Higher Education Emergency Relief Fund (HEERF) I, I

Conducted by: OMB No. 1840-0850 Expires TBD

U.S. Department of Education

Higher Education Emergency Relief Fund (HEERF) I, II, & III Annual Performance Report Form

This data collection form applies to the following HEERF categories authorized under the Coronavirus Aid, Relief, and Economic Security (CARES) Act (HEERF I), the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSAA) (HEERF II), and the American Rescue Plan Act of 2021 (ARP) (HEERF III):

• Student Aid (ALN 84.425E)

• Institutional Portion (ALN 84.425F)

• Historically Black Colleges and Universities (ALN 84.425J)

• American Indian Tribally Controlled Colleges and Universities (ALN 84.425K)

• Minority Serving Institutions (ALN 84.425L)

• Strengthening Institutions Program (ALN 84.425M)

• Fund for the Improvement of Postsecondary Education (ALN 84.425N)

• Proprietary Institutions Grant Funds for Students (ALN 84.425Q)

• Supplemental Assistance to Institutions of Higher Education (ALN 84.425S)

• Supplemental Support under American Rescue Plan (SSARP) (ALN 84.425T)

The information collected on this form will be reviewed by the U.S. Department of Education to ensure that HEERF grant funds are used in accordance with applicable requirements under the HEERF grant program and will be shared with the public to promote transparency regarding the allocation and uses of funds. Furthermore, the information collected will be analyzed to provide aggregate statistics on institutional uses of HEERF grant funds to address the impacts of COVID-19 on students and institutions. This report should be completed based on all HEERF activities funded from the CARES Act, CRRSAA, and ARP (in the applicable reporting periods. Under 34 CFR 75.720(b), all HEERF grantees must submit a HEERF Annual Report. The failure to timely submit a HEERF Annual Report is a violation of the grantee’s Certification and Agreement or Supplemental Agreement and may lead to adverse action.

HEERF Reporting Form

Reporting Schedule
Annual Report	Due Date	Applicable Reporting Period
First Annual Report	Early 2021	March 13, 2020—December 31, 2020
Second Annual Report	Early 2022	January 1, 2021—December 31, 2021
Third Annual Report	Early 2023	January 1, 2022—December 31, 2022
Fourth Annual Report	Early 2024	January 1, 2023—December 31, 2023
Fifth Annual Report	Early 2025	January 1, 2024—December 31, 2024
Sixth Annual Report	Early 2026	January 1, 2025—December 31, 2025

Institutions must provide complete answers to each question.

1. Institutional Identifiers and Contact Information—

1. Institution Name ___<autofill from G5> ______

DUNS # ___<autofill from G5>_______

UEI (SAM) ___ <autofill>_______

2. Identify the applicable OPEID(s) for this annual report:

_______________________________________________________________________

2. Identify the applicable IPEDS unitid(s) for this annual report:

_______________________________________________________________________

2. For this annual report, please report on these HEERF grant PR/Award Numbers:

1. ___<autofill Award Number and Amount from G5>_____________________

2. ___<autofill Award Number and Amount from G5>_____________________

3. ____...____________________

2. Who is the lead contact for this annual report?

Name: ___<autofill> ______ (editable)

Title: ___<autofill> ______ (editable)

Phone: ___<autofill> ______(editable)

Email: ___<autofill> ______ (editable)

2. Institutional expenditures

1. Provide the total amount of HEERF funds expended during the reporting period on each of the following categories:

Category	Amount in (a)(1) institutional dollars	Amount in (a)(2) dollars, if applicable	Amount in (a)(3) dollars, if applicable1	Explanatory Notes
Providing additional Emergency Financial Aid Grants to students.
Using Emergency Financial Aid Grants to cover student outstanding account balances for costs such as debt forgiveness, room, board, tuition, or fees.
Indirect cost recovery/facilities and administrative costs charged on the grants.
Covering the cost of providing additional technology hardware to students, such as laptops or tablets, or covering the added cost of technology fees.
Providing or subsidizing the costs of high-speed internet to students or faculty to transition to an online environment.
Subsidizing off-campus housing costs due to dormitory closures or decisions to limit housing to one student per room; subsidizing housing costs to reduce housing density; paying for hotels or other off-campus housing for students who need to be isolated; paying travel expenses for students who need to leave campus early due to coronavirus infections or campus interruptions.
Subsidizing food service to reduce density in eating facilities, to provide pre-packaged meals, or to add hours to food service operations to accommodate social distancing.
Costs related to operating additional class sections to enable social distancing, such as those for hiring more instructors and increasing campus hours of operations.
Construction, Renovation, and Real Property Projects.2 3
Purchasing, leasing, or renting additional instructional equipment and supplies (such as laboratory equipment or computers) to reduce the number of students sharing equipment or supplies during a single class period and to provide time for disinfection between uses.
Purchasing faculty and staff training in online instruction; or paying additional funds to staff who are providing training in addition to their regular job responsibilities.
Purchasing, leasing, or renting additional equipment or software to enable distance learning, or upgrading campus wi-fi access or extending open networks to parking lots or public spaces, etc.
Implementing evidence-based practices to monitor and suppress coronavirus in accordance with public health guidelines.4
Conducting direct outreach to financial aid applicants about the opportunity to receive a financial aid adjustment due to the recent unemployment of a family member or independent student, or other circumstances, described in section 479A of the Higher Education Act of 1965.
Replacing lost revenue from all sources. 5
Other Uses of (a)(1) Institutional Portion funds.
Other uses of (a)(2) or (a)(3) funds, if applicable.
Annual Institutional Expenditures for each Program	<autofill>	<autofill>	<autofill>
Total of Institutional Annual Expenditures	<autofill>

<SKIP LOGIC for those who reported nonzero amounts for replacing lost revenue>

2. Estimate how much of the lost revenue reported above came from revenue lost from each of the following sources⁶:

Source of Lost Revenue	Estimated Amount
Academic sources
Unpaid student accounts receivable or other student account debts (including tuition, fees, and institutional charges)
Room and board
Enrollment declines, including reduced tuition, fees, and institutional charges
Supported research
Summer terms and camps
Auxiliary services sources
Cancelled ancillary events
Disruption of food service
Dormitory services
Childcare services
Use of facilities or venues, including external events such as weddings, receptions, or conferences (other than facilities associated with sectarian instruction or religious worship)
Bookstore revenue
Parking revenue
Lease revenue
Royalties
Other operating revenue
Total (a)(1) lost revenue funds	<autofill from Q9b>
Total (a)(2) lost revenue funds	<autofill from Q9b>
Total (a)(3) lost revenue funds	<autofill from Q9b>
TOTAL LOST REVENUE HEERF	<autofill from Q9b>7

<SKIP LOGIC for those who reported other operating revenue in 9c>

3. Briefly describe the “other operating revenue” reported above:_ ______________________ (1,000 characters maximum]

Paperwork 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 1840-0850. Public reporting burden for this collection of information is estimated to average 8 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. Under the PRA, participants are required to respond to this collection to obtain or retain a benefit. If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, please contact Brian Fu, US. Department of Education, 400 Maryland Avenue, SW, Washington, DC 20202.

1 The (a)(3) category is only applicable for 2024 calendar year implementation activities and will not be a table column for reporting after 2024.

2 The Consolidated Appropriations Act, 2022 (P.L. 117-103), signed into law by President Biden on March 15, 2022, expanded the allowable uses of funds for IHEs that received funds under the HEERF (a)(2) programs (ALN 84.425J; T84.425K; 84.425L; 84.425M). Specifically, IHEs that received HEERF (a)(2) grant funds now may expend them on the acquisition of real property, renovations, or construction related to preventing, preparing for, and responding to the coronavirus. Before commencing any renovations, construction, or real property projects supported by HEERF (a)(2) grant funds, grantees must receive approval for the project from the Department. Grantees should report any ”minor remodeling“ activities in the "other" category and provide details in the explanatory notes section. See question 2 of the HEERF (a)(2) construction FAQs for more information on minor remodeling.

3 Include in explanatory notes, title(s) of construction, renovation, and real property projects

4 Include campus safety and operations activities here. To the extent that campus safety and operations were not evidence-based, describe those activities in the explanatory notes field.

5 Please see the Department’s HEERF Lost Revenue FAQs (March 19, 2021) for more information regarding what may be appropriately included in an estimate of lost revenue.

6 These categories are the categories described in Question 3 of the HEERF Lost Revenue FAQs (March 19, 2021, available at https://www2.ed.gov/about/offices/list/ope/heerflostrevenuefaqs.pdf).

7 Estimated amounts need to sum to amounts reported in 9b

5