**SUPPORTING STATEMMENT FOR REVISION OF**

# OMB 0412-0543 (USAID 1558-1 and USAID 1558-1A)

EXCEPTION TO THE FINANCIAL STATUS REPORT (SF-269) and

SUPPLEMENT TO THE FINANCIAL STATUS REPORT (269.S)

(OFFICE OF USAID/DCHA/ASHA SPECIFIC)

## Section A. -- Justification

1.  *Need for Collection*

The currently used USAID form 1558-1 (**SF-269**) serves to

a.  Monitor applicable budgetary liquidation of federal disbursements;

b.  Calculate cash-on-hand; and

c.  Monitor pipeline of federal funds.

> The currently used USAID form 1558-1A (**269.S**) serves to

d.  Monitor expenditures;

e.  Provide proof of appropriate charges against federal grants awarded
    by USAID/DCHA/ASHA;

f.  Calculate applicable budgetary liquidation of federal disbursements
    when expenditures are effected in mix currencies; and

g.  Calculate program income credits or debits resulting from bank
    transactions to convert US Dollars in local foreign currency.

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2.  *Use of Information*

The alteration to the existing SF-269 will

a.  Improve the appearance and help distinguish it from another similar
    financial form (Exception to Request for Reimbursement or Advance);

b.  Permit computer spreadsheet replication that will warrant
    mathematical accuracy; and

c.  Clarify definitions of blocks and improve language in the
    "Instruction" section to make this form user-friendly.

The alteration to the existing form is needed to

d.  Improve understanding by grant recipients and

e.  Permit computer spreadsheet replication that will warrant
    mathematical accuracy.

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3.  *Technological Techniques*

The revised instructions on SF-269 will

a.  Facilitate grant recipients to properly list and calculate
    applicable amounts of liquidated funds and cash-on-hand;

b.  Monitor total disbursements and pipeline of federal funds; and

c.  Report program income credit ensuing from bank transactions, which
    recipients will report in the final financial reports.

The revised instructions on form 269.S will

d.  Facilitate grant recipients to properly list and calculate
    applicable liquidated using a spreadsheet format and

e.  Monitor any program income credit or debit ensuing from bank
    transactions.

> Recipients will be able to

f.  Transmit electronically the calculations of liquidations reported on
    financial reports -- SF-269, submitted on hard copy quarterly, and

g.  Include the total program income credit/debit on the FINAL SF-269.

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4.  *Duplications --* The proposed alterations do not duplicate any
    other form.

5.  *Significant Impact --* None.

6.  *Need for Collecting Data*

    a.  Relative to SF-269, USAID/DCHA/ASHA grants require, among other
        things that

> *"...Within 30 days after the end of each quarterly reporting period,
> the grantee shall submit to the Office of American Schools and
> Hospitals Abroad ... an original and one copy of the appended Standard
> Form 269/\[USAID\]-1558-1)..."*

b.  Relative to form 269.S, USAID/DCHA/ASHA grants require, among other
    things that

> *"...In the event that funds remain in excess of those needed to
> achieve the purpose of the \[grant\], either as a result of favorable
> currency exchange transactions or from unexpected reduction in costs,
> Grantee must refund excess funds to USAID..."*

c.  The modification to the existing OMB form 269.S will assist
    recipients to understand logically the calculation methodology of
    liquidations and take control of program income credit/debit.

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7.  *Method of Data Collection --* The collection of information is
    consistent with OMB guidelines.

8.  *Public Solicitation*

    a.  CFR 1320.8(d) -- Not applicable.

    b.  These forms are unique.

    c.  Consultation with recipient is continuous and necessary for the
        effective administration of the USAID/DCHA/ASHA grant program.

9.  *Payments --* Not applicable.

10. *Confidentiality --* The proposed revision to USAID 1558-1 and USAID
    1558-1A do not alter in anyway the applicable considerations
    regarding confidentiality of information.

11. *Additional Justifications and Questions of Sensitive nature --*
    None.

12. *Estimated Burden (to the Federal Government) --* Two persons, one
    from the office of USAID-DCHA/ASHA and a second from the
    USAID-FM/CMP/CGLC will handle Forms USAID 1558-1 (4 per grant per
    year). One person from USAID-DCHA/ASHA will handle FORMS USAID
    1558-1A. With an annual average of 95 active grants, the following
    personnel will process and store about 720 forms. The following
    table explains the type of processing that each form requires and
    calculates the estimated burden.

+-----+-----+-----------------------------------+------+------+------+
| #   | >   | **[Processing]{.smallcaps}**      | > *  | > ** | >    |
|  [O |  ** |                                   | *[Nu | [Min | **[T |
| ffi | [Em |                                   | mber | utes | otal |
| ce] | plo |                                   | > of | >    | >    |
| {.s | yee |                                   | >    | (ave | hour |
| mal | ]{. |                                   | form | rage | s]{. |
| lca | sma |                                   | s]{. | >    | smal |
| ps} | llc |                                   | smal | each | lcap |
|     | aps |                                   | lcap | >    | s}** |
|     | }** |                                   | s}** | form |      |
|     |     |                                   |      | )]{. |      |
|     |     |                                   |      | smal |      |
|     |     |                                   |      | lcap |      |
|     |     |                                   |      | s}** |      |
+-----+-----+-----------------------------------+------+------+------+
| >   | >   | USAID 1558-1A (Form 269.S)        | 380  |      |      |
| USA | GS- |                                   |      |      |      |
| ID- |     | 1.  *Verify Applicable Rates Of   |      |      |      |
| DCH |     |     Exchange And That             |      |      |      |
| A/A |     |     Expenditures Are Allowable    |      |      |      |
| SHA |     |     And Allocable* -- Check For   |      |      |      |
|     |     |     conformance to the Agreement, |      |      |      |
|     |     |     mathematical correctness,     |      |      |      |
|     |     |     justification of              |      |      |      |
|     |     |     disbursements, and the        |      |      |      |
|     |     |     analyses of program income    |      |      |      |
|     |     |     credit/debit.                 |      |      |      |
|     |     |                                   |      |      |      |
|     |     | 2.  *Log-in, file, and            |      |      |      |
|     |     |     distribute*                   |      |      |      |
+-----+-----+-----------------------------------+------+------+------+
|     |     | USAID 1558-1 (SF-269)             | 380  |      |      |
|     |     |                                   |      |      |      |
|     |     | 1.  *Administrative Approval* --  |      |      |      |
|     |     |     Check applicable reporting    |      |      |      |
|     |     |     period and mathematical       |      |      |      |
|     |     |     correctness assuring          |      |      |      |
|     |     |     agreement with data reported  |      |      |      |
|     |     |     on form 269.S                 |      |      |      |
|     |     |                                   |      |      |      |
|     |     | 2.  *Log-in, file and distribute* |      |      |      |
+-----+-----+-----------------------------------+------+------+------+
| >   | >   | USAID 1558-1 (SF-269)             |      |      |      |
| USA | GS- |                                   |      |      |      |
| ID/ |     | 1.  *Verify* -- Check for         |      |      |      |
| FM/ |     |     conformance to the Agreement, |      |      |      |
| CMP |     |     as amended, and mathematical  |      |      |      |
|     |     |     correctness                   |      |      |      |
|     |     |                                   |      |      |      |
|     |     | 2.  *Login and file*              |      |      |      |
|     |     |                                   |      |      |      |
|     |     | 3.                                |      |      |      |
+-----+-----+-----------------------------------+------+------+------+
| **  | **2 |                                   | **7  |      |      |
| TOT | ea  |                                   | 60** |      |      |
| .** | .** |                                   |      |      |      |
+-----+-----+-----------------------------------+------+------+------+

13. *Estimated Annual Burden and Cost to Recipients -- There are
    approximately 56 United States Organizations (recipients or USOs)*
    sponsoring some 80 Overseas Institutions (OSIs). From communications
    with most of the recipients and sub-recipients and intimate
    knowledge of the program, it is reasonable to assume that as many as
    60 OSIs have accountants who dedicate 30% of their time to compiling
    and recording data for these forms. Each OSI's executive officer
    dedicates about 10% of total activity. Moreover, about 30% of the
    USOs employ full time accountants who dedicate 33% of their time to
    this form while the remaining USOs' executive officers dedicated
    about 25% of their time. Hence,

  -------------- -------------- -------------- -------------- ---------------
  **Office**     **Employee**   **Hourly       **Time (hr)**  **Cost
                                rate**                        (U.S.\$)**

  Overseas       60 accountants 12             31,680         380,160
  Institution                                                 

  Overseas       80 executive   40             14,080         563,200
  Institution    officers                                     

  U.S.           17 accountants 21             9,874          207,346
  Organization                                                

  U.S.           39 executive   50             17,160         858,000
  Organization   officers                                     

  Contingency    ±10%                          7,206          191,294

  **TOTAL**      **196                         **80,000**     **2,200,000**
                 persons**                                    
  -------------- -------------- -------------- -------------- ---------------

14. *Estimated Annual Cost to the Federal Government --* One person in
    USAID-DCHA/ASHA and one from USAID-FM/CMP/CGLC will continue to
    handle Forms USAID 1558-1 and 1558-1A (four each per grant per
    year). With an annual average of 90 active grants, they will process
    and store about 380 forms. The total cost estimate is as follows:

  ----------------- -------------- -------------- -------------- --------------
  **Office**        **Employee**   **Hourly       **Time (hr)**  **Cost
                                   rate**                        (U.S.\$)**

  USAID-DCHA/ASHA   1 GS-                                        

  USAID-FM/CMP      1 GS-                                        

  Contingency       ±10%                                         

  **TOTAL**         **2 persons**                                
  ----------------- -------------- -------------- -------------- --------------

15. *Changes in Burden* -- The increase in estimated time resulted from
    reported and observed timekeeping.

16. *Tabulation and Publication --* Not applicable

17. *Expiration Date* -- Forms USAID 1558-1 and 1558-1A will bear the
    OMB approval expiration date.

18. *Exceptions -* None

**Section B. -- Collection of Information Employing Statistical
Methods**

> (Not Applicable)