![](media/image1.png){width="1.6784722222222221in"
height="1.3479166666666667in"}

  ----------------------------------- -----------------------------------
                                      

                                      

  1\. Name of Private Voluntary       
  Organization (PVO)                  

                                      

  2\. Acronym                         

  3\. Headquarters Address            

                                      

                                      

                                      

  4\. Telephone Number                5\. Facsimile Number

  [( )]{.underline}                   [( )]{.underline}

  6\. PVO E-mail Address @            

  7\. Web site                        

  8\. Executive Representative        

                                      

  Position Title                      

  9\. Financial Representative        

                                      

  Position Title                      

  10\. Correspondence Representative  

                                      

  Position Title                      

  Rep. E-mail Address @               

  11\. USAID-Assigned Identification  12\. Federal Employer
  Number (Decode Number)              Identification Number (EIN)

                                      

  13\. Date of Incorporation          14\. Dun & Bradstreet/DUNS No.

                                      

  15\. IRS Classification 501(c)( )   16\. Financial Statement Months
  ----------------------------------- -----------------------------------

# **INSTRUCTIONS**

**Note:** **The financial statements and AID Form 1550-2 must be for the
same fiscal year and the totals for the two documents [MUST
RECONCILE]{.underline}. Failure to reconcile the two documents could
cause a delay in processing the submission or may require the submission
to be returned.**

**In the checkboxes provided on the front page of this form, check
Initial Registration if this is your organization\'s application for
registration with USAID; otherwise, other registrants should check
Annual Return.**

**Line 1:** Enter the corporate name of the organization as shown in its
articles of incorporation. If the articles or bylaws have been changed
within the past 12 months or since your last submission, include the
amended documents with this form. Articles of incorporation and
amendments must be on state letterhead with state seal and authorizing
state signature.

**Line 2:** Enter the organization's acronym. **If no acronym is
provided**, a substitute abbreviation for the organization title may be
used in the narrative of the *Report of Voluntary Agencies Engaged in
Overseas Relief and Development Registered with the U.S. Agency for
International Development* (VolAg Report).

**Line 3:** Enter the address for the principal headquarters where
official correspondence is received. This location must be where
officials of the organization can be contacted on a daily basis. **A
post office box address is not acceptable.**

**Line 4:** Enter the telephone number at headquarters.

**Line 5:** Enter the facsimile number at headquarters.

**Line 6:** Enter the general PVO e-mail address for publication in the
VolAg Report. This e-mail address is used for USAID notifications.\
Example: *info@pvoname.org*

**Line 7:** Enter the Internet address.\
Example: *www.pvoname.org*

**Line 8:** Enter the designation (*Dr., Mr., Ms.*) name and title of
the executive representative. This individual receives correspondence
from the USAID Registrar.

**Line 9:** Enter the designation (*Dr., Mr., Ms.*) name and title of
the financial representative. This individual receives annual submission
notices and forms.

**Line 10:** Enter the designation (*Dr., Mr., Ms.*) name and title of
the correspondence representative. This point of contact will receive
e-mail correspondence sent from USAID.

**Line 11:** Enter the USAID-assigned identification number (decode
number). This is the five-digit alphanumeric code printed on the PVO's
letter of registration acceptance. *New applicants will be assigned a
USAID decode number upon registration.*

**Line 12:** Enter the federal employer identification number (EIN)
assigned to the organization by the Internal Revenue Service (IRS).

**Line 13:** Enter the organization's date of incorporation as stated in
the **[original]{.underline}** articles of incorporation.

**Line 14:** Enter the organization's Dun & Bradstreet Data Universal
Numbering System (DUNS) number.

**Line 15:** Enter the organization's Internal Revenue Service tax
exemption classification (i.e., 501(c)(3)).

**Line 16:** Enter the number of months the enclosed financial
statements represent (e.g., 12 for a full year, 1-12 for less than a
full year, 13-23 for greater than a full year).

### 

+-------+----------------------------------------------+--------------+
| *     | **ORGANIZATION INFORMATION**                 |              |
| *PART |                                              |              |
| 1**   | **PLEASE READ THE INSTRUCTIONS BEFORE        |              |
|       | COMPLETING THE FORM**.                       |              |
+-------+----------------------------------------------+--------------+
|       |                                              |              |
+-------+----------------------------------------------+--------------+
| 1     |                                              | Yes No       |
| .  Is |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|    or |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
|     a |                                              |              |
|       |                                              |              |
|   pri |                                              |              |
| vate, |                                              |              |
|     c |                                              |              |
| harit |                                              |              |
| able, |                                              |              |
|       |                                              |              |
|   and |                                              |              |
|       |                                              |              |
| nongo |                                              |              |
| vernm |                                              |              |
| ental |                                              |              |
|       |                                              |              |
|    or |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
|       |                                              |              |
|  that |                                              |              |
|       |                                              |              |
|  main |                                              |              |
| tains |                                              |              |
|       |                                              |              |
|   its |                                              |              |
|       |                                              |              |
|  prin |                                              |              |
| cipal |                                              |              |
|       |                                              |              |
|    he |                                              |              |
| adqua |                                              |              |
| rters |                                              |              |
|       |                                              |              |
|    in |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|     U |                                              |              |
| nited |                                              |              |
|       |                                              |              |
|    St |                                              |              |
| ates? |                                              |              |
|       |                                              |              |
| >     |                                              |              |
| Enter |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
| total |                                              |              |
| > n   |                                              |              |
| umber |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
|  empl |                                              |              |
| oyees |                                              |              |
| > org |                                              |              |
| aniza |                                              |              |
| tion- |                                              |              |
| wide. |                                              |              |
| >     |                                              |              |
| >     |                                              |              |
| Enter |                                              |              |
| > the |                                              |              |
| > n   |                                              |              |
| umber |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
|  empl |                                              |              |
| oyees |                                              |              |
| > at  |                                              |              |
| >     |                                              |              |
|  prin |                                              |              |
| cipal |                                              |              |
| > hea |                                              |              |
| dquar |                                              |              |
| ters. |                                              |              |
+-------+----------------------------------------------+--------------+
| 2.    |                                              | Yes No       |
|  Does |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|    or |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
|       |                                              |              |
|    re |                                              |              |
| ceive |                                              |              |
|       |                                              |              |
|  cash |                                              |              |
|       |                                              |              |
|   con |                                              |              |
| tribu |                                              |              |
| tions |                                              |              |
|       |                                              |              |
|  from |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|  U.S. |                                              |              |
|       |                                              |              |
|    ge |                                              |              |
| neral |                                              |              |
|     p |                                              |              |
| ublic |                                              |              |
|     ( |                                              |              |
| i.e., |                                              |              |
|       |                                              |              |
|    pr |                                              |              |
| ivate |                                              |              |
|       |                                              |              |
|    in |                                              |              |
| divid |                                              |              |
| uals, |                                              |              |
|       |                                              |              |
|    fo |                                              |              |
| undat |                                              |              |
| ions, |                                              |              |
|       |                                              |              |
|   and |                                              |              |
|       |                                              |              |
|  corp |                                              |              |
| orati |                                              |              |
| ons)? |                                              |              |
+-------+----------------------------------------------+--------------+
| 3.    |                                              | Yes No       |
|  Does |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|    or |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
|       |                                              |              |
|    so |                                              |              |
| licit |                                              |              |
|       |                                              |              |
|  cash |                                              |              |
|       |                                              |              |
|   con |                                              |              |
| tribu |                                              |              |
| tions |                                              |              |
|       |                                              |              |
|  from |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|  U.S. |                                              |              |
|       |                                              |              |
|    ge |                                              |              |
| neral |                                              |              |
|     p |                                              |              |
| ublic |                                              |              |
|     ( |                                              |              |
| i.e., |                                              |              |
|       |                                              |              |
|    pe |                                              |              |
| rform |                                              |              |
|     f |                                              |              |
| undra |                                              |              |
| ising |                                              |              |
|       |                                              |              |
|    ac |                                              |              |
| tivit |                                              |              |
| ies)? |                                              |              |
|       |                                              |              |
|    If |                                              |              |
|       |                                              |              |
|   no, |                                              |              |
|     p |                                              |              |
| lease |                                              |              |
|       |                                              |              |
|   exp |                                              |              |
| lain. |                                              |              |
+-------+----------------------------------------------+--------------+
| 4.    |                                              | Yes No       |
|   Are |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
| organ |                                              |              |
| izati |                                              |              |
| on\'s |                                              |              |
|       |                                              |              |
| board |                                              |              |
|       |                                              |              |
|    me |                                              |              |
| mbers |                                              |              |
|     c |                                              |              |
| ompen |                                              |              |
| sated |                                              |              |
|       |                                              |              |
|   for |                                              |              |
|       |                                              |              |
|    se |                                              |              |
| rving |                                              |              |
|       |                                              |              |
|    on |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|     b |                                              |              |
| oard? |                                              |              |
|       |                                              |              |
| > **R |                                              |              |
| equir |                                              |              |
| ed:** |                                              |              |
| >     |                                              |              |
|  List |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
| board |                                              |              |
| > me  |                                              |              |
| mbers |                                              |              |
| >     |                                              |              |
|  with |                                              |              |
| >     |                                              |              |
|  empl |                                              |              |
| oyees |                                              |              |
| > of  |                                              |              |
| > the |                                              |              |
| > or  |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
| >     |                                              |              |
| indic |                                              |              |
| ated. |                                              |              |
| >     |                                              |              |
| >     |                                              |              |
| Enter |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
| total |                                              |              |
| > n   |                                              |              |
| umber |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
| board |                                              |              |
| > me  |                                              |              |
| mbers |                                              |              |
| >     |                                              |              |
|  from |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
| list. |                                              |              |
| >     |                                              |              |
| >     |                                              |              |
| Enter |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
| total |                                              |              |
| > n   |                                              |              |
| umber |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
|  empl |                                              |              |
| oyees |                                              |              |
| >     |                                              |              |
|  indi |                                              |              |
| cated |                                              |              |
| > on  |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
|  list |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
| board |                                              |              |
| > mem |                                              |              |
| bers. |                                              |              |
| >     |                                              |              |
| >     |                                              |              |
| Enter |                                              |              |
| > the |                                              |              |
| > n   |                                              |              |
| umber |                                              |              |
| > of  |                                              |              |
| > mee |                                              |              |
| tings |                                              |              |
| >     |                                              |              |
|  held |                                              |              |
| > by  |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
| board |                                              |              |
| > w   |                                              |              |
| ithin |                                              |              |
| > the |                                              |              |
| >     |                                              |              |
|  past |                                              |              |
| > 12  |                                              |              |
| > mo  |                                              |              |
| nths. |                                              |              |
+-------+----------------------------------------------+--------------+
| 5     |                                              | Yes No       |
| .  Is |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|    or |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
|       |                                              |              |
|    en |                                              |              |
| gaged |                                              |              |
|       |                                              |              |
|    in |                                              |              |
|       |                                              |              |
| volun |                                              |              |
| tary, |                                              |              |
|     c |                                              |              |
| harit |                                              |              |
| able, |                                              |              |
|       |                                              |              |
|    or |                                              |              |
|     d |                                              |              |
| evelo |                                              |              |
| pment |                                              |              |
|       |                                              |              |
| assis |                                              |              |
| tance |                                              |              |
|       |                                              |              |
|    ab |                                              |              |
| road? |                                              |              |
|       |                                              |              |
| >     |                                              |              |
| Enter |                                              |              |
| > the |                                              |              |
| > n   |                                              |              |
| umber |                                              |              |
| > of  |                                              |              |
| >     |                                              |              |
| volun |                                              |              |
| teers |                                              |              |
| > wo  |                                              |              |
| rking |                                              |              |
| >     |                                              |              |
|  over |                                              |              |
| seas. |                                              |              |
|       |                                              |              |
| If    |                                              |              |
| the   |                                              |              |
| a     |                                              |              |
| nswer |                                              |              |
| to    |                                              |              |
| que   |                                              |              |
| stion |                                              |              |
| 5 is  |                                              |              |
| Yes,  |                                              |              |
| then  |                                              |              |
| go to |                                              |              |
| que   |                                              |              |
| stion |                                              |              |
| 7.    |                                              |              |
+-------+----------------------------------------------+--------------+
| 6.    |                                              | Yes No       |
|  Does |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
|    or |                                              |              |
| ganiz |                                              |              |
| ation |                                              |              |
|       |                                              |              |
| antic |                                              |              |
| ipate |                                              |              |
|       |                                              |              |
|   bec |                                              |              |
| oming |                                              |              |
|       |                                              |              |
|   inv |                                              |              |
| olved |                                              |              |
|       |                                              |              |
|    in |                                              |              |
|       |                                              |              |
|   ove |                                              |              |
| rseas |                                              |              |
|       |                                              |              |
|  prog |                                              |              |
| rams? |                                              |              |
|     W |                                              |              |
| here? |                                              |              |
|       |                                              |              |
| (List |                                              |              |
| a     |                                              |              |
| ntici |                                              |              |
| pated |                                              |              |
| c     |                                              |              |
| ountr |                                              |              |
| ies.) |                                              |              |
+-------+----------------------------------------------+--------------+
| 7.    |                                              | Yes No       |
|   Are |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|       |                                              |              |
| organ |                                              |              |
| izati |                                              |              |
| on\'s |                                              |              |
|       |                                              |              |
|  fina |                                              |              |
| ncial |                                              |              |
|       |                                              |              |
| state |                                              |              |
| ments |                                              |              |
|       |                                              |              |
|  avai |                                              |              |
| lable |                                              |              |
|       |                                              |              |
|    to |                                              |              |
|       |                                              |              |
|   the |                                              |              |
|     p |                                              |              |
| ublic |                                              |              |
|       |                                              |              |
|  upon |                                              |              |
|       |                                              |              |
|  requ |                                              |              |
| est?\ |                                              |              |
|       |                                              |              |
|    If |                                              |              |
|       |                                              |              |
|   no, |                                              |              |
|     p |                                              |              |
| lease |                                              |              |
|       |                                              |              |
|   exp |                                              |              |
| lain. |                                              |              |
+-------+----------------------------------------------+--------------+

# **INSTRUCTIONS FOR PART 1**

**Note:** The Conditions of Registration can be found at: www.usaid.gov
*Keyword: PVC*

**Question 1:** If the answer is no, then your organization is not
meeting Condition No.1, which states an organization must have its
headquarters in the United States; where officials of the organization
can be contacted on a daily basis.

**Question 2:** If your organization receives cash contributions during
the current fiscal year, answer yes to this question. Any organization
that does not receive cash contributions---as supported by the financial
statements---does not meet Condition No. 2.

**Question 3:** If your organization actively solicits cash
contributions during the current fiscal year, answer yes to this
question.

**Question 4:** If your organization\'s board members are compensated
for the sitting on the board, then your organization does not meet
Condition No. 7. Compensation is defined as payment made specifically
for being a member of the Board of Directors. Wages and benefits, both
current and deferred, that staff receives from their employment with the
organization are not considered compensation for sitting on the board.
Reimbursement for reasonable travel expenses to attend board meetings is
acceptable.

**Question 5:** If your organization implements overseas charitable or
development activities without volunteer support, answer yes to the
question and enter zero for the number of overseas volunteers.

**Question 6:** If your organization intends on implementing overseas
activities, please indicate in which countries the program(s) will
begin.

**Question 7:** USAID will publish the financial information provided in
Part 2, VolAg Report Data.

### 

+--------+-------------------------------------------------+----------+
| **PART | **[VOLAG REPORT DATA]{.smallcaps}**             |          |
| 2**    |                                                 |          |
|        | **Support, Revenue, and Expenses**              |          |
|        |                                                 |          |
|        | **PLEASE READ THE INSTRUCTIONS BEFORE           |          |
|        | COMPLETING THE FORM.**                          |          |
+--------+-------------------------------------------------+----------+
|        | ***NOTE: The figures below will be included in  |          |
|        | the VolAg Report.***                            |          |
+--------+-------------------------------------------------+----------+
| *      | 1\. Section 123 Ocean Freight                   | \$       |
| *USAID |                                                 |          |
| SUP    |                                                 |          |
| PORT** |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | 2\. P.L. 480 Freight                            | \$       |
+--------+-------------------------------------------------+----------+
|        | 3\. P.L. 480 Donated Food                       | \$       |
+--------+-------------------------------------------------+----------+
|        | 4\. USAID Grants and Cooperative Agreements     | \$       |
+--------+-------------------------------------------------+----------+
|        | 5\. USAID Contracts                             | \$       |
+--------+-------------------------------------------------+----------+
|        | **6. Total USAID Support (Add Lines 1 Through   | \$       |
|        | 5) (Complete Part 3A)**                         |          |
+--------+-------------------------------------------------+----------+
| **F    | 7\. U.S. Federal Government Grants and          | \$       |
| EDERAL | Cooperative Agreements                          |          |
| GOVE   |                                                 |          |
| RNMENT |                                                 |          |
| SUP    |                                                 |          |
| PORT** |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | 8\. U.S. Federal Government Contracts           | \$       |
+--------+-------------------------------------------------+----------+
|        | 9\. U.S. Federal Government Excess Property     | \$       |
+--------+-------------------------------------------------+----------+
|        | **10. Total Other U.S. Federal Government       | \$       |
|        | Support (Add Lines 7 Through 9) *(Complete Part |          |
|        | 3B)***                                          |          |
+--------+-------------------------------------------------+----------+
| **P    | 11\. Private Contributions (Percentages)        | \$       |
| RIVATE | ***(Complete Part 5)***                         |          |
| SUP    |                                                 |          |
| PORT** |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | Individuals % Bequests/Legacies/Endowments %    |          |
+--------+-------------------------------------------------+----------+
|        | Foundations % Other: %                          |          |
+--------+-------------------------------------------------+----------+
|        | Corporations % **Total** [**100**]{.underline}  |          |
|        | %                                               |          |
+--------+-------------------------------------------------+----------+
|        |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | 12\. Subgrants                                  | \$       |
+--------+-------------------------------------------------+----------+
|        | 13\. Privately Donated Goods and Equipment      | \$       |
+--------+-------------------------------------------------+----------+
|        | 14\. Privately Donated Services                 | \$       |
+--------+-------------------------------------------------+----------+
|        | 15\. Private Revenue (i.e., interest income,    | \$       |
|        | investment income, sales)                       |          |
+--------+-------------------------------------------------+----------+
|        | 16\. Foreign Government Support                 | \$       |
+--------+-------------------------------------------------+----------+
|        | 17\. International Organization Support         | \$       |
+--------+-------------------------------------------------+----------+
|        | 18\. Other U.S. Government Support (i.e., State | \$       |
|        | and Local Grants and Contracts)                 |          |
+--------+-------------------------------------------------+----------+
|        | **19. Total Private Support (Add Lines 11       | \$       |
|        | Through 18)**                                   |          |
+--------+-------------------------------------------------+----------+
|        | **20. Total Support and Revenue per Financial   | \$       |
|        | Statement (Add Lines 6, 10 & 19)**              |          |
|        |                                                 |          |
|        | ***([This total must equal the total on the     |          |
|        | financial statements]{.smallcaps})***           |          |
+--------+-------------------------------------------------+----------+
| **EXPE | 21\. Overseas Program Expenses                  | \$       |
| NSES** |                                                 |          |
+--------+-------------------------------------------------+----------+
|        |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | 22\. Domestic Program Expenses                  | \$       |
+--------+-------------------------------------------------+----------+
|        | 23\. Administrative and Management Expenses     | \$       |
+--------+-------------------------------------------------+----------+
|        |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | 24\. Fundraising Expenses                       | \$       |
+--------+-------------------------------------------------+----------+
|        | **25. Total Expenses per Financial Statements   | \$       |
|        | (Add Lines 21 Through 24)**                     |          |
|        |                                                 |          |
|        | ***([This total must equal the total on the     |          |
|        | financial statements]{.smallcaps})***           |          |
+--------+-------------------------------------------------+----------+

**INSTRUCTIONS FOR PART 2**

**Note:** **[The financial statements and the AID Form 1550-2 must be
for the same fiscal year and the totals for the two documents must
reconcile.]{.underline}**

**Lines 1 - 5:** Enter only amounts as a prime recipient of USAID awards
reported as revenue in your organization\'s financial statements that
have been listed in Part 3, Item A.

**Line 6:** Compute total USAID support by adding lines 1 through 6.

**Lines 7 - 9:** Enter only amounts as a prime recipient of other U.S.
Federal Government awards reported as revenue in your organization\'s
financial statements that have been listed in Part 3, Item B.

**Line 10:** Compute Total Other U.S. Federal Government support by
adding lines 7 through 9.

**Line 11:** Enter the amount of private contributions and grants
(include all fund groups, such as restricted, unrestricted, endowment,
plant, etc.). Indicate by percentage the distribution of these sources.

**Required: Complete Part 5, Schedule of Top Ten Cash Contributors. This
schedule will [not]{.underline} be available to the public.**

**Line 12:** Enter the amount as a sub-recipient with nongovernmental
organizations (NGOs), PVOs, and any grants received from the National
Endowment for Democracy (NED).

**Line 13:** Enter the amount of donated goods and equipment reported in
the financial statements.

**Line 14:** Enter the amount of donated services reported in the
financial statements.

**Line 15:** Enter the amount of private revenue. This revenue includes
sales of publications, service fees, membership dues, income from
investments, gains and losses from investments, and miscellaneous
income, as well as other similar sources.

Line 16: Enter the amount of support received from any foreign
government.

**Line 17:** Enter the amount of support from international
organizations, such as the United Nations and its agencies, and the
World Bank and its agencies.

**Line 18:** Enter the amount of support reported as revenue from U.S.
state and local governments.

**Line 19:** Compute total private support by adding lines 11 through
18.

**Line 20:** Add lines 6, 10, and 19. **The amount on this line must
agree with the total support and revenue reported in the financial
statements for both operating and nonoperating sources.**

**Line 21:** Enter expenses for overseas programs. Report USAID-funded
expenses as overseas programs.

**Note:** Overseas activities are those programs that benefit
development in countries other than the United States. Certain
activities that support these programs may take place in the United
States, such as commodity purchasing, participant training, or
conference planning. The purpose of the program and the country of
origin of its beneficiaries establish whether activities undertaken in
implementing the program are overseas or domestic.

**Line 22:** Enter expenses for domestic programs. No USAID-funded
expenses are reported on this line.

**Line 23:** Enter the expenses for administrative and management
activities as reported in the financial statements.

***Organizations that report no expenses on this line must furnish an
explanation.***

**Line 24:** Enter the expenses for fundraising activities. **If the
amount of fundraising expenses equals zero, enter an explanation in Part
1, Line 3.**

**Line 25:** Add lines 21 through 24. **The amount on this line must
agree with the total expenses reported in the financial statements.**

### 

+-------+--------------------------------------------------------------+
| *     | **SCHEDULE OF GOVERNMENT AWARDS**                            |
| *PART |                                                              |
| 3**   | **LIST ALL AWARDS. COPY THIS PAGE IF ADDITIONAL SPACE IS     |
|       | NEEDED.**                                                    |
+-------+--------------------------------------------------------------+

**A. USAID Grants, Cooperative Agreements, Contracts, P.L. 480 Food and
Freight, Section 123 Ocean Freight, and Excess Property**

  ---------------------- --------------- ------------------------ ------------
  Award Number           Office or       Program Title            Current FY
                         Mission                                  Amount

                                                                  

  Example:               DCHA/PVC-ASHA   Microenterprise          \$150,000
  FAO-A-00-04-00001-00                   Development              

  1\.                                                             \$

  2\.                                                             \$

  3\.                                                             \$

  4\.                                                             \$

  5\.                                                             \$

  6\.                                                             \$

  7\.                                                             \$

  8\.                                                             \$

  9\.                                                             \$

  10\.                                                            \$

                                         **Total:**               \$

                                                                  Equals Part
                                                                  2, line 6
  ---------------------- --------------- ------------------------ ------------

**B. Other U.S. Federal Government (USG) Grants, Cooperative Agreements,
Contracts, and Excess Property**

  ------------------------ ------------------- ----------------------- ------------
  **Other USG Grants,                                                  
  Cooperative Agreements,                                              
  Contracts, and Excess                                                
  Property\                                                            
  for                                                                  
  [Overseas]{.underline}                                               
  Activities**                                                         

  Award Number             Department/Agency   Program Title           Current FY
                                                                       Amount

                                                                       

  Example: IA-000-000-G    Dept. of State      Anti-Trafficking        \$400,000

  1\.                                                                  \$

  2\.                                                                  \$

  3\.                                                                  \$

  4\.                                                                  \$

  5\.                                                                  \$

                                               **Subtotal:**           \$

                                                                       

  **Other USG Grants,                                                  \+ \$
  Cooperative Agreements,                                              
  Contracts and Excess                                                 
  Property\                                                            
  for                                                                  
  [Domestic]{.underline}                                               
  Activities**                                                         

                                                                       

                                               **Total:**              \$

                                                                       Equals Part
                                                                       2, line 10
  ------------------------ ------------------- ----------------------- ------------

**INSTRUCTIONS FOR PART 3**

**Item A:** Enter only the amount as a prime recipient of USAID awards
reported as revenue in your organization\'s financial statements. USAID
award numbers are 15-digit numbers that take the following form:

  ------------- ------- ---------- ---------- ------------------ ----------
  **XXX**       **X**   **XX**     **XX**     **XXXXX**          **XX**

  ------------- ------- ---------- ---------- ------------------ ----------

> **Examples of USAID Grants, Cooperative Agreements, Contracts:**
>
> **Award Number Office or Mission Program Title Amount**
>
> FFP-G-00-05-00250-00 DCHA/FFP Farm Bill 202E \$25,000
>
> 656-A-00-04-00113-00 USAID/Mozambique Ovata Development Program
> \$287,000
>
> 262-C-00-05-00026-00 USAID/Cairo Admin. of Justice Support \$500,000

Total must match Part 2, line 6.

**Item B:** Enter only the amount as a prime recipient of other USG
awards for overseas activities reported as revenue in your
organization\'s financial statements.

> **Examples of Other USG Grants, Cooperative Agreements, Contracts:**
>
> **Award Number Department/Agency Program Title Amount**
>
> FFEE-440-2003/000-00 Dept. of Agriculture Scientific Resources
> \$775,000
>
> DE-FG12-12DE12345 Dept. of Energy Envir. Friendly Drilling \$1,450,000
>
> Funded Transportation Dept. of Defense Transportation \$1,565,000

Add the amount as a prime recipient of other USG awards for domestic
activities reported as revenue in your organization\'s financial
statements.

Total must match Part 2, line 10.

### 

+--------+-------------------------------------------------+----------+
| **PART | **SCHEDULE OF OVERSEAS PRIVATE SUPPORT**        |          |
| 4**    |                                                 |          |
|        | **PLEASE READ THE INSTRUCTIONS BEFORE           |          |
|        | COMPLETING THE FORM.**                          |          |
+--------+-------------------------------------------------+----------+
|        |                                                 |          |
+--------+-------------------------------------------------+----------+
| **OVE  | 1\. Private Contributions                       | \$       |
| RSEAS\ |                                                 |          |
| P      |                                                 |          |
| RIVATE |                                                 |          |
| SUP    |                                                 |          |
| PORT** |                                                 |          |
+--------+-------------------------------------------------+----------+
|        | 2\. Subgrants                                   | \$       |
+--------+-------------------------------------------------+----------+
|        | 3\. Privately Donated Goods and Equipment       | \$       |
+--------+-------------------------------------------------+----------+
|        | 4\. Privately Donated Services                  | \$       |
+--------+-------------------------------------------------+----------+
|        | 5\. Private Revenue (i.e., interest income,     | \$       |
|        | investment income, sales)                       |          |
+--------+-------------------------------------------------+----------+
|        | 6\. Foreign Government Support                  | \$       |
+--------+-------------------------------------------------+----------+
|        | 7\. International Organization Support          | \$       |
+--------+-------------------------------------------------+----------+
|        | 8\. Other U.S. Government Support (i.e., State  | \$       |
|        | and Local Grants and Contracts)                 |          |
+--------+-------------------------------------------------+----------+
|        | **9. Total Overseas Private Support (Add Lines  | \$       |
|        | 1 Through 8)**                                  |          |
+--------+-------------------------------------------------+----------+

**INSTRUCTIONS FOR PART 4**

**Note:** If the organization performs overseas programs, as well as
domestic programs, only the portions attributable to the overseas
programs should be reported on the above schedule.

**Overseas programs** are those programs that benefit development in
countries other than the United States. Certain activities that support
these programs may take place in the United States, such as commodity
purchasing, participant training, or conference planning. The purpose of
the program and its beneficiaries' country of origin establish whether
activities undertaken in implementing the program are overseas or
domestic.

**Line 1:** Enter the amount of private contributions and grants
(include all fund groups, such as restricted, unrestricted, endowment,
plant, etc.). Indicate by percentage the distribution of these sources.

**Line 2:** Enter the amount as a sub-recipient with nongovernmental
organizations (NGOs), PVOs, and any grants received from the National
Endowment for Democracy (NED).

**Line 3:** Enter the amount of donated goods and equipment reported in
the financial statements.

**Line 4:** Enter the amount of donated services reported in the
financial statements.

**Line 5:** Enter the amount of private revenue. This revenue includes
sales of publications, service fees, membership dues, income from
investments, gains and losses from investments, and miscellaneous
income, as well as other similar sources.

**Line 6:** Enter the amount of support received from any foreign
government.

**Line 7:** Enter the amount of support from international
organizations, such as the United Nations and its agencies, and the
World Bank and its agencies.

**Line 8:** Enter the amount of support reported as revenue from U.S.
state and local governments.

**Line 9:** Compute total overseas private support by adding lines 1
through 8.

### 

+-------+--------------------------------------------------------------+
| *     | **SCHEDULE OF TOP TEN CASH CONTRIBUTORS**                    |
| *PART |                                                              |
| 5**   | **THIS SCHEDULE IS NOT AVAILABLE FOR PUBLIC DISCLOSURE.**    |
+-------+--------------------------------------------------------------+

  ------------------------------------------------------------ ----------
                                                               

  Name and Address                                             Current FY
                                                               Amount

                                                               

  1\.                                                          \$

  2\.                                                          \$

  3\.                                                          \$

  4\.                                                          \$

  5\.                                                          \$

  6\.                                                          \$

  7\.                                                          \$

  8\.                                                          \$

  9\.                                                          \$

  10\.                                                         \$

  **Total**                                                    \$

                                                               
  ------------------------------------------------------------ ----------

**INSTRUCTIONS FOR PART 5**

Enter the names, addresses and amounts received from your
organization\'s top 10 contributors for the current year. You may attach
Schedule B, Schedule of Contributors of the IRS Form 990 as a substitute
for this schedule.\
**[Any information you provide on this schedule is not open to the
public.]{.underline}**

### 

  -------- --------------------------------------------------------------
  **PART   **STATEMENT OF AUTHORIZATION**
  6**      

  -------- --------------------------------------------------------------

+-------------------------------------------------------+--------------+
| 1.  Is the checklist carefully reviewed, completed,   | Yes          |
|     and included in the submission?                   |              |
+-------------------------------------------------------+--------------+
| 2.  Does the submission contain all the required      | Yes          |
|     documents as listed on the checklist?             |              |
+-------------------------------------------------------+--------------+

**AID FORM 1550-2 PREPARER**

Please print or type the contact information for the preparer of this
form.

  ----------------------------------- -----------------------------------
  AID Form 1550-2 Preparer            Telephone Number

  Date                                Facsimile Number

                                      E-mail Address
  ----------------------------------- -----------------------------------

**AUTHORIZED SIGNATURES**

Under penalty of perjury, I certify that this is a nonprofit
organization with a tax-exemption status under the\
501(c)( ) provision of the Internal Revenue Code.

I am authorized to sign this form on behalf of the organization. I have
examined this form, including the accompanying schedules, and to the
best of my knowledge it is true, correct, and complete.

  ----------------------------------- -----------------------------------
  Chief Executive Officer             Chief Financial Officer

  Date                                Date

  Telephone Number                    Telephone Number

  Facsimile Number                    Facsimile Number

  E-mail Address                      E-mail Address
  ----------------------------------- -----------------------------------

**BURDEN ESTIMATE STATEMENT**

> PAPERWORK REDUCTION ACT NOTICE: Public reporting burden for this
> collection of information is estimated to average one to three 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. The Agency may
> not conduct or sponsor, and a person is not required to respond to, a
> collection of information unless it displays a currently valid OMB
> control number. Send comments regarding this burden estimate or any
> other aspect of this collection of information, including suggestions
> for reducing this burden, to USAID, Chief, Policy, Planning and
> Outreach Division (PPO), Room 7.06, Ronald Reagan Building,
> Washington, DC 20523-7600 and to the Office of Information and
> Regulatory Affairs, Office of Management and Budget, Paperwork
> Reduction Project (0412-0035), Washington, DC 20503.