Interim Performance Report Template

OMB No. 0581-NEW

Interim Performance Report

An Interim Performance Report must be received within 90 days after the end of the first year of the date of the signed grant agreement and 90 days after the end of each subsequent year until the expiration date of the grant period. Interim Performance Reports must illustrate the progress made toward the completion of each project within the grant agreement.

Grant Information

Agreement

AMS Agreement Number:	Enter Agreement Number (e.g., 17FSMIPXX####).
Project Title	Enter Project Title as Stated on the Grant Agreement.
Period of Performance:	Start Date:	Enter Date.	End Date:	Enter Date.
Award Amount:	Enter AMS Funding Amount ($).
Match Amount (if applicable):	Enter Non-Federal Matching Amount ($).

Recipient

Recipient Organization Name:	Enter Recipient Organization Name.
Recipient’s Project Contact
Name:	Enter the Project Contact’s Name.
Phone:	Enter the Project Contact’s Phone Number.
Email:	Enter the Project Contact’s Email.

Report

Interim Report Type:	Enter the Type of Interim Report (e.g., 1st Interim, 2nd Interim).
Reporting Period:	Start Date:	Enter Date.	End Date:	Enter Date.

Performance Narrative

Activities Performed

Address the below sections as they relate to this reporting period.

Accomplishments

List your accomplishments for this reporting period and indicate how these accomplishments assist in the fulfillment of your project’s objective(s), outcome(s), and/or indicator(s). This listing should identify your project’s partners and their contributions.

#	Accomplishment	Relevance to Objective, Outcome, and/or Indicator
1
2
3
4

Challenges and Developments

Provide any challenges to the completion of your project or any positive developments outside of the project’s original intent that you experienced during this reporting period. If those challenges or developments resulted or will result in corrective actions and/or changes to the project, include those in the space below.

#	Challenges or Developments	Corrective Action and/or Project Change(s)
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2
3
4

Outcome and Indicator Results to Date

Quantify the overall progress on the outcomes and indictors of your project.

#	Outcome/Indicator	Quantifiable Results
1
2
3
4

Discussion of Results

If necessary, include further explanation of the quantifiable results to date.

Upcoming Activities

Provide a description of the activities that you are planning to complete during the next reporting period.

#	Activity	Anticipated Completion
1
2
3
4

Project Expenditures to Date

Expenditures

Cost Category	Federal Funds Budget (FEDERAL PORTION ONLY)		Matching Budget (IF APPLICABLE)
	Approved	Actual	Approved	Actual
Personnel
Fringe Benefits
Travel
Equipment
Supplies
Contractual
Other
Direct Costs Sub-Total
Indirect Costs
Total

Program Income (if applicable)

Source/Nature (i.e., registration fees)	Amount Approved in Budget	Actual Amount Earned
Total Program Income Earned

Use of Program Income

Describe how the earned program income was used to further the objectives of this project.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0581-NEW. The time required to complete this information collection is estimated to average 4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

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