowance your school claimed.
22. How much administrative cost allowance did
your school claim? (The amount may be the same or less
than the amount calculated in Step
2.) $____________
23. How much administrative cost allowance did
your school claim in each program?
(a) Federal Perkins Loan (must be the same
as Part III, Section B, Field 8) $__N/A_______
(b) FSEOG (must be the same as Part IV,
Section D, Field 15) $____________
(c) FWS (must be the same as Part V,
Section D, Field 15) $____________
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | 2013-2014 FISAP Form Rel 13.0 |
Author | Gay, Tammy |
File Modified | 0000-00-00 |
File Created | 2023-08-31 |