3 FFR with Instructions

OMB Number: 3265-0022
Expiration Date: 04/30/2025

Federal Financial Report
(Follow form Instructions)

1. Federal Agency and Organizational Element to Which Report is Submitted

2. Federal Grant or Other Identifying Number Assigned by Federal
Agency (To report multiple grants, use FFR Attachment)

3. Recipient Organization (Name and complete address including Zip code)
Recipient Organization Name:
Street1:
Street2:
City:

County:
Province:

State:
Country:

ZIP / Postal Code:

USA: UNITED STATES

4a. UEI

6. Report Type

4b. EIN

7. Basis of Accounting

Quarterly

Cash

Semi-Annual

Accrual

5. Recipient Account Number or Identifying Number
(To report multiple grants, use FFR Attachment)

8. Project/Grant Period
From:

9. Reporting Period End Date

To:

Annual
Final
10. Transactions

Cumulative

(Use lines a-c for single or multiple grant reporting)
Federal Cash (To report multiple grants, also use FFR attachment):
a. Cash Receipts

0.00

b. Cash Disbursements

0.00

c. Cash on Hand (line a minus b)

0.00

(Use lines d-o for single grant reporting)
Federal Expenditures and Unobligated Balance:
d. Total Federal funds authorized

0.00

e. Federal share of expenditures

0.00

f. Federal share of unliquidated obligations

0.00

g. Total Federal share (sum of lines e and f)

0.00

h. Unobligated balance of Federal Funds (line d minus g)

0.00

Recipient Share:
i. Total recipient share required

0.00

j. Recipient share of expenditures

0.00

k. Remaining recipient share to be provided (line i minus j)

0.00

Program Income:
l. Total Federal program income earned

0.00

m. Program Income expended in accordance with the deduction alternative

0.00

n. Program Income expended in accordance with the addition alternative

0.00

o. Unexpended program income (line l minus line m and line n)

0.00

Federal Interest:
p. Total Federal interest earned
q. Federal interest expenditures
r. Remaining Federal interest to be expended (line l minus m)

0.00

11. Indirect Expense
a. Type

b. Rate

c. Period From

Period To

g.

d. Base

e. Amount Charged

f. Federal Share

Totals:

12. Program Income Source(s) and Remarks
a.

State Interest Earned

b.

State Interest Expended

c.

State Program Income Earned

d.

State Program Income Expended

Additional Document Attachment Function

13. Certification: By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the
expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I
am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or
administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730
and 3801-3812).
a. Name and Title of Authorized Certifying Official
Prefix:

First Name:

Last Name:

Middle Name:
Suffix:

Title:
b. Signature of Authorized Certifying Official

c. Telephone (Area code, number, and extension)

d. Email Address

e. Date Report Submitted

General Comments

Standard Form 425

Federal Financial Report Instructions
Report Submissions
1) Recipients will be instructed by Federal agencies to submit the Federal Financial Report (FFR) to
a single location, except when an automated payment management reporting system is utilized. In
this case, a second submission location may be required by the agency.
2)

If recipients need more space to support their FFRs, or FFR Attachments, they should provide
supplemental pages. These additional pages must indicate the following information at the top of
each page: Federal grant or other identifying number (if reporting on a single award), recipient
organization, Unique Entity Identifier (UEI) number, Employer Identification Number (EIN), and
period covered by the report.

Reporting Requirements
1) The submission of interim FFRs will be on a quarterly, semi-annual, or annual basis, as directed by
the Federal agency. A final FFR shall be submitted at the completion of the award agreement. The
following reporting period end dates shall be used for interim reports: 3/31, 6/30, 9/30, or 12/31.
For final FFRs, the reporting period end date shall be the end date of the project or grant period.
2) Quarterly and semi-annual interim reports shall be submitted no later than 30 days after the end of
each reporting period. Annual reports shall be submitted no later than 90 days after the end of each
reporting period. Final reports shall be submitted no later than 90 days after the project or grant
period end date.
Note: For single award reporting:
1) Federal agencies may require both cash management information on lines 10(a) through 10(c) and
financial status information lines 10(d) through 10(o).
2) 10(b) and 10(e) may not be the same until the final report.

Line Item Instructions for the Federal Financial Report

Reporting Item
FFR
Number
Cover Information
1
Federal Agency and
Organizational Element to
Which Report is Submitted
2
Federal Grant or Other
Identifying Number
Assigned by Federal
Agency
3
Recipient Organization
4a
4b
5

Instructions

Enter the name of the Federal agency and organizational element
identified in the award document or as instructed by the agency.
For a single award, enter the grant number assigned to the award by the
Federal agency. For multiple awards, report this information on the FFR
Attachment. Do not complete this box if reporting on multiple awards.

Enter the name and complete address of the recipient organization
including zip code.
UEI
Enter the recipient organization's Unique Entity Identifier
(UEI) or Central Contract Registry UEI.
EIN
Enter the recipient organization's Employer Identification Number (EIN).
Recipient Account Number Enter the account number or any other identifying number assigned by the
or Identifying Number
recipient to the award. This number is for the recipient's use only and is
not required by the Federal agency. For multiple awards, report this
Revised 6/28/2024

FFR
Number

Reporting Item

6

Report Type

7

Basis of Accounting
(Cash/Accrual)

8

9

10

Instructions
information on the FFR Attachment. Do not complete this box if
reporting on multiple awards.
Mark appropriate box.

Specify whether a cash or accrual basis was used for recording transactions
related to the award(s) and for preparing this FFR. Accrual basis of
accounting refers to the accounting method in which expenses are recorded
when incurred. For cash basis accounting, expenses are
recorded when they are paid.
Indicate the period established in the award document during which
Project/Grant Period,
From: (Month, Day, Year) Federal sponsorship begins and ends.
Note: Some agencies award multi-year grants for a project period that is
funded in increments or budget periods (typically annual increments).
Throughout the project period, agencies often require cumulative
reporting for consecutive budget periods. Under these circumstances,
enter the beginning and ending dates of the project period not the budget
period.
Do not complete this line if reporting on multiple awards.
Project/Grant Period, To: See the above instructions for "Project/Grant Period, From: (Month, Day,
(Month, Day, Year)
Year)."
Enter the ending date of the reporting period. For quarterly, semi-annual,
Reporting Period End
Date: (Month, Day, Year) and annual interim reports, use the following reporting period end dates:
3/31, 6/30, 9/30, or 12/31. For final FFRs, the reporting period end date shall
be the end date of the project or grant period.
Transactions
Enter cumulative amounts from date of the inception of the award through the end date of the
reporting period specified in line 9.
Use Lines 10a through 10c, Lines 10d through 10o, or Lines 10a through 10o, as specified by the
Federal agency, when reporting on single grants.
Use Line 12, Remarks, to provide any information deemed necessary to support or explain FFR data.
For EAC Awards: Please note the additional steps in lines 10p, 10q, and 10r to provide Federal Interest
earned and expended on the grant.

Federal Cash (To report multiple grants, also use FFR Attachment)
10a
Cash Receipts
Enter the cumulative amount of actual cash received from the Federal
agency as of the reporting period end date.
10b
Cash Disbursements
Enter the cumulative amount of Federal fund disbursements (such as cash
or checks) as of the reporting period end date. Disbursements are the sum of
actual cash disbursements for direct charges for goods and services, the
amount of indirect expenses charged to the award, and the amount of cash
advances and payments made to subrecipients and contractors. For EAC
Awards: The amount entered should be the same as the amount you enter
on Line 10e.
For multiple grants, report each grant separately on the FFR Attachment.
The sum of the cumulative cash disbursements on the FFR Attachment
must equal the amount entered on Line 10b, FFR.
Revised 6/28/2024

10c

Cash On Hand (Line 10a
Minus Line 10b)

10f

Federal Share of
Unliquidated Obligations

Enter the amount of Line 10a minus Line 10b. This amount represents
immediate cash needs. If more than three business days of cash are on
hand, the Federal agency may require an explanation on Line 12, Remarks,
explaining why the drawdown was made prematurely or other reasons for
the excess cash.
Federal Expenditures and Unobligated Balance: Do not complete this section if reporting on multiple
awards.
10d
Enter the total Federal funds authorized as of the reporting period end
Total Federal Funds
date.
Authorized
10e
Federal Share of
For reports prepared on a cash basis, expenditures are the sum of cash
Expenditures
disbursements for direct charges for property and services; the amount of
indirect expense charged; and the amount of cash advance payments and
payments made to subrecipients. For reports prepared on an accrual basis,
expenditures are the sum of cash disbursements for direct charges for
property and services; the amount of indirect expense incurred; and the net
increase or decrease in the amounts owed by the recipient for (1) goods
and other property received; (2) services performed by employees,
contractors, subrecipients, and other payees; and (3) programs for which
no current services or performance are required. Do not include program
income expended in accordance with the deduction alternative, rebates,
refunds, or other credits. (Program income expended in accordance with
the deduction alternative should be reported separately on Line 10o.)
Unliquidated obligations on a cash basis are obligations incurred, but not
yet paid. On an accrual basis, they are obligations incurred, but for which
an expenditure has not yet been recorded. Enter the Federal portion of
unliquidated obligations. Those obligations include direct and indirect
expenses incurred but not yet paid or charged to the award, including
amounts due to subrecipients and contractors. On the final report, this line
should be zero unless the awarding agency has provided other
instructions.

Do not include any amount in Line 10f that has been reported in Line 10e.
Do not include any amount in Line 10f for a future commitment of funds
(such as a long-term contract) for which an obligation or expense has not
been incurred.
10g
Total Federal Share (Sum Enter the sum of Lines 10e and 10f.
of Lines 10e and 10f)
10h
Unobligated Balance of
Enter the amount of Line 10d minus Line 10g.
Federal Funds (Line 10d
Minus Line 10g)
Recipient Share: Do not complete this section if reporting on multiple awards.
10i
Enter the total required recipient share for reporting period specified in
Total Recipient Share
line 9. The required recipient share should include all matching and cost
Required
sharing provided by recipients and third-party providers to meet the level
required by the Federal agency. This amount should not include cost
sharing and match amounts in excess of the amount required by the
Federal agency (for example, cost overruns for which the recipient incurs
additional expenses and, therefore, contributes a greater level of cost

Revised 6/28/2024

FFR
Number

Reporting Item

Instructions
sharing or match than the level required by the Federal agency). For EAC
Awards: Report your cumulative required state match. Interest earned on
your state share, and all program income from the state share from the
beginning of the grant should be reported in 12a- 12d where needed.

10j

Recipient Share of
Expenditures

Enter the recipient share of actual cash disbursements or outlays (less any
rebates, refunds, or other credits) including payments to subrecipients and
contractors. This amount may include the value of allowable third party
in-kind contributions and recipient share of program income used to
finance the non-Federal share of the project or program. Note: On the
final report this line should be equal to or greater than the amount of Line
10i.
10k
Remaining Recipient Share Enter the amount of Line 10i minus Line 10j. If recipient share in Line
10j is greater than the required match amount in Line 10i, enter zero.
to be Provided (Line 10i
Minus Line 10j)
Program Income: Do not complete this section if reporting on multiple awards.
10l
Total Federal Program
Enter the amount of Federal program income earned. Do not report any
Income Earned
program income here that is being allocated as part of the recipient's cost
sharing amount included in Line10j.
10m
Program Income Expended Enter the amount of program income that was used to reduce the Federal
share of the total project costs. For EAC Awards: The EAC has
in Accordance With the
historically used the additive method for their awards, not the deductive
Deduction Alternative
method that is reported in this box. Do not use this line unless otherwise
specified in your award terms and conditions.
10n
Program Income Expended Enter the amount of program income that was added to funds committed
in Accordance With the
to the total project costs and expended to further eligible project or
Addition Alternative
program activities.
10o
Enter the amount of Line 10l minus Line 10m or Line 10n. This amount
Unexpended Program
equals the program income that has been earned but not expended, as of
Income (Line 10l Minus
the reporting period end date.
Line 10m or Line 10n)
10p
Enter the amount of Federal interest earned on the deposit of funds. Do not
Total Federal interest
report any interest earned on your state match share here. (Interest earned
earned
on your state share should be recorded on line 10i as part of the recipient
share total).
10q
Enter the amount of Federal interest that was added to funds committed to
Federal interest
the total project costs and expended to further eligible project or program
expenditures
activities.
10r
Remaining Federal interest Enter the amount of line 10p minus 10q. This amount equals the Federal
interest that has been earned but not expended, as of the reporting period
to be expended (line l
end date.
minus m)
11

Indirect Expense: Complete this information only if required by the awarding agency. Enter
cumulative amounts from date of the inception of the award through the end date of the reporting
period specified in line 9.
Type of Rate(s)
State whether indirect cost rate(s) is Provisional, Predetermined, Final, or
Fixed. If using de minimis, please choose Fixed.
Rate
Enter the indirect cost rate(s) in effect during the reporting period.
Period From; Period To
Enter the beginning and ending effective dates for the NICRA rate(s).
Base
Enter the actual amount of the base against which the rate(s) was applied.
The amount should reflect expenses from the beginning of the FY through
the reporting period date. Example: 10/01/2024- 3/31/2024

11a
11b
11c
11d

Revised 6/28/2024

FFR
Reporting Item
Number
11e
Amount Charged

Instructions

11f
11g
12a

Federal Share
Totals
State Interest Earned

12b

State Interest Expended

12c

State Program Income
Earned
State Program Income
Expended
State Program Income
Earned Breakdown

Enter the amount of indirect costs charged during the time period
specified. (Multiply 11b. x 11d.)
Enter the Federal share of the amount in 11e.
Enter the totals for respective columns in 11d, 11e, and 11f.
Enter the amount of earned state match interest for the reporting period
only
Enter the amount of expended state match interest for the reporting period
only
Enter the amount of program income earned resulting from expending state
match dollars
Enter the amount of program income expended resulting from the use of
state match dollars
List each source of program income individually next to each amount
(federal interest earned is not program income)

12f

Total

Automatic calculating total for each identified state program income entry

13a

Typed or Printed Name and Enter the name and title of the authorized certifying official.
Title of Authorized
Certifying Official
Signature of Authorized
The authorized certifying official must sign here.
Certifying Official
Enter the telephone number (including area code and extension) of the
Telephone (Area Code,
individual listed in Line 13a.
Number and Extension)
E-mail Address
Enter the e-mail address of the individual listed in Line 13a.
Date Report Submitted
Enter the date the FFR is submitted to the Federal agency using the
(Month, Day, Year)
month, day, year format.
General Comments
Enter any explanations or additional information required by the Federal
sponsoring agency including excess cash as stated in line 10c.

12d
12e

13b
13c
13d
13e
14

Revised 6/28/2024