Declaration Statement with Required Information

OMB Control No. 0648-0432
Expiration Date: 12/31/2020

DECLARATION STATEMENT:
I, the undersigned, declare, under penalty of perjury, that:
I understand and agree to the limitations of the allowable costs for the scholarship funds as defined in this
FFO and that I am aware of the data sharing stipulation policy applicable to all NOAA Federal Funding
Opportunities. This statement serves as my "Data/Information Sharing Plan" insofar as it expressly
states that no funds associated with this award will be used for the collection or creation of any
environmental information or data.
All statements and information in my application are true and correct at the time of this application.
Executed on [insert date] ______________________________________________________________

Print or Type Name___________________________________________________________________

Signature___________________________________________________________________________

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a
penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of
1995 unless the information collection has a currently valid OMB Control Number. The approved OMB Control Number for
this information collection is 0648-0432. Without this approval, we could not conduct this information collection. Public
reporting for this information collection is estimated to be approximately 2 minutes/hours per response, including the time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the information collection. All responses to this information collection are voluntary. Send comments regarding
this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the
Dr. Nancy Foster Scholarship Program Manager, NOAA Office of National Marine Sanctuaries, 1305 East-West Highway,
11th Floor, Silver Spring, MD, 20910.