Table 1

Participants by Entering Educational Functioning Level, Ethnicity, and Sex

Enter the number of participants* by educational functioning level,** ethnicity,*** and sex.

Entering Educational

Functioning Level

American 

Indian or 

Alaska Native Asian

Black or 

AfricanAmericanHispanic/

Latino

Native 

Hawaiian or 

Other Pacific 

Islander White

Two or more 

races Total

Male Female Male Female Male Female Male Female Male Female Male Female Male Female

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) (L) (M) (N) (O) (P)

ABE Beginning Literacy

ABE Beginning Basic Education

ABE Intermediate Low

ABE Intermediate High

ASE Low

ASE High

ESL Beginning Literacy

ESL Low Beginning

ESL High Beginning

ESL Intermediate Low

ESL Intermediate High

ESL Advanced

Total

OMB Number 1830-0027, Expires 08/31/2014. 

*A participant is an adult who receives at least twelve (12) hours of instruction. Work-based project learners are not included in this table.

**See definitions for educational functioning levels.

*** See definitions of race/ethnicity categories and examples that demonstrate how to report them. A participant should be included in the racial/ethnic group to which he or she appears to belong, 

identifies with, or is regarded in the community as belonging. If a student does not self-identify a race/ethnicity, the program must use observer identification.
Table 2 

Participants by Age, Ethnicity, and Sex

Enter the number of participants by age,* ethnicity,** and sex.

Age Group

American Indian 

or Alaska Native Asian

Black or AfricanAmericanHispanic/

Latino

Native Hawaiian 

or Other Pacific 

Islander White

Two or more 

races

Total

Male Female Male Female Male Female Male Female Male Female Male Female Male Female

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) (L) (M) (N) (O) (P)

16–18

19–24

25–44

45–59

60 and Older

Total

Work-based project learners are not included in this table.

*Participants should be classified based on their age at entry. However, participants entering the program prior to the current program year should be classified based on their age at the beginning of 

the current program year. 

** See definitions of race/ethnic categories and examples that demonstrate how to report them.

The Total row in Columns B–O should equal the Total row in Columns B–O of Table 1. Row totals in Column P should equal the corresponding Total row in Table 3.

OMB Number 1830-0027, Expires 08/31/2014.
Table 3

Participants by Program Type and Age

Enter the number of participants by program type and age.

Program Type 16–18 19–24 25–44 45–59 60 and Older Total

(A) (B) (C) (D) (E) (F) (G)

Adult Basic Education

Adult Secondary Education

English-as-a-Second Language

Total

Work-based project learners are not included in this table.

The Total row in Column G should equal the Total row in Column P of Table 1.

OMB Number 1830-0027, Expires 08/31/2014.
Table 4

Educational Gains and Attendance by Educational Functioning Level

Enter number of participants for each category listed, total attendance hours, and calculate percentage of participants completing each level.

Entering Educational 

Functioning Level

Total Number 

Enrolled

Total 

Attendance 

Hours

Number 

Completed 

Level

Number Who 

Completed a 

Level and 

Advanced One 

or More Levels

Number 

Separated 

Before 

Completed

Number 

Remaining 

Within Level

Percentage 

Completing 

Level

(A) (B) (C) (D) (E) (F) (G) (H)

ABE Beginning Literacy

ABE Beginning Basic Education

ABE Intermediate Low

ABE Intermediate High

ASE Low

ASE High*

ESL Beginning Literacy

ESL Low Beginning

ESL High Beginning

ESL Intermediate Low

ESL Intermediate High

ESL Advanced

Total

Work-based project learners are not included in this table.

The numbers in each row of Column B should equal the numbers in the corresponding rows of Column P of Table 1.

Column D is the total number of learners who completed an educational functioning level, including learners who left after completing and learners who remained enrolled and moved to one or more 

higher levels.

Column E represents a subset of Column D (Number Completed Level) and is learners who completed a level and enrolled in one or more higher levels.

Column F is students who left the program before completing a level. It also includes students who have not completed a level, received no services for 90 consecutive days, and have no scheduled 

services.

Column D + F + G should equal the total in Column B.

Column G represents the number of learners still enrolled who are at the same educational level as when they entered.

Each row total in Column H is calculated by using the following formula: ColumnB

ColumnD H 
*Completion of ASE High level is attainment of a secondary school credential or completing all components of a state-recognized examination leading to a secondary credential or 

its equivalent.

OMB Number 1830-0027, Expires 08/31/2014.
Table 4B 

Educational Gains and Attendance for Pre- and Post-tested Participants

Enter number of pre- and post-tested participants for each category listed, calculate percentage of post-tested participants completing each level, and enter total 

attendance hours for post-tested completion.

Entering Educational Functioning 

Level

Total Number 

Enrolled

Pre- and Posttested

Total 

Attendance 

Hours

Number 

Completed 

Level

Number Who 

Completed a 

Level and 

Advanced One 

or More Levels

Number 

Separated 

Before 

Completed

Number 

Remaining 

Within Level

Percentage 

Completing 

Level

(A) (B) (C) (D) (E) (F) (G) (H)

ABE Beginning Literacy

ABE Beginning Basic Education

ABE Intermediate Low

ABE Intermediate High

ASE Low

ASE High*

ESL Beginning Literacy

ESL Low Beginning

ESL High Beginning

ESL Intermediate Low

ESL Intermediate High

ESL Advanced

Total

Include in this table only students who are both pre- and post-tested.

Work-based project learners are not included in this table.

Column D is the total number of learners who completed a level, including learners who left after completing and learners who remained enrolled and moved to one or more higher levels.

Column E represents a subset of Column D (Number Completed Level) and is learners who completed a level and enrolled in one or more higher levels.

Column F is students who left the program before completing a level. It is also students who have not completed, received no services for 90 consecutive days, and have no scheduled services.

Column D + F + G should equal the total in Column B.

Column G represents the number of learners still enrolled who are at the same educational level as when they entered.

Each row total in Column H is calculated using the following formula: ColumnB

ColumnD H 
*Completion of ASE high level is attainment of a secondary school credential or completing all components of a state-recognized examination leading to a secondary credential or its equivalent.

OMB Number 1830-0027, Expires 08/31/2014.

Table 4C 

Educational Gains and Attendance for Participants in Distance Education

Enter number of distance education participants for each category listed, calculate percentage of participants completing each level, and enter total proxy and direct 

attendance hours.

Entering Educational 

Functioning Level

Total Number 

Enrolled

In Distance 

Education

Total Estimated 

and Actual

Attendance 

Hours

Number 

Completed 

Level

Number Who 

Completed a 

Level and 

Advanced One 

or More Levels

Number 

Separated 

Before 

Completed

Number 

Remaining 

Within Level

Percentage 

Completing 

Level

(A) (B) (C) (D) (E) (F) (G) (H)

ABE Beginning Literacy

ABE Beginning Basic Education

ABE Intermediate Low

ABE Intermediate High

ASE Low

ASE High*

ESL Beginning Literacy

ESL Low Beginning

ESL High Beginning

ESL Intermediate Low

ESL Intermediate High

ESL Advanced

Total

Include in this table only students who are counted as distance education students.

Work-based project learners are not included in this table.

Column D is the total number of learners who completed a level, including learners who left after completing and learners who remained enrolled and moved to one or more higher levels.

Column E represents a subset of Column D (Number Completed Level) and is learners who completed a level and enrolled in one or more higher levels.

Column F is students who left the program before completing a level. It is also students who have not completed, received no services for 90 consecutive days, and have no scheduled services.

Column D + F + G should equal the total in Column B.

Column G represents the number of learners still enrolled who are at the same educational level as when they entered.
Each row total in Column H is calculated using the following formula: ColumnB

ColumnD H 

*Completion of ASE high level is attainment of a secondary school credential or successful completion of all components of a state-recognized examination leading to a secondary credential or its 

equivalent. 

OMB Number 1830-0027, Expires 08/31/2014.
Table 5

Core Follow-up Outcome Achievement

Core Follow-up 

Outcome Measures

M

e

t

h

o

d

Number of 

Participants 

in Cohort

Number of 

Participants 

Used for 

Representative 

Cohort

Number of 

Participants 

Responding 

to Survey or 

Available for 

Data Matching

Response 

Rate or 

Percent 

Available 

for Match

Number of 

Participants 

Achieving 

Outcome 

(Unweighted)

Number of 

Participants 

Achieving 

Outcome 

(Weighted)

Percent 

Achieving 

Outcome 

(Weighted)

(A) (B) (C) (D) (E) (F) (G) (H)

Entered Employment* U N/A

R

C

Retained 

Employment**

U N/A

R

C

Obtained a Secondary 

School Credential or Its 

Equivalent***

U N/A

R

C

Entered Postsecondary 

Education or Training –

current program 

year 

U N/A

R

C

Entered Postsecondary 

Education or Training –

prior program year** **

U N/A

R

C

U = Universe cohort; programs attempted to collect data for all eligible participants either by survey, data 

match or both

R = Representative cohort; programs attempted to collect data for a representative subset of eligible 

participants

C = Combined universe and representative cohort totals; these numbers will be calculated automatically 

by OCTAE’s data system
Instructions for Completing Table 5

Note: All shaded columns (E, G, and H) and rows for cohort totals will be calculated automatically by 

OCTAE’s data system.

Work-based project learners are not included in this table.

* Report in Column B the number of participants who were unemployed and in the labor force at entry who 

exited during the program year. Do not exclude students because of missing Social Security numbers or 

other missing data. 

** Report in Column B: (1) the number of participants who were unemployed and in the labor force at entry 

who exited during the program year and who entered employment by the end of the first quarter after 

program exit and (2) the number of participants employed at entry who exited during the program year.

*** Report in Column B the number of participants who exited during the program year and (1) took all 

components of a state-recognized examination leading to a secondary credential or its equivalent or (2) 

were enrolled in adult high school at the high ASE level or (3) were enrolled in the assessment phase of the 

EDP.

**** Report in Column B the number of participants who exited during the program year and (1) have 

earned a secondary school credential or its equivalent while enrolled in adult education, or (2) have a 

secondary school credential at entry, or (3) are enrolled in a class specifically designed for transitioning to 

community college. Enter the number of these participants who enrolled during the current program year in 

the row labeled “current program year.” Enter the number of these participants who enrolled during the 

program year immediately prior to the current year in the row labeled “prior program year.” For Columns B 

through D and Column F, the first row for each follow-up outcome measure should be used to report 

information based on universe cohorts, and the second row should be used to report information based on 

representative cohorts. If no program used representative cohorts, the “R” rows should be left blank. If no

program used universe cohorts, the “U” row should be left blank.

For programs using universe cohorts, Column E

ColumnB

ColumnD

 . 

For programs using representative cohorts, Column E

ColumnC

ColumnD

 .

Column H is the number in Column G divided by the number in Column B. Column H should never be 

greater than 100 percent. If the response rate is less than 50 percent (Column E) for universe cohorts or 

less than 70 percent for representative cohorts, the data system will not return a valid percent in Column H.

OMB Number 1830-0027, Expires 08/31/2014.
Table 5A

Core Follow-up Outcome Achievement for Participants in Distance Education

Core Follow-up 

Outcome Measures

M

e

t

h

o

d

Number of 

Participants 

in Cohort

Number of 

Participants 

Used for 

Representative 

Cohort

Number of 

Participants 

Responding 

to Survey or 

Available for 

Data Matching

Response 

Rate or 

Percent 

Available 

for Match

Number of 

Participants 

Achieving 

Outcome 

(Unweighted)

Number of 

Participants 

Achieving 

Outcome 

(Weighted)

Percent 

Achieving 

Outcome 

(Weighted)

(A) (B) (C) (D) (E) (F) (G) (H)

Entered Employment* U N/A

R

C

Retained 

Employment**

U N/A

R

C

Obtained a Secondary 

School Credential or Its 

Equivalent***

U N/A

R

C

Entered Postsecondary 

Education or Training –

current program 

year 

U N/A

R

C

Entered Postsecondary 

Education or Training –

prior program year** **

U N/A

R

C

U = Universe cohort; programs attempted to collect data for all eligible participants either by survey, data 

match or both

R = Representative cohort; programs attempted to collect data for a representative subset of eligible 

participants

C = Combined universe and representative cohort totals; these numbers will be calculated automatically 

by OCTAE’s data system
Instructions for Completing Table 5A

Include in this table only students who are counted as distance education students.

Follow the same instructions for Completing Table 5 to complete Table 5a, repeated below.

Note: All shaded columns (E, G, and H) and rows for cohort totals will be calculated automatically by 

OCTAE’s data system.

Work-based project learners are not included in this table.

* Report in Column B the number of participants who were unemployed and in the labor force at entry who 

exited during the program year. Do not exclude students because of missing Social Security numbers or 

other missing data. 

** Report in Column B: (1) the number of participants who were unemployed and in the labor force at entry 

who exited during the program year and who entered employment by the end of the first quarter after 

program exit and (2) the number of participants employed at entry who exited during the program year.

*** Report in Column B the number of participants who exited during the program year and (1) took all 

components of a state-recognized examination leading to a secondary credential or its equivalent or (2) 

were enrolled in adult high school at the high ASE level or (3) were enrolled in the assessment phase of the 

EDP.

**** Report in Column B the number of participants who exited during the program year and (1) have 

earned a secondary school credential or its equivalent while enrolled in adult education, or (2) have a 

secondary credential at entry, or (3) are enrolled in a class specifically designed for transitioning to 

community college. Enter the number of these participants who enrolled during the current program year in 

the row labeled current program year. Enter the number of these participants who enrolled during the 

program year immediately prior to the current year in the row labeled prior program year. For Columns B 

through D and Column F, the first row for each follow-up outcome measure should be used to report 

information based on universe cohorts, and the second row should be used to report information based on 

representative cohorts. If no programs used representative cohorts, the “R” rows should be left blank. . If 

no programs used universe cohorts, the “U” row should be left blank.

Column E

ColumnB

ColumnD

 , for programs that used universe cohorts. 

For programs using representative cohorts, Column E

ColumnC

ColumnD

 .

Column H is the number in Column G divided by the number in Column B. Column H should never be 

greater than 100 percent. If the response rate is less than 50 percent (Column E) for universe cohorts or 

less than 70 percent for representative cohorts, the data system will not return a valid percent in Column H.

OMB Number 1830-0027, Expires 08/31/2014.
Table 6

Participant Status and Program Enrollment

Enter the number of participants for each of the categories listed.

Participant Status on Entry into the Program Number

(A) (B)

Disabled

Employed

Unemployed

Not in the Labor Force

On Public Assistance

Living in Rural Area*

Highest Degree or Level of School Completed ***

US Based 

Schooling

Non-US Based 

Schooling

No schooling

Grades 1-5

Grades 6-8

Grades 9-12 (no diploma)

High School Diploma or alternate credential

GED

Some college, no degree

College or professional degree

Unknown

 TOTAL (both US Based and Non-US Based)

Program Type**

In Family Literacy Program

In Workplace Literacy Program

In Program for the Homeless

In Program for Work-based Project Learners

Institutional Programs

In Correctional Facility

In Community Correctional Program
In Other Institutional Setting

Secondary Status Measures (Optional)

Low Income

Displaced Homemaker

Single Parent

Dislocated Worker

Learning Disabled Adult

*Rural areas are places with less than 2,500 inhabitants and located outside urbanized areas.

** Participants counted here must be in a program specifically designed for that purpose.

*** Enter the highest level of schooling or degree attained for each student in US or non-US-based schooling. Provide 

only one entry per student. The total number of students reported here must be the same as the number reported in the 

Total row of Column P, Table 1.

OMB Number 1830-0027, Expires 08/31/2014.
Table 7

Adult Education Personnel by Function and Job Status

Adult Education Personnel

Unpaid Volunteers

Total Number of

Part-time Personnel

Total Number of

Full-time Personnel

(A) (B) (C) (D)

Function*

 State-level Administrative/

 Supervisory/Ancillary Services

 Local-level Administrative/

 Supervisory/Ancillary Services

 Local Counselors

 Local Paraprofessionals

 Local Teachers

Teacher Experience

In Adult Education**

Less than one year

One to three years

More than three years

 Total Teachers Reported

Teacher Post-Secondary 

Education***

 Bachelor’s Degree or Higher

 No Bachelor’s Degree

 Total Teachers Reported

Teacher Certification****

No certification

Adult Education Certification

K-12 Certification

Special Education Certification

TESOL Certification

* Enter an unduplicated count of personnel by function and job status.

In Column B, count one time only each part-time employee of the program administered under the Adult Education State Plan 

who was paid out of Federal, State, and/or local education funds.

In Column C, count one time only each full-time employee of the program administered under the Adult Education State Plan 

who was paid out of Federal, State, and/or local education funds.
In Column D, report the number of volunteers (personnel who are not paid) who served in the program administered under the 

Adult Education State Plan. 

** Report adult education experience for paid teachers only, not volunteers. Report an unduplicated count of teachers. The total

number of teachers for whom experience is reported must equal the sum of the numbers reported in Columns B and C for the 

row labeled “Local Teachers .“

*** In the first row, report an unduplicated count of teachers who have earned a bachelor’s degree or higher. In the second row, 

report an unduplicated count of teachers who have not earned a bachelor’s degree. In both rows, report only paid teachers. The 

sum of the two rows must equal the sum of numbers reported in Columns B and C for the row labeled “Local Teachers.”

**** See definitions of the teacher certification categories that are relevant to report. Report certifications for paid teachers only, 

not volunteers. Report all certifications that a teacher has. A duplicated count, i.e. multiple responses for a single teacher, is

allowed. Report teachers who lack certifications in the “No Certification” category. 

OMB Number 1830-0027, Expires 08/31/2014.
Table 8

Outcomes for Adults in Family Literacy Programs (Optional)

Enter the number of participants in family literacy programs for each of the categories listed.

Core Follow-up 

Outcome Measures

M

e 

t 

h

o

d

Number of 

Participants

in Cohort

Number of 

Participants 

Used for 

Representative 

Cohort

Number of 

Participants 

Responding 

to Survey or 

Available for 

Data Matching

Response 

Rate or 

Percent 

Available 

for Match

Number of 

Participants 

Achieving 

Outcome 

(Unweighted)

Number of 

Participants 

Achieving 

Outcome 

(Weighted)

Percent 

Achieving 

Outcome 

(Weighted)

(A) (B) (C) (D) (E) (F) (G) (H)

Completed Educational 

Functioning Level*

U N/A

Entered Employment U N/A

R

C

Retained Employment U N/A

R

C

Obtained a Secondary 

School Credential or 

Its Equivalent

U N/A

R

C

Entered 

Postsecondary 

Education or Training –

current program year

U N/A

R

C

Entered 

Postsecondary 

Education or Training –

prior program year

U N/A

R

C
Increased Involvement 

in Children’s Education

U N/A

R

C

Helped more 

frequently with school

Increased contact 

with children’s 

teachers

More involved in 

children’s school 

activities

Increased Involvement 

in Children’s Literacy 

Activities

U N/A

R

C

Reading to children

Visiting library

Purchasing books or 

magazines

For reporting completion of Educational Functioning Level:

* Report in Column B for this row all family literacy program participants who received 12 or more hours of service. Column F should 

include all participants reported in Column B who advanced one or more levels. 

Compute Column H for this row using the following formula: 

ColumnB

ColumnF H 

For reporting Follow-up Measures:

Follow instructions for completing Table 5 to report these outcomes. However, include only family literacy program participants in 

Table 8.

Achievement of one or more of the increased involvement in children’s education or children’s literacy activities measures should be 

counted only once per participant. However, the specific outcome should be recorded in the subcategory and more than one outcome 

may be reported, so that the total for the three subcategories may be greater than the total reported for the overall category. For 

example, a participant who helped more frequently with schoolwork and increased contact with child’s teachers would be recorded in 

both categories but would be counted only once in the overall category of “increased involvement in children’s education.”

OMB Number 1830-0027, Expires 08/31/2014.
Table 9

Outcomes for Adults in Workplace Literacy Programs (Optional)

Enter the number of participants in workplace literacy programs for each of the categories listed.

Core Follow-up 

Outcome Measures

M

e 

t 

h

o

d

Number of 

Participants 

in Cohort

Number of 

Participants 

Used for 

Representative 

Cohort

Number of 

Participants 

Responding 

to Survey or 

Available for 

Data Matching

Response 

Rate or 

Percent 

Available 

for Match

Number of 

Participants 

Achieving 

Outcome 

(Unweighted)

Number of 

Participants 

Achieving 

Outcome 

(Weighted)

Percent 

Achieving 

Outcome 

(Weighted)

(A) (B) (C) (D) (E) (F) (G) (H)

Completed an 

Educational 

Functioning Level*

Entered Employment U N/A

R

C

Retained Employment U N/A

R

C

Obtained a Secondary 

School Credential or 

Its Equivalent

U N/A

R

C

Entered 

Postsecondary 

Education or Training –

current program year

U N/A

R

C

Entered 

Postsecondary 

Education or Training –

prior program year

U N/A

R

C
For reporting completion of Educational Functioning Level:

* Report in Column B for this row all workplace literacy program participants who received 12 or more hours of 

service. Column F should include all participants reported in Column B who advanced one or more levels. 

Compute Column G for this row using the following formula: 

ColumnB

ColumnF G 

For reporting Follow-up Measures:

Follow instructions for completing Table 5 to report the outcomes. However, include only workplace literacy program 

participants in Table 9.

OMB Number 1830-0027, Expires 08/31/2014.
Table 10

Outcomes for Adults in Correctional Education Programs

Enter the number of participants in correctional education programs for each of the categories listed.

Core Follow-up 

Outcome Measures

M

e 

t 

h

o

d

Number of 

Participants 

in Cohort

Number of 

Participants 

Used for 

Representative 

Cohort

Number of 

Participants 

Responding 

to Survey or 

Available for 

Data Matching

Response 

Rate or 

Percent 

Available 

for Match

Number of 

Participants 

Achieving 

Outcome 

(Unweighted)

Number of 

Participants 

Achieving 

Outcome 

(Weighted)

Percent 

Achieving 

Outcome 

(Weighted)

(A) (B) (C) (D) (E) (F) (G) (H)

Completed an 

Educational 

Functioning Level*

Entered Employment U N/A

R

C

Retained Employment U N/A

R

C

Obtained a Secondary 

School Credential or 

Its Equivalent

U N/A

R

C

Entered 

Postsecondary 

Education or Training –

current program year

U N/A

R

C

Entered 

Postsecondary 

Education or Training –

prior program year

U N/A

R

C
For reporting completion of Educational Functioning Level:

* Report in Column B for this row all correctional educational program participants who received 12 or more hours of 

service. Column F should include all participants reported in Column B who advanced one or more levels. 

Compute Column G for this row using the following formula: 

ColumnB

ColumnF G 

For reporting Follow-up Measures:

Follow instructions for completing Table 5 to report the outcomes. However, include only correctional educational 

program participants in Table 10.

OMB Number 1830-0027, Expires 08/31/2014.
Table 11

Secondary Outcome Measures (Optional)

Enter the number of participants for each of the categories listed. 

Secondary Outcome Measures*

Number of 

Participants

Number of 

Participants 

Obtaining 

Outcome

Percentage 

Achieving 

Outcome

(A) (B) (C) (D)

Achieved Work-Based Project Learning Goal

Left Public Assistance

Achieved Citizenship Skills

Increased Involvement in Children’s Education**

Increased Involvement in Children’s Literacy 

Activities*

Voted or Registered to Vote

Increased Involvement in Community Activities

Each row total In Column D is calculated using the following formula: 

ColumnB

ColumnC D 

* See definitions of secondary outcome measures.

** Enter the total number of participants who achieved this outcome regardless of whether the participant was in a family literacy 

program. Use Table 8 to enter achievements of family literacy participants. The number reported here may be higher than 

reported in Table 8 because it includes all participants who achieved this goal.

OMB Number 1830-0027, Expires 08/31/2014.
Table 12 (Optional) 

Work-based Project Learners by Age, Ethnicity, and Sex

Enter the number of work-based project learners by age,* ethnicity, and sex.

Age Group

American Indian 

or Alaska Native Asian

Black or 

AfricanAmericanHispanic/ 

Latino

Native 

Hawaiian or 

Other Pacific 

Islander White

Two or more 

races Total

Male Female Male Female Male Female Male Female Male Female Male Female Male Female

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) (L) (M) (N) (O) (P)

16–18

19–24

25–44

45–59

60 and Older

Total

Only participants designated as work-based project learners should be included in this table. These participants should not be included in Tables 1–5.

The number in the Total row of Column P should equal the number of work-based project learners reported in Table 6.

*Participants should be classified based on their age at entry.

OMB Number 1830-0027, Expires 08/31/2014.
Table 14 

Local Grantees by Funding Source

Enter the number of each type of grantee (see attached definitions) directly funded by the state and the 

amount of federal and state funding they receive.

Provider Agency

(A)

Total 

Number of 

Providers

(B)

Total 

Number of 

SubRecipients

(C)

WIA Funding State Funding

Total

(D)

% of Total

(E)

Total

(F)

% of Total

(G)

Local Education Agencies

Public or Private Nonprofit Agency

Community-based Organizations

Faith-based Organizations

Libraries

Institutions of Higher Education

Community, Junior or Technical 

Colleges

Four-year Colleges or Universities

Other Institutions of Higher 

Education

Other Agencies

Correctional Institutions

Other Institutions (non-correctional)

All Other Agencies

Total

1. In Column (B), report the number of providers receiving a grant award or contract for instructional services from the eligible 

agency. 

2. In Column (C), report the total number of each entity receiving funds as a sub-recipient of providers in column B. (Entities 

receiving funds from a grantee as part of a consortium are reported in column (C).) 

3. In Column (E), the percentage for each row is to be calculated using the following formula: Column D

 ------------------------- = Col (E)

Total WIA Funding

4. In Column (F), report total amount of state funds contributed. This amount need not necessarily equal the non-federal 

expenditure reported in the Federal Financial Report. 

5. In Column (G), the percentage for each row is to be calculated using the following formula: Column F

----------------------- = Col (G) 

Total State Funding

OMB Number 1830-0027, Expires 08/31/2014.
Grantee Definitions for Table 14

Local Education Agencies are publicly funded entities designated to administer and provide primary and secondary 

education instruction and services within a city, county, school district, township or region. 

Community-based Organizations (CBOs) are private nonprofit organizations of demonstrated effectiveness that 

are representative of a community or significant segment of a community.

Faith-based Organizations (FBO) are non-profit organizations associated with a faith community or multiple faith 

ministries.

Libraries are public state and community funded institutions that offer education and community services in addition 

to providing access to print, audio-visual and technology resources.

Community, Junior or Technical Colleges are public institutions of higher education that offer associate’s degree 

and certificate programs but, with few exceptions, award no baccalaureate degrees. 

Four Year Colleges or Universities are a public or private non-profit institutions of higher education that primarily 

offers baccalaureate degree programs.

Other Institutions of Higher Education include public or private non-profit institutions that are not community, 

junior, or technical colleges or four-year colleges or universities.

Correctional Institutions refer to state or federal penal institutions for criminal offenders. These include prisons, 

jails, and other correctional detention centers.

Other Institutions (Non-Correctional) are any medical or special institutions not designed for criminal offenders.

All Other Agencies include other public (federal, state, local) agencies not listed in the categories above.
Instructions

Narrative Report

These instructions provide descriptive information for the narrative items in the report.

The maximum number of pages is 10.

Use the following outline in preparing the narrative part of the Annual Performance Report:

1. Describe successful activities, programs, and projects supported with State Leadership funds 

and describe the extent to which these activities, programs, and projects were successful in 

implementing the goals of the State Plan.

2. Describe any significant findings from the Eligible Agency's evaluation of the effectiveness 

of the adult education and literacy activities based on the core indicators of performance. 

3. Describe how the Eligible Agency has supported the integration of activities sponsored 

under Title II with other adult education, career development, and employment and training 

activities. Include a description of how the eligible agency is being represented on the Local 

Workforce Investment Boards, adult education’s involvement on the State Workforce 

Investment Board, the provision of core and other services through the One-Stop system and 

an estimate of the Title II funds being used to support activities and services through the 

One-Stop delivery system. 

4. Describe successful activities and services supported with EL Civics funds, including the 

number of programs receiving EL Civics grants and an estimate of the number of adult 

learners served. (Only states receiving EL-Civics funds should respond to question #4). 
INSTRUCTIONS

Federal Financial Report

OMB Number 1830-0027

U.S. Department of Education

Office of Career, Technical, and Adult Education

Adult Education and Family Literacy Act of 1998

Basic Grants to States—CFDA 084.002

A separate Federal Financial Report (FFR) is to be submitted for each Grant Period

reported in Block 8 of this form.

FFR 

Box 

Number 

Reporting Item Instructions 

1 

Federal Agency and 

Organizational 

Element to Which 

Report is Submitted 

This block is preprinted.

2 

Federal Grant or Other 

Identifying Number 

Assigned by Federal 

Agency

Enter the PR/Award number as indicated in Block 2 of the 

Grant Award Notification. 

3 Recipient Organization Enter the name and complete address of the recipient 

organization including zip code. 

4a DUNS Number 

Enter the recipient organization’s Data Universal Numbering 

System (DUNS) number or Central Contract Registry

extended DUNS number. 

4b EIN Enter the recipient organization’s Employer Identification 

Number (EIN). 

5 

Recipient Account 

Number or Identifying 

Number 

Enter the account number or any other identifying number 

assigned by the recipient to the award. This number is for the 

recipient’s use only and is not required by the Federal 

agency.

6 Report Type Indicate whether this FFR is an initial or final report.

7 Basis of Accounting 

(Cash/Accrual) 

Specify whether a cash or accrual basis was used for 

recording transactions related to the award and for preparing 

this FFR. Accrual basis of accounting refers to the 

accounting method in which expenses are recorded when 

incurred. For cash basis accounting, expenses are recorded 

when they are paid. 

8 Project/Grant Period Enter the Budget Period described in Block 6 of the Grant 

Award Notification.
9 Reporting Period: 

(Month, Day, Year) 

Enter the beginning and ending dates of the period in which 

you are reporting the financial activity of the grant. A first 

year report will cover the first 15 months of the grant period 

e.g., July 1, 2013 through September 30, 2014. The final 

report will cover the entire 27 months that grantees have to 

obligate their funds, e.g., July 1, 2012 through September 30, 

2014.

10 Transactions: In 10a through 10n, enter cumulative amounts from the beginning to 

the end dates of the reporting period specified in line 9.

10a Cash Receipts Enter the cumulative amount of actual cash received from the 

Federal agency during the reporting period. 

10b Cash Disbursements 

Enter the cumulative amount of Federal fund disbursements 

(such as cash or checks) during the reporting period. 

Disbursements are the sum of actual cash disbursements for 

direct charges for goods and services, the amount of indirect 

expenses charged to the award, and the amount of cash 

advances and payments made to subrecipients and 

contractors.

10c Cash On Hand (line a 

minus line b)

Enter the amount of Line 10a minus Line 10b. This amount 

represents immediate cash needs. If more than three business 

days of cash are on hand, the Federal agency may require an 

explanation on Line 12, Remarks, explaining why the 

drawdown was made prematurely or other reasons for the 

excess cash.

10d Total Federal Funds 

Authorized 

Enter the total Federal funds authorized during the reporting 

period. 

10e Federal Share of 

Expenditures 

Enter the amount of Federal fund expenditures during the 

reporting period. For reports prepared on a cash basis, 

expenditures are the sum of cash disbursements for direct 

charges for property and services; the amount of indirect 

expense charged; and the amount of cash advance payments 

and payments made to subrecipients. For reports prepared on 

an accrual basis, expenditures are the sum of cash 

disbursements for direct charges for property and services; 

the amount of indirect expense incurred; and the net increase 

or decrease in the amounts owed by the recipient for (1) 

goods and other property received; (2) services performed by 

employees, contractors, subrecipients, and other payees; and 

(3) programs for which no current services or performance 

are required.
10f 

Federal Share of 

Unliquidated 

Obligations 

Enter the Federal portion of unliquidated obligations during 

the reporting period. Unliquidated obligations on a cash 

basis are obligations incurred, but not yet paid. On an accrual 

basis, they are obligations incurred, but for which an 

expenditure has not yet been recorded. Those obligations 

include direct and indirect expenses incurred but not yet paid 

or charged to the award, including amounts due to 

subrecipients and contractors. On the final report, this line 

should be zero unless the awarding agency has provided 

other instructions. Do not include any amount in Line 10f 

that has been reported in Line 10e. Do not include any 

amount in Line 10f for a future commitment of funds (such as 

a long-term contract) for which an obligation or expense has 

not been incurred. 

10g 

Total Federal Share 

(sum of line e and line 

f) 

Enter the sum of line 10e and line10f. 

10h 

Unobligated Balance 

of Federal Funds (line

d minus line g) 

Enter the amount of line 10d minus line 10g. 

10i Total Recipient Share 

Required

Enter the total required recipient share (i.e. the greater of 

required match or maintenance of effort) for reporting period 

specified in line 9. The required recipient share should 

include all matching and cost sharing provided by recipients 

and third-party providers to meet the level required by the 

Federal agency.

10j Recipient Share of 

Expenditures 

Enter the recipient share of actual cash disbursements or 

outlays (less any rebates, refunds, or other credits) including 

payments to subrecipients and contractors. This amount may

include the value of allowable third party in-kind 

contributions. Note: On the final report this line should be 

equal to or greater than the amount of Line 10i. 

10k 

Remaining Recipient 

Share to be Provided 

(line i minus line j) 

Enter the amount of line10i minus line 10j. If recipient share 

in line 10j is greater than the required match amount in line 

10i, enter zero. 

10l Total Program Income 

Earned Enter the amount of program income earned. 

10m Program Income 

Expended 

Enter the amount of program income that was added to funds 

committed to the total project costs and expended to further 

eligible project or program activities. 

10n 

Unexpended Program 

Income (line l minus 

line m) 

Enter the amount of line 10l minus line 10m. This amount 

equals the program income that has been earned but not 

expended as of the reporting period end date. 

11 Indirect Expense: In 11a through 11g, enter cumulative amounts from the 

beginning through the end date of the reporting period. 
11a Type of Rate Indicate whether indirect cost rate is Restricted Provisional or 

Restricted Final. 

11b Rate Enter the indirect cost rate in effect during the reporting period. 

11c Period From; Period To Enter the beginning and ending effective dates for the rate. 

11d Base Enter the amount of the base against which the rate was applied. 

11e Amount Charged Enter the amount of indirect costs charged during the time 

period specified. (Multiply 11b. x 11d.) 

11f Federal Share Enter the Federal share of the amount in 11e. 

11g Totals Enter the totals for columns 11d, 11e, and 11f. 

12 Remarks Enter any explanations or additional information required by 

the Federal sponsoring agency including excess cash as stated 

in line 10c. 

13a Typed or Printed Name 

and Title of Authorized 

Certifying Official 

Enter the name and title of the authorized certifying official. 

13b Signature of Authorized 

Certifying Official 

The authorized certifying official must sign here. 

13c Telephone (Area Code, 

number and extension) 

Enter the telephone number (including area code and extension) 

of the individual listed in line 13a. 

13d E-mail Address Enter the e-mail address of the individual listed in line 13a. 

13e Date Report Submitted 

(Month, Day, Year) 

Enter the date the FFR is submitted to the U.S. Department of 

Education using the month, day, year format. 

14 Agency Use Only This section is reserved for U.S. Department of Education use.

Federal Financial Reports are due on December 31 of each year. Reports must be submitted 

electronically via the online NRS reporting system. 
FEDERAL FINANCIAL REPORT

TOTAL ALLOCATION

1. Federal Agency and Organizational Element to Which

Report is Submitted

U.S. Department of Education

Division of Adult Education and Literacy

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

OMB Approval Number: 1830-0027

Expiration Date: 8/31/2014

3. Recipient Organization (Name and complete address including Zip code) 4a. DUNS Number 4b. EIN 5. Recipient Account Number or Identifying Number 6. Report Type

Initial

Final

7. Basis of Accounting

Cash

Accrual

8. Project/Grant Period (Month, Day, Year) 9. Reporting Period (Month, Day, Year)

From: To: From: To:

10. Transactions (a) State Administration (b) State Leadership ( c) Programs of Instruction

(0-8)

(d) Programs of Instruction

(9-12)

(e) Institutionalized Persons (f) Total

Federal Cash:

a. Cash Receipts

b. Cash Disbursements

c. Cash on Hand (line a minus line b)

Federal Expenditures and Unobligated Balance:

d. Total Federal funds authorized

e. Federal share of expenditures

f. Federal share of unliquidated obligations

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

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

Recipient Share:

i. Total recipient share required (i.e. Maintenance of Effort)

j. Recipient share of expenditures

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

Program Income:

l. Total program income earned

m. Program income expended

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

11. 

Indirect 

Expense

a. Type

Restricted Provisional

Restricted Final

b. Rate c. Period From Period To d. Base e. Amount Charged f. Federal Share

g. Totals:

12. Remarks: Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation:

13. Certification: By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and intent set forth in the award documents. I am 

aware that any false, fictitious, or fraudulent information may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001)

a. Typed or Printed Name and Title of Authorized Certifying Official c. Telephone (Area code, number, and extension)

d. Email Address

b. Signature of Authorized Certifying Official e. Date Report Submitted (Month, Day, Year)

14. Agency use only:
Financial Reporting Requirements for EL-Civics Funding

States expending EL-Civics funds under the conditions outlined in Program Memorandum 2000–19, 

issued by Ronald S. Pugsley on May 16, 2000, shall report those expenditures as follows:

In addition to submitting an annual FFR that reports all Federal and non-Federal expenditures, 

including those for EL-Civics, states must submit, on an annual basis, a separate FFR for EL-Civics 

expenditures. This EL-Civics FFR, which represents a subset of the overall FFR report, will provide 

the necessary information to determine whether EL-Civics expenditures are in compliance with 

existing statutory requirements. 
FEDERAL FINANCIAL REPORT

EL / Civics

1. Federal Agency and Organizational Element to Which

Report is Submitted

U.S. Department of Education

Division of Adult Education and Literacy

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

OMB Approval Number: 1830-0027

Expiration Date: 8/31/2014

3. Recipient Organization (Name and complete address including Zip code) 4a. DUNS Number 4b. EIN 5. Recipient Account Number or Identifying Number 6. Report Type

Initial

Final

7. Basis of Accounting

Cash

Accrual

8. Project/Grant Period (Month, Day, Year) 9. Reporting Period (Month, Day, Year)

From: To: From: To:

10. Transactions (a) State Administration (b) State Leadership ( c) Programs of Instruction

(0-8)

(d) Programs of Instruction

(9-12)

(e) Institutionalized Persons (f) Total

Federal Cash:

a. Cash Receipts

b. Cash Disbursements

c. Cash on Hand (line a minus line b)

Federal Expenditures and Unobligated Balance:

d. Total Federal funds authorized

e. Federal share of expenditures

f. Federal share of unliquidated obligations

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

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

Recipient Share:

i. Total recipient share required (i.e. Maintenance of Effort)

j. Recipient share of expenditures

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

Program Income:

l. Total program income earned

m. Program income expended

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

11. 

Indirect 

Expense

a. Type

Restricted Provisional

Restricted Final

b. Rate c. Period From Period To d. Base e. Amount Charged f. Federal Share

g. Totals:

12. Remarks: Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation:

13. Certification: By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and intent set forth in the award documents. I am 

aware that any false, fictitious, or fraudulent information may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001)

a. Typed or Printed Name and Title of Authorized Certifying Official c. Telephone (Area code, number, and extension)

d. Email Address

b. Signature of Authorized Certifying Official e. Date Report Submitted (Month, Day, Year)

14. Agency use only: