**Administration for Native Americans**

**Objective Progress Report (OPR)**

The Paperwork Reduction Act of 1995: Public reporting burden for this
collection of information is estimated to average 1 hour per response,
including the time for reviewing instructions, gathering and maintaining
the data needed, and reviewing the collection of information. An 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
number.

+-------------------+---------+----+---------+-----+------+-----+---+
|                   |         |    |         |     | P    | >   |   |
|                   |         |    |         |     | age: |  of |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     |      | Pa  |   |
|                   |         |    |         |     |      | ges |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| 1.Grantee Name    |         | 2  |         |     | 3a.  |     | [ |
|                   |         | \. |         |     | DUNS |     | ] |
|                   |         | G  |         |     | Nu   |     | { |
|                   |         | ra |         |     | mber |     | . |
|                   |         | nt |         |     |      |     | m |
|                   |         | Nu |         |     |      |     | a |
|                   |         | mb |         |     |      |     | r |
|                   |         | er |         |     |      |     | k |
|                   |         |    |         |     |      |     | } |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
|                   |         |    |         |     | 3b.  |     | [ |
|                   |         |    |         |     | EIN  |     | ] |
|                   |         |    |         |     |      |     | { |
|                   |         |    |         |     |      |     | . |
|                   |         |    |         |     |      |     | m |
|                   |         |    |         |     |      |     | a |
|                   |         |    |         |     |      |     | r |
|                   |         |    |         |     |      |     | k |
|                   |         |    |         |     |      |     | } |
+-------------------+---------+----+---------+-----+------+-----+---+
| 4\. Recipient     |         |    |         |     | *5.  |     |   |
| Organization      |         |    |         |     | S    |     |   |
| (Name and         |         |    |         |     | F269 |     |   |
| complete address  |         |    |         |     | Long |     |   |
| including zip     |         |    |         |     | Form |     |   |
| code)             |         |    |         |     | At   |     |   |
|                   |         |    |         |     | tach |     |   |
|                   |         |    |         |     | ed?* |     |   |
|                   |         |    |         |     | Yes  |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     | No   |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| 6\. Project       |         |    | 7\.     |     | 8\.  |     |   |
| Period            |         |    | Re      |     | F    |     |   |
|                   |         |    | porting |     | inal |     |   |
|                   |         |    | Period  |     | Rep  |     |   |
|                   |         |    | End     |     | ort? |     |   |
|                   |         |    | Date    |     | Yes  |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     | No   |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| Start Date:       | End     |    | *       |     | 9\.  |     |   |
| *(Month, Day,     | Date:   |    | (Month, |     | Re   |     |   |
| Year)*            | *       |    | Day,    |     | port |     |   |
|                   | (Month, |    | Year)*  |     | F    |     |   |
|                   | Day,    |    |         |     | requ |     |   |
|                   | Year)*  |    |         |     | ency |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     | *qu  |     |   |
|                   |         |    |         |     | arte |     |   |
|                   |         |    |         |     | rly* |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     | *ot  |     |   |
|                   |         |    |         |     | her* |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     | *(If |     |   |
|                   |         |    |         |     | ot   |     |   |
|                   |         |    |         |     | her, |     |   |
|                   |         |    |         |     | de   |     |   |
|                   |         |    |         |     | scri |     |   |
|                   |         |    |         |     | be:* |     |   |
|                   |         |    |         |     | [    |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     | ]{.u |     |   |
|                   |         |    |         |     | nder |     |   |
|                   |         |    |         |     | line |     |   |
|                   |         |    |         |     | }*)* |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| 10\. Performance  |         |    |         |     |      |     |   |
| Narrative         |         |    |         |     |      |     |   |
| *(attach          |         |    |         |     |      |     |   |
| performance       |         |    |         |     |      |     |   |
| narrative as      |         |    |         |     |      |     |   |
| instructed by the |         |    |         |     |      |     |   |
| awarding Federal  |         |    |         |     |      |     |   |
| Agency)*          |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
| Project           |         |    |         |     |      |     |   |
| Title:            |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
| Report prepared   |         |    |         |     |      |     |   |
| by: Name:         |         |    |         |     |      |     |   |
| [                 |         |    |         |     |      |     |   |
|     ]{.underline} |         |    |         |     |      |     |   |
| Date:             |         |    |         |     |      |     |   |
| [                 |         |    |         |     |      |     |   |
|     ]{.underline} |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| 11\. Other        |         |    |         |     |      |     |   |
| Attachments:      |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| **12.             |         |    |         |     |      |     |   |
| Certification:**  |         |    |         |     |      |     |   |
| **I certify to    |         |    |         |     |      |     |   |
| the best of my    |         |    |         |     |      |     |   |
| knowledge and     |         |    |         |     |      |     |   |
| belief that this  |         |    |         |     |      |     |   |
| report is correct |         |    |         |     |      |     |   |
| and complete for  |         |    |         |     |      |     |   |
| performance of    |         |    |         |     |      |     |   |
| activities for    |         |    |         |     |      |     |   |
| the purposes set  |         |    |         |     |      |     |   |
| forth in the      |         |    |         |     |      |     |   |
| award             |         |    |         |     |      |     |   |
| documents.**      |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| 13a. Typed or     |         |    |         | 1   |      |     |   |
| Printed Name and  |         |    |         | 3c. |      |     |   |
| Title of          |         |    |         | Tel |      |     |   |
| Authorized        |         |    |         | eph |      |     |   |
| Certifying        |         |    |         | one |      |     |   |
| Official          |         |    |         | *(a |      |     |   |
|                   |         |    |         | rea |      |     |   |
|                   |         |    |         | co  |      |     |   |
|                   |         |    |         | de, |      |     |   |
|                   |         |    |         | num |      |     |   |
|                   |         |    |         | ber |      |     |   |
|                   |         |    |         | and |      |     |   |
|                   |         |    |         | ex  |      |     |   |
|                   |         |    |         | ten |      |     |   |
|                   |         |    |         | sio |      |     |   |
|                   |         |    |         | n)* |      |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
|                   |         |    |         | 1   |      |     |   |
|                   |         |    |         | 3d. |      |     |   |
|                   |         |    |         | Em  |      |     |   |
|                   |         |    |         | ail |      |     |   |
|                   |         |    |         | A   |      |     |   |
|                   |         |    |         | ddr |      |     |   |
|                   |         |    |         | ess |      |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
| 13b. Signature of |         |    |         | 1   |      |     |   |
| Authorized        |         |    |         | 3e. |      |     |   |
| Certifying        |         |    |         | D   |      |     |   |
| Official          |         |    |         | ate |      |     |   |
|                   |         |    |         | Rep |      |     |   |
|                   |         |    |         | ort |      |     |   |
|                   |         |    |         | Sub |      |     |   |
|                   |         |    |         | mit |      |     |   |
|                   |         |    |         | ted |      |     |   |
|                   |         |    |         | *(  |      |     |   |
|                   |         |    |         | Mon |      |     |   |
|                   |         |    |         | th, |      |     |   |
|                   |         |    |         | D   |      |     |   |
|                   |         |    |         | ay, |      |     |   |
|                   |         |    |         | Y   |      |     |   |
|                   |         |    |         | ear |      |     |   |
|                   |         |    |         | )*  |      |     |   |
|                   |         |    |         |     |      |     |   |
|                   |         |    |         |     |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+
|                   |         |    |         | 1   |      |     |   |
|                   |         |    |         | 4\. |      |     |   |
|                   |         |    |         | Age |      |     |   |
|                   |         |    |         | ncy |      |     |   |
|                   |         |    |         | use |      |     |   |
|                   |         |    |         | o   |      |     |   |
|                   |         |    |         | nly |      |     |   |
+-------------------+---------+----+---------+-----+------+-----+---+

**[Objective Work Plan Update]{.smallcaps}**

1\. Have any changes been made to the Objective Work Plan (OWP)? Yes No

If Yes, please explain.      

If Yes, did you receive ANA's approval for these changes? Yes No

2\. Please complete the tables below and include all objectives and
activities from your approved OWP. If you require more space, attach
additional sheets and follow the same format.

GOAL:      

OBJECTIVE 1: [     ]{.underline}

> **Describe how each activity was accomplished**

**Activity (or what prevented activity from being completed) S**tatus

+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+

OBJECTIVE 2: [     ]{.underline}

> **Describe how each activity was accomplished**

**Activity (or what prevented activity from being completed) S**tatus

+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+

OBJECTIVE 3: [     ]{.underline}

> **Describe how each activity was accomplished**

**Activity (or what prevented activity from being completed) S**tatus

+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+

OBJECTIVE 4: [     ]{.underline}

> **Describe how each activity was accomplished**

**Activity (or what prevented activity from being completed) S**tatus

+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+

OBJECTIVE 5: [     ]{.underline}

> **Describe how each activity was accomplished**

**Activity (or what prevented activity from being completed) S**tatus

+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+

OBJECTIVE 6: [     ]{.underline}

> **Describe how each activity was accomplished**

**Activity (or what prevented activity from being completed) S**tatus

+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+
|               |                               | Completed Ongoing   |
|               |                               | N/A this quarter    |
|               |                               |                     |
|               |                               | Not Completed (if   |
|               |                               | not completed,      |
|               |                               | include expected    |
|               |                               | completion date:    |
|               |                               | dd/mm/yr)           |
+---------------+-------------------------------+---------------------+

**IMPACT/PERFORMANCE INDICATORS**

3\. Please list all impact/performance indicators for this project and
provide details in the table below.

Note: If your grant started prior to 2004, please check here and skip to
#4.

**Total \# and/or \$ for this Total \# and/or \$ since**

**Impact/performance indicators Initial Target \# and/or \$ reporting
period beginning of project**

  --------------- ------------------ ------------------ -----------------
  1\. Resources                                              
  Leveraged                                             

  2\.                                                        
  Partnerships                                          
  Formed                                                

  3\.                                                        

  4\.                                                        

  5\.                                                        
  --------------- ------------------ ------------------ -----------------

**PARTNERSHIPS**

4\. Please list any partnerships formed during this reporting period:

**Brief description of partnership and**

**Partnering agency/organization/tribe Type of Partnership how it is**
benefiting the project

+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+
|                         | Local Regional  |                          |
|                         | State National  |                          |
|                         |                 |                          |
|                         | Federal         |                          |
|                         | International   |                          |
|                         | Faith-Based     |                          |
|                         |                 |                          |
|                         | Philanthropic   |                          |
|                         | Tribal Other    |                          |
|                         | [               |                          |
|                         |   ]{.underline} |                          |
+-------------------------+-----------------+--------------------------+

**LEVERAGED RESOURCES**

5\. Please list any resources leveraged during this reporting period
that are over and above the non-federal share match (e.g., other grants
secured as a result of this project, donated meeting
space/equipment/advertising, volunteer hours, etc.).

**Source** Federal or Non-Federal Dollar Value

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

                                                         

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

**NATIVE AMERICAN YOUTH AND ELDER OPPORTUNITIES**

6\. During this reporting period, did this project provide any
opportunities or activities for Native American youth or elders? Yes No
NA

If Yes, please list activity and provide details below:

**\# of Youth \# of Elders Was this an inter-**

**Activity Participating Participating Description generational
activity?**

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

                                                                   

                                                                   

                                                                   

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

**JOBS**

7\. Please list all jobs created during this reporting period as a
***[direct]{.underline}*** result of this award (i.e.,
salaries/consultant fees paid through ANA funding or in-kind) and
complete the following table:

**Position Title Name Full or Part Time Hours per Month Federal or
In-Kind**

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

                                                                 

                                                                 

                                                                 

                                                                 

                                                                 

                                                                 

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

8\. Were any jobs created in the community during this reporting period
as a result of this project (e.g., through businesses and/or services
resulting from this project but whose salaries were not paid with ANA
funds)? Yes No

If Yes, please list below:

**Position Title Full or Part Time Hours per M**onth

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

                                                       

                                                       

                                                       

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

**PROJECT PERSONNEL**

9\. Have you hired all key personnel, as outlined in the grant
application? Yes No

If No, please list vacant positions and explain:      

10\. Did you have any changes or turnover in key personnel, consultants
or contractors during this reporting period? Yes No

If Yes, please list affected positions and explain:      

**FINANCIAL**

11\. What were your forecasted cash needs for this reporting period
(from the Form 424A)? What were your actual expenditures?

Please list in the table below:

+------+------+-------+------+-------+------+-------+------+-------+
|      | 1st  |       | 2nd  |       | 3rd  |       | 4th  |       |
|      |      |       |      |       |      |       |      |       |
|      | Qua  |       | Qua  |       | Qua  |       | Qua  |       |
|      | rter |       | rter |       | rter |       | rter |       |
+------+------+-------+------+-------+------+-------+------+-------+
|      | Fo   | > A   | Fo   | > A   | Fo   | > A   | Fo   | > A   |
|      | reca | ctual | reca | ctual | reca | ctual | reca | ctual |
|      | sted |       | sted |       | sted |       | sted |       |
+------+------+-------+------+-------+------+-------+------+-------+
| Fed  |      |       |      |       |      |       |      |       |
| eral |      |       |      |       |      |       |      |       |
+------+------+-------+------+-------+------+-------+------+-------+
| Non  |      |       |      |       |      |       |      |       |
| -Fed |      |       |      |       |      |       |      |       |
| eral |      |       |      |       |      |       |      |       |
+------+------+-------+------+-------+------+-------+------+-------+

12\. Did you access funds through the Division of Payment Management
(DPM) during this reporting period? Yes No

If No, please explain:      

13\. Did you revise your budget during this reporting period? Yes No

If Yes, was it approved by ANA? Yes No

If a revision was made, please explain:      

14\. Have you met your Non-Federal Share of the project costs for this
reporting period? Yes No

If No, please explain.      

**OTHER**

15\. Please describe any challenges you encountered on this project
during this reporting period and include how you overcame (or plan to
overcome) them:      

16\. ANA is committed to assisting you in the successful implementation
of your project and offers free training and technical assistance. Are
you in need of any training or technical assistance to carry out your
project objectives? Yes No

> If Yes, what type of assistance would you like: Electronic On-site
> Other [     ]{.underline}

Please explain:      

17\. Do you expect to complete your project objectives and activities by
the project end date? Yes No

If No, please explain:      

18\. Please include any other information you would like to share with
ANA regarding your project here: