OMB No. 2025-0006

Expires xx/xx/xxxx 

EPA Form 5300-26 1

U.S. ENVIRONMENTAL PROTECTION AGENCY

Exchange Network Grant Program Progress Reporting Form

for Use by Recipients of Assistance Agreements

Please Check:

□ Semi-annual report

□ Final Report

Instructions: This form is for Exchange Network Grant recipients to report their progress. Recipients should send these 

to their regional grant project officer for spring reports by April 30 for the period October 1-March 31. Fall reports are 

due to the regional project officer by October 31 for the period April 1-September 30.

Recipient Information: 

 

 Agency Name:

EPA Grant Number – Program Code, Number, and Amendment Number (e.g., OS –

12345678 – 0):

For grants awarded before 2006 Exchange Network Grant Category (i.e., One Stop, 

Readiness, Implementation, or Challenge): 

Project Manager: 

 

 Name: 

 

 Phone:

 

 Email:

Funding Year: 

Award Amount:

Expenditures during this reporting period:

Funds Remaining:

Reporting Period (starting and ending 

dates, mm/dd/yyyy): 

Date Report Submitted (mm/dd/yyyy): 

EPA Project Officer to Whom Report is Submitted: 

 

 Name: 

 

 EPA Region/Program:

Focus:
EPA Form 5300-26 2

Progress Report Instructions:

1. List major goals and each goal’s outputs as described in the work plan. 

2. In the “Scheduled Date” column enter the dates from the grant work plan

3. In the “Completion Date” column enter the date each output completed as of the period covered by this report

4. In the Outcomes column, briefly outline how the goal or output will enhance the recipient’s ability to carry out its mission or result in other benefits. 

5. Use bold type for the outputs or outcomes you achieved during the current reporting period. 

6. Insert more rows if you need them by using the tab key in the last cell of the last row. 

EXAMPLE

Goals Outputs Scheduled 

Date

Completion 

date

List Outcomes for Each Goal, and, if they differ, 

each Output 

1. Begin flowing ambient air quality 

data through the Exchange Network.

1. Develop XML schema by. . mm/yyyy mm/yyyy Enhanced environmental decision-making due to 

more timely access to ambient air quality data.

2. Initiate first test data flow 

by mm/yyyy

mm/yyyy

Goals Outputs Scheduled 

Date

Completion 

date

List Outcomes for Each Goal, and, if they differ, 

each Output 
EPA Form 5300-26 3

Comments

Instructions: If you have had any problems during the current period please report them here. In accordance with 40 C.F.R. §30.51(f) and 40 C.F.R. 

§31.40(d), a recipient of an EPA assistance agreement must notify EPA of any problems, delays, or adverse conditions that will materially impair the 

recipient’s ability to achieve the outputs/outcomes specified in the assistance agreement work plan.

Current problems during this reporting period:

Describe any actions your organization has taken or plans to take to resolve the problem:

If you need help from EPA you may request it here: 

Other comments:

Definitions

 Project/Program Goal: A major objective or endpoint identified in the assistance agreement work plan. A work plan may include one or more 

project/program goals. Use the goals as described in the assistance agreement work plan.

 Output: A product, service, or implementation target that will be produced or achieved during the project/program. Outputs may be qualitative or 

quantitative, but they must be measurable during the assistance agreement funding period. 

 Outcome: Changes or benefits resulting from the successful achievement of the project/program activities and outputs. Outcomes may be 

environmental, behavioral, health-related, or programmatic in nature, but they must be quantitative. Outcomes may not necessarily be achievable within 

the assistance agreement funding period, and they can be described as short-term, intermediate, or long-term: 

1) short-term – changes in learning, knowledge, attitudes, or skills; 

2) intermediate – changes in behavior, practices, or decisions; or 

3) long-term – changes in environmental, human health, or other conditions. 

Paperwork Reduction Act (PRA) Burden Statement: The public reporting and recordkeeping burden for this collection of information is estimated to 

average ninety minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any 

suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies 

Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any 

correspondence. Do not send the completed form to this address.
EPA Form 5300-26 4