Financial Management Survey

OMB Control Number: 3045-0102 Expiration Date: May 31, 2021 

This survey is intended to collect information about the capacity of organizations to manage federal grant funds. 

Information from the survey will be used to assess an organization’s structure and capacity-building needs and 

identify any appropriate technical assistance and/or resources to strengthen operations. Completion of this survey is 

required, but is independent from the competitive grant process. Responding organizations are advised to ensure that 

the person or persons completing this form are those responsible for, and with sufficient knowledge of, the 

organization’s financial management functions.

Organization Name:

EIN: DUNS Number: 

Throughout this survey, documents are identified and copies requested. Provide copies of the most recent versions of 

all referenced and requested documents. Check boxes to indicate which documents are attached. If you do not provide 

a document, please explain why it is not being provided. If necessary, attach additional sheets in order to provide full 

responses to all questions. 

I. Documents, Policies and Procedures

A. Public Disclosure Documents 

 IRS Determination letter, and any amendments, reflecting approval or denial of tax-exempt status 

Internal Revenue Service Form 990 “Return of Organization Exempt from Income Tax” including all applicable 

 schedules and attachments; if Form 990 filing can be downloaded, provide the website address: 

____________________________________________________________________________________ 

Audited financial statements including auditor's Management Letter (single audit, or other audits if not subject to 

federal audit requirements). 

List of federal grants, cooperative agreements, contracts, and subgrants/sub-contracts awarded to the organization 

in the last two years including the identifying award numbers, amounts and awarding agencies. 

B. Governance 

Articles of Incorporation and By-Laws 

Organizational Chart identifying: (a) key staff by name and title; (b) all budget and accounting office staff; (c) any 

staff with responsibility to approve, record or reconcile financial records of any type; (c) identify all individuals 

permitted to approve payroll; (b) all staff positions listed on the grant budget submitted to CNCS; and (d) all 

governing boards or councils, with membership names and titles listed. 

Public reporting burden -- Estimated time to complete this form, including time for reviewing instructions and 

gathering and providing the information needed to complete the form is 2 hours. Send comments regarding this burden 

or the content of this form to: Corporation for National and Community Service, Chief Grants Officer, OGM, 250 E 

Street, SW, Washington, DC 20525. CNCS informs the potential persons who are to respond to this collection of 

information that such persons are not required to respond to the collection of information unless it displays a currently 

valid OMB control number on this page of the form (see 5 CFR 1320.5(b)(2)(1)) 
C. Organizational Policies and Procedures

The list of policies below is designed to identify some of the most critical policies for administration of a federal grant. If 

you are a first time recipient of federal funds, your organization may not yet have these and other appropriate policies in 

place. As a recipient of federal funds, you are required to have a full complement of financial, programmatic, and 

administrative polices, as well as internal controls in place, as applicable. 

Please indicate whether the organization has written policies and procedures in the following areas. If yes, attach 

the document and report the date it was implemented or most recently updated.

Provided Item As of Date 

 Yes No Table of Contents for Personnel/Employee Handbook/Manual _____________ 

 Yes No Table of Contents for Financial/Internal Controls Policy Manual _____________ 

 Yes No Sub-award monitoring and oversight policy _____________ 

 Yes No Timekeeping Guide or Policy _____________ 

 Yes No Travel Guide or Policy, including purchase/travel credit card use _____________ 

 Yes No Procurement Guide or Policy _____________ 

 Yes No Standards for Use of Federal Funds Policy _____________ 

 Yes No Code(s) of Conduct/Ethics applicable to employment/purchasing _____________ 

 Yes No Document Retention Policy _____________ 

II. General Information

1. What year was the organization established? _________________________________

2. When did the organization receive its first federal grant (enter year of award or “none” if this CNCS grant 

is first federal grant awarded)? _________. When did the organization receive its first federal contract 

(enter year of award, or “none” if no federal contracts ever awarded)? _________. 

3. How many employees work for the organization (in full-time equivalents)? 

 Fewer than 10 10-49 50-99 

 100-249 250-500 > 500 

4. What was the organization’s total budget for the last completed fiscal year?

 $0 - $499,000 $500,000 - $999,999 $1 M - $4,999,999 

 $5 M - $9,999,999 $10 M - $24,999,999 $25 M or more 

5. What percentage of the total budget for the last completed fiscal year came from federal and state grants 

and contracts? 

 0 – 10% 11 – 20% 21 – 30% 

 31 – 40% 41 – 50% 51 - 60% 

 61 – 70% 71 – 80% 81% or more 
III. Financial Management

6. Identify the type of accounting system (cash or accrual): ______________________________ 

7. Indicate whether the Board has the following committees, and whether they are permanent or ad-hoc. 

 Executive Committee Permanent Ad-Hoc 

 Finance Committee Permanent Ad-Hoc 

 Audit Committee Permanent Ad-Hoc 

 Other – List Below: 

 ________________________ Permanent Ad-Hoc 

 ________________________ Permanent Ad-Hoc 

8. Do any paid employees serve as voting members of the Board of Directors, Tribal Council, or other 

governing body? 

 Yes No

9. Identify key financial staff and incumbents’ education/experience. Provide position descriptions (PD), 

indicating Yes (attached) or No (does not exist); if a PD does not exist explain why. If financial 

management services are contracted, enter “outsourced” and describe the outsourced services; provide 

copy of contract and the vendor qualification requirements. 

Position 

Total Years Experience Position Education Description 

Performing Similar Duties 

Attached? 

10a. Chief Financial Officer or equivalent _____________________ ________________ _________ 

10b. Bookkeeper / Accountant or equivalent _____________________ ________________ _________ 

10c. Other key financial staff positions, list below: 

____________________________ _____________________ ________________ _________ 

____________________________ _____________________ ________________ _________ 

10. Who is responsible for approving / accepting the annual independent audit? (Check all that apply) 

 Audit Committee Board Chair Board of Directors Chief Executive 

 Chief Financial Officer Finance Committee Other (Specify): 

11. Financial reports prepared for executive staff: Identify by frequency and type(s):

Is Report Compared Frequency Report Type to Projections? 

Annual 

Yes Quarterly 

__________________________________________________ No Monthly 

Weekly 

Annual 

Yes Quarterly 

__________________________________________________ No Monthly 

Weekly 

Annual 

Yes Quarterly 

__________________________________________________ No Monthly 

Weekly 
12. Identify who approves the organization’s operating budget and fundraising plan; e.g., Board of Directors. 

Enter “None” if no approval process. Enter “N/A” if no operating budget or fundraising plan.

Annual Operating Budget Approved By: __________________________________________________ 

Fundraising Plan Approved By: _________________________________________________________ 

IV. Financial Controls

13. Identify the accounting system name and software including version: ______________________________

14. Does the organization maintain a chart of accounts? 

 Yes No

If yes, attach copy of chart of accounts.

15. Does the organization perform job cost center accounting? Yes No

(A job cost accounting system allows you to record budgets, revenues and expenses by cost centers, jobs, grants, 

and activities) 

16. How often do you post transactions to the accounting system ledger(s)? 

 Daily Weekly Monthly Annually Other: _______________ 

17. Are at least two original signatures required on checks greater than dollar threshold (determined by the 

organization) from any bank account(s) that are used for the receipt and/or disbursement of funds, 

including from federal sources?

 Yes No 

If yes, what is the dollar threshold? ____________________________________ 

18. Does the organization use an automated payroll system? Yes No

If yes, identify system and provider name: _________________________________ 

19. Does the organization follow a review and approval Yes No procedure when disbursing payroll? 

20. Is Board approval required for any of the following financial transactions? 

Opening / Closing Bank Accounts Yes No Buying / Selling Property Yes No

Opening Lines of Credit Yes No Financial Investment / Divestment Yes No

Assigning Credit Cards Yes No Other specify: ________________________________ 

21. Has the organization issued loans to an employee or officer of the organization Yes No or forgiven / written-off any loan or debts in the last year? 

22. Who is authorized to write-off any debt owed the organization as a bad debt? 

 Accountant Chief Financial Officer CEO/Executive Director Board Committee 

 Board Chair Other, specify: ______________________________________________________ 

23. How often does the organization experience cash flow deficits? 

 Weekly Monthly Quarterly Annually None in last 2 years 
V. Organizational Policies and Procedures 

24. How are the organization’s policies and procedures shared with employees? (Check all that apply)

 e-mail Memorandum Employee Handbook Management Informs 

 Orientation and training Intranet Staff meeting Other: ____________ 

 There is no existing procedure 

25. When training has been provided to staff on the following topics?

Subject Area Within 1 year Within 2 Within 3 > 3 years ago Never 

 Financial/Accounting 

 Federal Grant Management 

 Personnel/HR Issues 

 Risk Management 

 Cybersecurity 

 Fraud, Waste, Abuse 

 Audit Related 

26. What would increase the financial capacity and expertise of the organization? (Check all that apply)

Financial Professional Additional Staff Computerized Accounting System Training Certifications 

 Other, specify:______________________________________________________________ 

27. What training and technical assistance do you believe would benefit your organization and enhance its 

ability to administer federal grant awards? (Check all that apply)

 Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (12/26/2013) 

 CNCS Regulations 

 Programmatic performance metrics and management 

 Budget development and execution 

 Federal cash management 

 Documenting in-kind and matching contributions 

 Avoiding common audit findings 

 Other: ______________________________________________________________________________________ 

 Other: ______________________________________________________________________________________ 

years years
Preparer’s Comments/Explanations: Please present any clarifications or similar remarks/information here: 

The total number of attachments is ______. Please number attachments in sequence. 

 

Preparer Certification 

By my signature below, I certify that the above information is complete and correct to the best of my knowledge and 

ability. 

____________________________________________ _____________________

 Signature of Preparer Date 

 

Printed Name and Title of Preparer 

____________________________________ 

Telephone Email 

On the lines below, identify anyone else involved in the preparation of this survey by name and position title. 

 

Privacy Statement -- In compliance with the Privacy Act of 1974, the following information is provided: The collection of this 

information is authorized by the provisions of the National and Community Service Act of 1990, by the National and Community Service Trust 

Act of 1993, and the Serve America Act of 2009. The primary purpose of the information is to determine if appropriate systems are in place to 

manage federal grant funds or, if not, to identify training and technical assistance a new grantee may need to develop and implement appropriate 

systems. CNCS requires new grantees which have never before received CNCS funds to complete the form. Completion of this survey is 

required as an element of CNCS’ risk assessment process. The information provided will be maintained and treated confidentially. However, 

appropriate federal, state, and local law enforcement entities may request and obtain this information under certain circumstances. Otherwise, 

the information provided will not be disclosed without express written permission. 

CNCS Receipt Record: 

Date Received: ____________ CNCS Staff Print Name and Signature: 

_______________________________________________