Page 1 of 4 INSTRUCTIONS FOR COMPL ETION OF THE FINANCIAL REPORT FOR TITLE III PART A, TI TL E III PART B AND TITLE V PROGRAMS ENDOWMENT ACTIVITY AND TITLE III PART C ENDOWMENT CHALLENGE GRANT PROGRAM Please use the following link to access the Financial Report for Titl e III Part A, Title III Part B and Title V Program Endowment Activities and Title III Part C Endowment Challenge Grant Program: https://opeweb.ed.gov/endow Please use this electronic form to enter your insti tution’s financial data. Itis highly recommended that a hard copy be utilized for draft purposes, prior to entering the data into the sy stem. A hard copy has been provided to you along with the PI N number to access the electronic reporting form. A hard copy may also be printed from the Web. In ad dition, you may

utilize your PIN to save your submission and access it at a later time. **However, once the reporting form is submitted electronically, it will NOT be accessible for any modifications.**  All submissi ons will be time and date stamped. Please pay careful attention to the last section regarding the certification requirement. The certification requirement states that all signature pages must be faxed to the number provided. Your financial report will NOT be considered complete without this certification form. Please enter the name, address, cit y, state, and zip code of your institution. Also, enter the name, telephone number, fax number, and email address of the “contact person” for the grant program at your institution. The contact person is responsible for the administration and management of your institution’s Title III Part A, Title III Part B and Title V Program Endowment activities and Title III Part C Endowment Challenge Grant Program. Please fo llow the se instruction : **PR Award Number Title III Part C only**  : Enter the Grant Number (GOO _ _ _ _ _ _ _). Grants awarded since 1987 have onl y a Project Award (PR/Award) Number. **Title III Part A, Title III Part B and Title V Program Endowment Activit y only**  **:** Enter the Project Award Number ( P031 _ _ _ _ _ _

_) **Endowment Fund Corpus**
**- The “Endowment Fund Corpus” is the Federal grant**  **amount plus the institution’s matching amount.** Title III Part C only **:** Enter the amount of the original Endowment Fund C orpus. Title III Part A & B and Title V Program Endowment Activity only **:** This amount may change from year to year if you elected to use federal funds for endowment building more than one ye ar of yo ur five ye ar grant period and added to the original corpu s ratherPage 2 of 4

than creating a different account for each drawdown. For example, if in year one you raised and matched $50,000 of Federal funds, and you invested $100,000 to form the endowment corpus, then in year two you elected to raise and match $25,000 of F ederal funds for a total of $50,000 and decided to add this $50,000 to the original $100,000, yo ur corpus then changes from $100,000 to $150,000. However, if y ou have chosen to develop a separate endowment corpus for each year, you will report on each ind ividual investment. **Report Number** Enter the report number for which this financial report is being submitted. (For example, the first financial report you submit would be Report Number 1 of 20. The last report yo u submit would be No. 20 of 20.) **Investm ent Distribution**  Enter the t ype of savings account or securit y, the amount invested, and the financial institution(s) managing your Endowment Fund Corpus (Section 628.43 of the program regulations).
AFTER THE FIRST YEAR, THE AMOUNT OF MONEY REPORTED TO BE IN VESTED SHOULD BE THE ‘CORPUS’ PLUS ALL THE UNSPENT OR UNUSED ENDOWMENT FUND INCOME. THI S FIGURE SHOULD BE THE AMOUNT AT THE BEGINNING OF THE INVESTMENT PERIOD. THIS INVESTMENT PERI OD IS FOR THE 12

- MONTH PERI OD BEG INNIN G OCTOBER 1 ST AND ENDING SEPTEM BER 30 TH

. Examples of investment entities include but are not limited t o : (A) A federall y insured bank savings account; (B) A comparable interest bearing account; (C) Money

Market fund; (D) Certificates of Deposit; (E) Mutual funds; (F) Stocks (G) Bonds; and (H) Other (If not listed in A through G above, please enter the ty pe of investment account.) (I)
**Income Earned** Enter the amount of the Endowment Fund Income earned onl y for the 12

- month period covered b y this financial report.Page 3 of 4

Enter the cumulative (aggregate) amount of the Endo wment Fund Income earned since the initial investment of your endowment fund corpus.

**Income Used** In the appropriate spaces, enter the amount for the reporting year and aggregate amounts of the Endowment fund income which you expended for an y of the fo llowing categories: a) Operations and maintenance

– Includes expenditures established to provide services and maintenance related to campus grounds and facilities, including utilities, propert y insurance, fire protection, janitorial services, and similar ite ms. b) Administration

– In cludes expenditures for activities carried out to provide for the day

- to

- day

functioning as well as the long

- range viability of the institution as an operating organization. This also includes costs for general executive and admini strative offices and other expenses of a general character which do not relate solely to (l) instruction, (2) organized research, or (3) other institutional activities. c) Academic and support personnel

– Includes expenditures for all faculty and academic administrators. d) Construction and renovation

– In cludes expenditures for renewal and replacement of the campus grounds and facilities. e) Community

and student services programs and technical assistance

– Includes expenditures for activities that primarily pr ovide services beneficial to groups outside the institution. Included in this category are conferences, institutes, programs, advertising, consulting, and similar services to particular sectors of the community . Also included are expenditures for counsel ors, career guidance and placement personnel as well as expenditures connected with auxiliary programs, student aid administration, student activities, cultural events, student newspaper, intramural athletics, student organizations, student aid administrat ion and student health services. Further included are expenditures for activities of specific professional or technical groups such as conferences, workshops, or meetings where specific and practical advice is given to a group of lawyers, doctors, busines s executives, etc. f) Other

– Includes expenditures for education

- related activities not included in the categories above. Indicate in the space provided the nature of the expenditure.Page 4 of 4

**Certification** This financial report must be signed b y the President or Chief Executive Officer of the institution certifying that all information is correct to the best of his/her knowledge. After completing the signature page, please fax it to the attention of your program contact at fax number : (202) 502

- 7861.

**IMPORTANT NOTE If your institution has been awarded more than one Endowment grant, report each**  **separately by submitting individual**  **financial reports with the respective project award and/or grant numbers.**  FORM APPROVED OMB No. 1840

- 0564 Expiration Date: **Paperwork Burden Statement** According to the Paperwork Reduction Act of 1995, no persons are required to respond t o a collection of information unless such collection display s a valid OMB control number. The valid OMB control number for this information collection is 1840

- 0564. The time required to complete this information collection is estimated to average 3 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. **If you have any comments concerning the accuracy of the time estimate(s) or suggestions**  **for improving this form, please write to** : U.S. Department of Education, Washington, D.C. 20202

- 4651. **If you have comments or concerns regarding the status of your individual submission of this form, write directly to:**  U.S. Department of Education, Offic e of Postsecondary Education, Institutional Development and Undergraduate Education Service

. Attention: Karen W. Johnson, 1 990 K Street, NW, 6 th Floor, Washington, D.C. 20006.