OMB Control Number 3045-0102

Expiration: 05/31/2021

**Applicant Operational and Financial Management Survey**

This survey is intended to collect information about the capacity of applicants to manage federal grant funds.  Per 2 CFR §200.205, the Corporation for National and Community Service must evaluate the degree of risk posed by an applicant. Information from the survey will be used to assess an organization’s operational and financial management capabilities prior to receiving a federal award. 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 preparing this form are those responsible for, and with sufficient knowledge of, the organization’s operational and financial management functions.  The information provided may be used to support future monitoring activities, should the applicant receive federal funds from CNCS. In completing this form, each question requires a response. Please include the completed form within the application materials that are submitted to the Corporation for National and Community Service.  The form must be submitted as a Word document, do not save as a PDF. Refer to the applicable Notice of Funding Opportunity for instructions on how to submit all application materials.

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, Office of Grants Management, 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)).

NOTE: An organization must complete a separate Operational and Financial Management Survey form for each application it submits under the applicable Notice of Funding Opportunity. The form(s) must be submitted as a Word document, do not save as a PDF.

**This form must be saved and submitted as a Word document, do not save as a PDF.**

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 grantee may need to develop or enhance appropriate systems.  Completion of this survey is required as an element of CNCS’ pre-award 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.