Form 17001a NHPRC Grant Offer Acknowledgement

OMB Control No. 3095-0013
Expiration date: XX/3X/20XX

NHPRC GRANT OFFER ACKNOWLEDGMENT
NHPRC Application No.

(please complete)

On behalf of

, we agree to comply with all applicable

Federal grants management and NHPRC rules and regulations.
If indirect cost rates are included in your budget, please indicate the rate and when it is due to expire:
Indirect Cost Rate:
Authorizing Federal Agency:
Expiration Date:

Please sign and date:

Authorized Representative

Date

Project Director

Date

Additional Remarks:

Please complete this form and return it to the NHPRC no later than six weeks after receipt via email
to your program officer.

Paperwork Reducation Act Public Burden Statement
A Federal agency may not conduct or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control
number. The OMB control number for this information collection is 3095-0013. Send comments regarding the burden estimate or any other aspect of the collection
of information, including suggestions for reducing this burden, to National Archives and Records Administration (MP), Room 4100, 8601 Adelphi Road, College
Park, MD 20740-6001. DO NOT SEND COMPLETED FORMS TO THIS ADDRESS.

NA Form 17001a (07-24)

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION

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