2023-24 FISAP Form_CLEAN_to OMB

OMB No 1845-0030 Expires: 05/31/2023

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 Common Origination and Disbursement (COD) 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, 2021 through June 30, 2022; Application: Award Year July 1, 2023 through June 30, 2024

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

5. Additional Institutions

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 2021–22 FSEOG and FWS authorizations allocated to each institution must be provided. See instructions

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

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 ______________ 2021–22 FSEOG $______________ 2021–22 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 ____________

Section B. Certification and Warning

Name of School _____________________________________________________

OPEID Number _________ State _______

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 30, 2022 deadline date.

Standard Mail: U.S. Department of Education P.O. Box 9003 Niagara Falls, NY 14302

Overnight Mail/Courier: U.S. Department of Education 2429 Military Road, Suite 200 Niagara Falls, NY 14304

Application to Participate, Part II

Name of School _____________________________________________________

OPEID Number _________ State _______

Part II. Application to Participate for Award Year July 1, 2023 through June 30, 2024

Section A. Request for Funds for the 2023–24 Award Year

1. Federal Perkins Loan Level of Expenditures $ _________

2. Federal Perkins Loan Federal Capital Contribution $ _________

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 2021–22 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

Application to Participate, Part II (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part II. Application to Participate for Award Year July 1, 2023 through June 30, 2024

Section D. Information on Enrollment

My school’s calendar is __Traditional __Non-Traditional

Schools with a traditional calendar that had 2021–22 enrollment, fill in Field 7.

7. Total number students, 2021–22 (a) Undergraduate ____________ (b) Graduate/Professional ____________

Schools with a traditional calendar that did not have 2021–22 enrollment, fill in Field 8.

8. Estimated number students, 2022–23 (a) Undergraduate ____________ (b) Graduate/Professional ____________

Schools with a non-traditional calendar that had 2021–22 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, 2021 ____________ ____________ ____________ ____________

10. August 1 ____________ ____________ ____________ ____________

11. September 1 ____________ ____________ ____________ ____________

12. October 1 ____________ ____________ ____________ ____________

13. November 1 ____________ ____________ ____________ ____________

14. December 1 ____________ ____________ ____________ ____________

15. January 1, 2022 ____________ ____________ ____________ ____________

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, 2021 to June 30, 2022 $____________ $____________

23. Total Federal Pell Grants expenditures for the 2021–22 award year $____________

24. Total expended for state grants and scholarships made to

undergraduates for the award year July 1, 2021 to June 30, 2022 $____________

Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year 2021–22

Dependent Undergraduate Independent Undergraduate Independent

Without Baccalaureate/ With Baccalaureate Without Baccalaureate/ With Baccalaureate/ Graduate/

1^st Prof. Degree (a) 1^st Prof. Degree (b) 1^st Prof Degree (c) 1^st 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 ___________ ___________ ___________

Fiscal Operations Report, Part III

Name of School _____________________________________________________

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2021 through June 30, 2022
Section A. Fiscal Report (Cumulative) as of June 30, 2022

Field Item Amount Number of Borrowers Debit Balances Credit Balances

(a) (b) (c) (d)

1.1. Cash on hand and in depository as of 6/30/2022 $__________

1.2. Cash on hand and in depository as of 10/31/2022 $__________

2. Funds receivable from federal government $__________

3. Funds receivable from school $__________

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 $__________

Fiscal Operations Report, Part III (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2021 through June 30, 2022
Section A. Fiscal Report (Cumulative) as of June 30, 2022

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) $__________ $__________

Fiscal Operations Report, Part III (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2021 through June 30, 2022

Section B. Annual Activity During the 2021–22 Award Year (July 1, 2021 through June 30, 2022)

Number of Borrowers Amount

(a) (b)

1. Final adjusted Federal Capital Contribution (FCC) authorization $__________
2. FWS funds transferred to the Fund +$___________

3. FCC transferred to:

(a) FSEOG -$__________

(b) FWS -$__________
4. Total federal funds available for the 2021–22- award year (fields 1 + 2 – 3(a) – 3(b)) $__________

5. The unexpended amount of final adjusted authorized FCC for award year 2021–22

that was NOT requested from G5 by June 30, 2022. This amount will be reduced
from your total award amount next spring (see instructions). $__________

6. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 2021 and June 30, 2022 $__________

7. Loans advanced to students from the Fund during the 2021–22 award year

(minus 2021–22 award year refunds) $__________

8. Administrative cost allowance claimed for the 2021–22 award year (see

instructions) $__________

9.1 Total principal repaid by borrowers from all sources during the 2021–22 award year __________ $__________

9.2 Total interest repaid by borrowers from all sources during the 2021–22 __________ $__________ award year

10. Total principal repaid by borrowers from all sources during the 2021–22 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 2021–22 award

year for loans in default for more than 5 years __________ $__________

12. Annual servicing costs paid with institutional funds during the 2021–22 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 2021–22 award year, if applicable

(do not include this amount in Section A, field 33) $__________

Fiscal Operations Report, Part III (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2021 through June 30, 2022

Section C. Cumulative Repayment Information as of June 30, 2022

Status of Borrowers as of June 30, 2022 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, 2022

(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 2020–21 award year should skip to Section E.

Section D. Schools with 30 or More Borrowers Who Entered Repayment in the 2020–21 Award Year

1.1. Number of borrowers who entered repayment in 2020–21 __________

1.2. Number of borrowers from Field 1.1 above with loans in default by June 30, 2022 __________

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 2020–21 Award Year

2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by:

(a) 2018–19 (07/01/2018-06/30/2019) __________ (a) June 30, 2020 (those in 2.1(a) only) __________

(b) 2019–20 (07/01/2019-06/30/2020) __________ (b) June 30, 2021 (those in 2.1(b) only) __________

(c) 2020–21 (07/01/2020-06/30/2021) __________ (c) June 30, 2022 (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) __________

Fiscal Operations Report, Part III (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2021 through June 30, 2022

Section F. Capital Contributions to the Perkins Fund

1. 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) $__________

1.2 Total net FCC (field 1 – field 1.1) $__________

2. 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) $__________

3. Total net capital contributions made to the Fund (net FCC field 1.2 + net ICC field 2.2) $__________

4. Federal share percentage of total net capital contributions (field 1.2 divided by field 3) __________%

5. Institutional share percentage of total net capital contributions (field 2.2 divided by field 3) __________%

Fiscal Operations Report, Part IV

Name of School _____________________________________________________

OPEID Number _________ State _______

Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 2021 through June 30, 2022

Section A. Federal Funds Authorized for FSEOG

1. Final adjusted FSEOG authorization (as of 10/1/2022) $____________

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 +$____________

4. FSEOG funds transferred to and spent in FWS - $____________

5. 2022–23 FSEOG funds carried back and spent in 2021–22 + $____________

6. Additional 2022–23 FSEOG funds carried back and spent for 2022 summer enrollment + $____________

7. 2020–21 funds carried forward and spent in 2021–22 + $____________

8. 2021–22 funds carried forward to be spent in 2022–23 - $____________

9. 2021–22 funds carried back and spent in 2020–21 - $____________

10. Additional 2021–22 funds carried back and spent for 2021 summer enrollment - $____________

11. Total federal funds available for 2021–22 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 $____________

Fiscal Operations Report, Part V

Name of School _____________________________________________________

OPEID Number _________ State _______

Part V. Federal Work-Study (FWS) Program for Award Year July 1, 2021 through June 30, 2022

Section A. Federal Funds Authorized for FWS

1. Final adjusted FWS authorization (as of 10/1/2022) $____________

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 - $____________

(c) Work Colleges Program - $____________

5. 2022–23 FWS funds carried back and spent in 2021–22 +$____________

6. Additional 2022–23 FWS funds carried back and spent for 2022 summer employment +$____________

7. 2020–21 funds carried forward and spent in 2021–22 +$____________

8. 2021–22 funds carried forward to be spent in 2022–23 - $____________

9. 2021–22 funds carried back and spent in 2020–21 - $____________

10. Additional 2021–22 funds carried back and spent for 2021 summer employment - $____________

11. Total federal funds available for 2021–22 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) $____________

Fiscal Operations Report, Part V (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part V. Federal Work-Study (FWS) Program for Award Year July 1, 2021 through June 30, 2022

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 $____________

Fiscal Operations Report, Part VI

Name of School _____________________________________________________

OPEID Number _________ State _______

Part VI. Program Summary for Award Year July 1, 2021 through June 30, 2022

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 _________ _________ _________ _________ _________ _________ ­_________

2. $6,000 - $11,999 _________ _________ _________ _________ _________ _________ ­_________

3. $12,000 - $23,999 _________ _________ _________ _________ _________ _________ ­_________

4. $24,000 - $29,999 _________ _________ _________ _________ _________ _________ ­_________

5. $30,000 - $41,999 _________ _________ _________ _________ _________ _________ ­_________

6. $42,000 - $59,999 _________ _________ _________ _________ _________ _________ ­_________

7. $60,000 - $69,999 _________ _________ _________ _________ _________ _________ ­_________

8. $70,000 - $79,999 _________ _________ _________ _________ _________ _________ ­_________

9. $80,000 - $89,999 _________ _________ _________ _________ _________ _________ ­_________

10. $90,000 - $99,999 _________ _________ _________ _________ _________ _________ ­_________

11. $100,000 and over _________ _________ _________ _________ _________ _________ ­_________

Undergraduate

Independent

12. $0 - $1,999 _________ _________ _________ _________ _________ _________ ­_________

13. $2,000 - $3,999 _________ _________ _________ _________ _________ _________ ­_________

14. $4,000 - $7,999 _________ _________ _________ _________ _________ _________ ­_________

15. $8,000 - $11,999 _________ _________ _________ _________ _________ _________ ­_________

16. $12,000 - $15,999 _________ _________ _________ _________ _________ _________ ­_________

17. $16,000 - $19,999 _________ _________ _________ _________ _________ _________ ­_________

18. $20,000 - $24,999 _________ _________ _________ _________ _________ _________ ­_________

19. $25,000 - $29,999 _________ _________ _________ _________ _________ _________ ­_________

20. $30,000 - $34,999 _________ _________ _________ _________ _________ _________ ­_________

21. $35,000 - $39,999 _________ _________ _________ _________ _________ _________ ­_________

22. $40,000 and over _________ _________ _________ _________ _________ _________ ­_________

23. Graduate/Professional _________ _________ _________ _________ _________ _________ ­_________

24. TOTAL (fields 1-23) _________ _________ _________ _________ _________ _________ ­_________

25. Total less-than-full-time

students

(from fields 1-23) _________ _________ _________ _________ _________ _________ ­_________

26. Total “Automatic” Zero

EFC students

(from fields 1-23) _________ _________ _________ _________ _________ _________ ­_________

Fiscal Operations Report, Part VI (continued)

Name of School _____________________________________________________

OPEID Number _________ State _______

Part VI. Program Summary for Award Year July 1, 2021 through June 30, 2022

Section B. Calculating the Administrative Cost Allowance

Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews)

Step 1. Calculate the amount spent in 2021–22 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) +$____________

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) $____________

(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) $____________

FISAP Version: Page A-3

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	2023-08-28