OMB No 1845-0030

Expires: 

FISAP Version: Page A-1

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid 

OMB control number. The valid OMB control number for this information collection is 1845-0030. The time required to complete this information collection 

is estimated to average 20.91 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. 20202-4537. If you have comments or concerns regarding 

the status of your individual submission of this form, write directly to: Grants & Campus-Based Division, Federal Student Aid, Union Center Plaza, 

830 First Street, NE, Washington, D.C. 20202.

Fiscal Operations Report and Application to Participate (FISAP) 

Report: Award Year July 1, 2012 through June 30, 2013; Application: Award Year July 1, 2014 

through June 30, 2015

Part I. Identifying Information, Certification and Warning

Section A. Identifying Information

1(a) Name and address of school 

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

2. OPEID Number _____________________ 

3. Type of school (select one) 

__ 3.1 public

__ 3.2 private/non-profit 

__ 3.3 proprietary

(Select one if proprietary) 

__ (a) art

__ (b) business

__ (c) cosmetology

__ (d) trade and technical

__ (e) other 

5. Additional Institutions 

If the data reported on this form applies to more than one 

eligible institution (unique 8-digit Institution OPEID not an

OPEID that identifies an additional location), you must identify 

all institutions for which this form is applicable. This is a 

change – See instructions

1(b) Mailing address (if different from 1(a)) 

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

4. Length/type of longest program (select one) 

__ 4.1 less than 1 year 

__ 4.2 1 year but less than 2 years 

__ 4.3 2 years but less than 3 years 

__ 4.4 3 years but less than 4 years 

__ 4.5 4 years (no higher than a baccalaureate degree) 

__ 4.6 5 years or more 

__ 4.7 post-baccalaureate only 

This FISAP includes data for additional institutions.

. __ yes __ no

6. Financial Aid Administrator 

Name _____________________________ Telephone No. ______________

E-mail address _____________________________ Fax No. ______________

7. Name and address of private financial aid consultant firm, if any 

Name _____________________________________________ 

Address 1_____________________________________________

Address 2_____________________________________________

City ____________________ State ______ Zip ____________
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Section B. Certification and Warning 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Applicants must review the requirements for certification regarding lobbying included in the regulations 

cited below before completing this form. Applicants must sign this form to comply with the certification 

requirements under 34 CFR Part 82, “New Restrictions on Lobbying.” This certification is a material 

representation of fact upon which the Department of Education relies when it makes a grant or enters into 

a cooperative agreement.

As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering 

into a Federal contract, grant or cooperative agreement over $100,000, as defined at 34 CFR Part 82, Sections 

82.105 and 82.110, the applicant certifies that:

(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any 

person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an 

officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any 

Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, 

amendment, or modification of any Federal grant or cooperative agreement;

(b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing 

or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of 

Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative 

agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report 

Lobbying,” in accordance with its instructions; and

(c) The undersigned shall require that the language of this certification be included in the award documents for all 

subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all 

subrecipients shall certify and disclose accordingly.

As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with 

the above certification. I further certify that the information contained in this electronic FISAP is in 

compliance with governing legislation and regulations and is true and accurate. I understand that all 

information associated with this FISAP is subject to audit and program review by representatives of the Secretary 

of Education.

WARNING: If you purposely give false or misleading information, you may be fined up to $20,000, sent 

to prison, or both.

8. Chief Executive Officer (includes President, Chancellor, and Director)

Signature _________________________________ Date signed _______________

Name ____________________________________ Telephone No. ____________

Title _____________________________________ Fax No. _________________

E-mail address _____________________________ 

Mail signed form to:

FISAP Administrator

3130 Fairview Park Drive

Suite 800

Falls Church, VA 22042
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Application to Participate, Part II 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part II. Application to Participate for Award Year July 1, 2014 through June 30, 2015

Section A. Request for Funds for the 2014-2015 Award Year 

1. Federal Perkins Loan Level of Expenditures $ _________

2. Federal Perkins Loan Federal Capital Contribution $ _________ 

3. FSEOG federal funds $ _________

4. FWS federal funds $ _________

Section B. Federal Perkins Loan Program Liquidation Request 

(Applies only to certain schools; see instructions) 

5. My school wishes to discontinue participation in the Federal Perkins Loan Program. __ yes __ no 

Section C. Waiver Request for the Underuse of Funds

My school has returned more than 10 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the 2012-

2013 award year. 

6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional 

Information screen, a written explanation of the circumstances. __ yes __ no
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Application to Participate, Part II (continued) 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part II. Application to Participate for Award Year July 1, 2014 through June 30, 2015

Section D. Information on Enrollment 

My school’s calendar is __Traditional __Non-Traditional

Schools with a traditional calendar that had 2012-2013 enrollment, fill in Field 7.

7. Total number students, 2012-2013 (a) Undergraduate ____________ (b) Graduate/Professional ____________

Schools with a traditional calendar that did not have 2012-2013 enrollment, fill in Field 8.

8. Estimated number students, 2013-2014 (a) Undergraduate ____________ (b) Graduate/Professional ____________

Schools with a non-traditional calendar that had 2012-2013 enrollment, fill in fields 9 through 20.

Undergraduate Undergraduate Graduate/Professional Graduate/Professional

Continuing Students New Starts Continuing Students New Starts

 (a) (b) (c) (d)

9. July 1, 2012 ____________ ____________ ____________ ____________

10. August 1 ____________ ____________ ____________ ____________

11. September 1 ____________ ____________ ____________ ____________

12. October 1 ____________ ____________ ____________ ____________

13. November 1 ____________ ____________ ____________ ____________

14. December 1 ____________ ____________ ____________ ____________

15. January 1, 2013 ____________ ____________ ____________ ____________

16. February 1 ____________ ____________ ____________ ____________

17. March 1 ____________ ____________ ____________ ____________

18. April 1 ____________ ____________ ____________ ____________

19. May 1 ____________ ____________ ____________ ____________

20. June 1 ____________ ____________ ____________ ____________

21. TOTAL ____________ ____________ ____________ ____________

Section E. Assessments and Expenditures

 Undergraduate (a) Graduate/Professional (b)

22. Total tuition and fees for the award year July 1, 2012 to June 30, 2013 $____________ $____________

23. Total Federal Pell Grants expenditures for the 2012-2013 award year $____________

24. Total expended for state grants and scholarships made to 

undergraduates for the award year July 1, 2012 to June 30, 2013 $____________

Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year 2012-2013

 Dependent Undergraduate Independent Undergraduate Independent

Without Baccalaureate/ With Baccalaureate Without Baccaluareate/ With Baccalaureate/ Graduate/

 1

st Prof. Degree (a) 1st Prof. Degree (b) 1st Prof Degree (c) 1st Prof. Degree (d) Professional (e)

25. Students with an

“Automatic” Zero EFC ____________ ____________ ____________ ____________ ____________ 

Taxable and Untaxed Income Taxable and Untaxed Income

26. $0 - $2,999 ___________ ___________ $0 - $999 ___________ ___________ ___________

27. $3,000 - $5,999 ___________ ___________ $1,000 - $1,999 ___________ ___________ ___________

28. $6,000 - $8,999 ___________ ___________ $2,000 - $2,999 ___________ ___________ ___________

29. $9,000 - $11,999 ___________ ___________ $3,000 - $3,999 ___________ ___________ ___________

30. $12,000 - $14,999 ___________ ___________ $4,000 - $4,999 ___________ ___________ ___________

31. $15,000 - $17,999 ___________ ___________ $5,000 - $5,999 ___________ ___________ ___________

32. $18,000 - $23,999 ___________ ___________ $6,000 - $7,999 ___________ ___________ ___________

33. $24,000 - $29,999 ___________ ___________ $8,000 - $9,999 ___________ ___________ ___________

34. $30,000 - $35,999 ___________ ___________ $10,000 - $11,999 ___________ ___________ ___________

35. $36,000 - $41,999 ___________ ___________ $12,000 - $13,999 ___________ ___________ ___________

36. $42,000 - $47,999 ___________ ___________ $14,000 - $15,999 ___________ ___________ ___________

37. $48,000 - $53,999 ___________ ___________ $16,000 - $17,999 ___________ ___________ ___________

38. $54,000 - $59,999 ___________ ___________ $18,000 - $19,999 ___________ ___________ ___________

39. $60,000 and over ___________ ___________ $20,000 and over ___________ ___________ ___________

40. TOTAL ___________ ___________ TOTAL ___________ ___________ ___________
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Fiscal Operations Report, Part III 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2012 through June 30, 2013

Section A. Fiscal Report (Cumulative) as of June 30,2013

Field Item Amount Number of Borrowers Debit Balances Credit Balances

 (a) (b) (c) (d)

1.1. Cash on hand and in depository as of 6/30/2013 $__________

1.2. Cash on hand and in depository as of 10/31/2013 $_________

2. Funds receivable from federal government $__________

3. Funds receivable from school $__________

4. Funds advanced to students _________________ $__________

5. Loan principal collected _________________ $__________

6. Loan principal assigned to and accepted by the United 

States _________________ $__________

Loan principal canceled for the following categories:

7. teaching/military service (applies to loans made prior to 

07/01/1972) _________________ $__________

8. certain subject matter teaching service (math,

science, foreign languages, bilingual education) _________________ $__________

9. all other authorized pre-K or K-12 teaching service _________________ $__________

10. military service (applies to loans made 07/01/1972 and after) _________________ $__________

11. volunteer service _________________ $__________

12. law enforcement and corrections officer service _________________ $__________

13. child/family/early intervention service _________________ $__________

14. nurse/medical technician service ____________________ $____________

15. pre-K or child care program staff member service ____________________ $____________

16. service as an attorney in a public defender organization ____________________ $____________

17. fire fighter service ____________________ $____________

18. Tribal College or University faculty service ____________________ $____________

19. librarian service ____________________ $____________

20. speech-language pathology service ____________________ $__________

21. death/disability _________________ $__________

22. disability based on VA determination _____________________ $____________

23. bankruptcy _________________ $__________

24. surviving spouses of public service victims of 9-11 terrorist attacks _________________ $__________

25. loans discharged due to closed schools _________________ $__________

26. Loan principal adjustments – other _________________ $__________

27. Federal Capital Contributions $__________

28. Repayments of fund capital to federal government $__________

29.1.Short-term loans to the Fund $___________

29.2. ICC deposited to the Fund $___________

29.3. Institutional Capital Contributions $__________

30.1.Repayment of short-term loans to the fund $___________

30.2.Distribution of excess/liquidated fund capital $___________

30.3.Repayments of fund capital to school $__________

31. Interest income on loans $__________

32. Other income $__________

33. Reimbursements to the Fund of the amounts canceled 

 on loans made 07/01/1972 and after $__________

34.1. Administrative cost allowance $_________

34.2. Collection costs $_________

34.3. Administrative cost allowance and collection costs (control) $__________ 

Cost of loan principal and interest canceled for the following categories:

35. teaching/military service (applies to loans made prior to

 07/01/1972) $__________

36. certain subject matter teaching service (math, science,

 foreign languages, bilingual education) $__________

37. all other authorized pre-K or K-12 teaching service (applies to loans made

 07/01/1972 and after) $__________

38. military service (applies to loans made 07/01/1972 and after) $__________

39. volunteer service in the Peace Corps or under the

 Domestic Volunteer Service Act of 1973 $__________
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Fiscal Operations Report, Part III (continued)

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2012 through June 30, 2013

Section A. Fiscal Report (Cumulative) as of June 30, 2013

Field Item Amount Number of Borrowers Debit Balances Credit Balances

 (a) (b) (c) (d)

40. law enforcement and corrections officer service $__________

41. child/family/early intervention service $__________

42. nurse/medical technician service $__________

43. pre-K or child care program staff member service $____________

44. service as an attorney in a public defender organization $____________

45. fire fighter service $____________

46. Tribal College or University faculty service $____________

47. librarian service $____________

48. speech-language pathology service $____________

49. death/disability $__________

50. VA disability determination $____________

51. bankruptcy $__________

52. surviving spouses of public service victims of 9-11 terrorist attacks $__________

53. Cost of loan principal and interest assigned to and accepted

 by the United States $__________

54. Cost of loan principal and interest canceled for loans discharged due to closed schools $__________

55. Other costs or losses $__________

56. Balancing Adjustments (Debits) $__________

57. Balancing Adjustments (Credits) $__________

58. Total debits and credits (Sum of fields 1.1 through 57) $__________ $__________

Section B. Fund Activity (Annual) During the 2012-2013 Award Year (July 1, 2012 through June 30, 2013)

Number of Borrowers Amount

(a) (b)

1. Final adjusted Federal Capital Contribution (FCC) authorization $__________ 

2. FWS funds transferred to the Fund +$____________

3. FCC transferred to: 

 (a) FSEOG -$__________

 (b) FWS -$__________ 

4. Total federal funds available for the 2012-2013 award year (fields 1 + 2 – 3(a) – 3(b)) $___________

5. The unexpended amount of final adjusted authorized FCC for award year 2012-2013 

that was NOT requested from G5 by June 30, 2013. This amount will be reduced

 from your total award amount next spring (see instructions). $__________ 

6. Institutional Capital Contribution (ICC) deposited into the Fund between July 1,

2012 and June 30, 2013 $__________

7. Loans advanced to students from the Fund during the 2012-2013 award year

(minus 2012-2013 award year refunds) $__________

8. Administrative cost allowance claimed for the 2012-2013 award year (see

 instructions) $__________

9. Total principal and interest repaid by borrowers from all sources during the 2012-2013

award year _________________ $__________

10. Total principal repaid by borrowers from all sources during the 2012-2013 award

 year for loans in default for more than 2 years but not more than 5 years _________________ $__________

11. Total principal repaid by borrowers from all sources during the 2012-2013 award

 year for loans in default for more than 5 years _________________ $__________
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Fiscal Operations Report, Part III (continued)

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part III. Federal Perkins Loan Program for Award Year July 1, 2012 through June 30, 2013

Section C. Cumulative Repayment Information as of June 30, 2013

Status of Borrowers as of June 30, 2013

Amount Number of Amount Lent Principal Amount

Borrowers Outstanding

(a) (b) (c) (d)

1.1. Borrowers whose loans are fully retired ________ $__________

1.2. Loans that have been purchased $_________

2. Borrowers whose loans were assigned to and officially accepted

by the U.S. Department of Education as of June 30, 2013

(Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) ________ $__________ $____________

2.1. Assignments due to default or liquidation ________ $__________ $____________

2.2. Assignments due to total and permanent disability discharge ________ $__________ $____________

3. Total borrowers not in repayment status ________ $____________

4. Borrowers on schedule in repayment status ________ $____________

5.1. In default less than 240 days (monthly installments) or less than

270 days (other installments) ________ $__________ $____________

5.2. In default 240 days or more (monthly installments) or 270 days

or more (other installments), up to 2 years ________ $__________ $____________

5.3. In default more than 2 years but not more than 5 years ________ $__________ $____________

5.4. In default more than 5 years ________ $__________ $____________

Cohort Default Rate (Sections D and E)

Schools with fewer than 30 borrowers who entered repayment in the 2011-2012 award year should skip to Section E.

Section D. Schools with 30 or More Borrowers Who Entered Repayment in the 2011-2012 Award Year

1.1. Number of borrowers who entered repayment in 2011-2012 __________________________

1.2. Number of borrowers from Field 1.1 above with loans in default by June 30, 2013 __________________________

1.3. Cohort default rate ((Field 1.2 / Field 1.1) x 100) __________________________

Section E. Schools with Fewer than 30 Borrowers Who Entered Repayment in the 2011-2012 Award Year

2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by:

(a) 2009-2010 (07/01/2009-06/30/2010) __________ (a) June 30, 2011(those in 2.1(a) only) __________

(b) 2010-2011 (07/01/2010-06/30/2011) __________ (b) June 30, 2012 (those in 2.1(b) only) __________

(c) 2011-2012 (07/01/2011-06/30/2012) __________ (c) June 30, 2013 (those in 2.1(c) only) __________

2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1(b) + 2.1(c)) __________

2.4. Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c)) __________

2.5. Cohort default rate ((Field 2.4 / Field 2.3) x 100) __________
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Fiscal Operations Report, Part IV 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year 

July 1, 2012 through June 30, 2013

Section A. Federal Funds Authorized for FSEOG

1. Final adjusted FSEOG authorization $____________

Section B. Federal Funds Available for FSEOG Expenditures

2. FWS funds transferred to and spent in FSEOG +$____________

3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG +$____________

4. FSEOG funds transferred to and spent in FWS -$___________

5. 2013-2014 FSEOG funds carried back and spent in 2012-2013 +$____________

6. Additional 2013-2014 FSEOG funds carried back and spent for 2013 summer enrollment +$____________

7. 2011-2012 funds carried forward and spent in 2012-2013 +$____________

8. 2012-2014 funds carried forward to be spent in 2013-2014 - $____________

9. 2012-2013 funds carried back and spent in 2011-2012 - $____________

10. Additional 2012-2013 funds carried back and spent for 2012summer enrollment - $____________

11. Total federal funds available for 2012-2013 FSEOG 

 (fields 1 + 2 + 3 + 5 + 6 + 7) minus (fields 4 + 8 + 9 + 10) $____________

Section C. Funds to FSEOG Recipients

12. Total funds to FSEOG recipients (fields 13 + 14) $____________

13. Nonfederal share of funds to FSEOG recipients (25 percent of Field 12) $____________ 

 (a) Cash outlay contributed $____________

 (b) Other resources designated $____________

Section D. Federal Funds Spent for FSEOG Program

14. Federal share of funds to FSEOG recipients (75 percent of Field 12) $____________

15. Administrative cost allowance claimed (see instructions) +$____________

16. Federal funds spent for FSEOG (fields 14 + 15) $____________

Section E. Use of FSEOG Authorization

17. Expended FSEOG authorization (fields 4 + 8 + 9 + 10 + 16) minus (fields 2 + 3 + 5 + 6 + 7) $____________

18. Unexpended FSEOG authorization (Field 1 - Field 17) (cannot be negative) $____________
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Fiscal Operations Report, Part V 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part V. Federal Work-Study (FWS) Program for Award Year July 1, 2012 through June 30, 2013

Section A. Federal Funds Authorized for FWS

1. Final adjusted FWS authorization $____________

Section B. Federal Funds Available for FWS Expenditures

2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS +$____________

3. FSEOG funds transferred to and spent in FWS +$_____________

4. FWS funds transferred to and spent in:

(a) FSEOG -$____________

(b) Federal Perkins Loan Program -$___________

5. 2013-2014 FWS funds carried back and spent in 2012-2013 +$____________

6. Additional 2013-2014 FWS funds carried back and spent for 2013 summer employment +$____________

7. 2011-2012 funds carried forward and spent in 2012-2013 +$____________

8. 2012-2013 funds carried forward to be spent in 2013-2014 - $____________

9. 2012-2013 funds carried back and spent in 2011-2012 - $____________

10. Additional 2012-2013 funds carried back and spent for 2012 summer employment - $____________

11. Total federal funds available for 2012-2013 FWS 

(fields 1 + 2 + 3 + 5 + 6 + 7) minus (fields 4(a) + 4(b) + 8 + 9 + 10) $____________

Section C. Total Compensation for FWS

12. Total earned compensation for FWS Program $____________

(a) On-campus earned compensation $____________

(b) Off-campus earned compensation for public or private non-profit

 agencies, excluding amounts reported in Field 12(c) $____________

(c) Off-campus earned compensation for agencies that were unable to pay

 regular nonfederal share and had a federal share up to 90 percent $____________

(d) Off-campus earned compensation for private for-profit organizations $____________

13. Total institutional share of earned compensation (see instructions) $____________

Section D. Funds Spent from Federal Share of FWS

14. Total federal share of FWS earned compensation $____________

(a) Federal share paid at a rate up to 75 percent $____________

(b) Federal share paid at a rate up to 100 percent for waivers of 

 nonfederal share $____________

(c) Federal share paid at a rate up to 90 percent for agencies that were 

 unable to pay regular nonfederal share $____________

(d) Federal share paid at a rate up to 50 percent for off-campus, private 

 for-profit organizations $____________

15. Administrative cost allowance claimed (see instructions) +$____________

16. Federal share of Job Location and Development (JLD) Program expenditures +$____________

17. Total federal funds spent for FWS (fields 14 + 15 + 16) $____________
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Fiscal Operations Report, Part V (continued)

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part V. Federal Work-Study (FWS) Program for Award Year July 1, 2012 through June 30, 2013

Section E. Use of FWS Authorization

18. Expended FWS authorization (fields 4(a) + 4(b) + 8 + 9 + 10 + 17) minus (fields 2 + 3 + 5 + 6 + 7) $____________

19. Unexpended FWS authorization (Field 1 - Field 18) $____________

Section F. Information About the Job Location and Development (JLD) Program

20. Total expenditures for the JLD Program $____________

21. Institutional expenditures for the JLD Program (see instructions) $____________

22. Number of students for whom jobs were located or developed ____________

23. Total earnings of the students in Field 22 above $____________

Section G. Information About FWS Students Employed in Community Service Activities

24. Number of students in community service employment _____________

25. Federal share of community service earned compensation $____________

26. Nonfederal share of community service earned compensation $____________

Section H. Information About FWS Students Employed as Reading Tutors of Children or Employed in 

 Family Literacy Activities 

27. Number of FWS students employed as reading tutors of children or employed in family literacy 

 activities _____________

28. Federal share of earned compensation for FWS students employed as reading tutors of children 

 or employed in family literacy activities $____________

 (a) Amount of the federal share in Field 28 spent on community service 

 employment $____________

29. Total earned compensation for FWS students employed as reading tutors of children or employed 

 in family literacy activities $____________

Section I. Information About FWS Students Employed as Mathematics Tutors of Children

30. Number of FWS students employed as mathematics tutors of children _____________

31. Federal share of earned compensation for FWS students employed as mathematics tutors of 

 children $____________

32. Total earned compensation for FWS students employed as mathematics tutors of children $____________

Section J. Information About FWS Students in Civic Education and Participation Activities

33. Number of students in civic education and participation activities _______________

34. Federal share spent for students in civic education and participation activities $______________

35. Total spent for students in civic education and participation activities $______________

Section K. Information About FWS Disaster-Affected Students 

36. Number of disaster-affected students receiving FWS funds _______________

37. Federal share of funds to disaster-affected students $______________

38. Total funds to disaster-affected students $______________ 
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Fiscal Operations Report, Part VI 

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part VI. Program Summary for Award Year July 1, 2012 through June 30, 2013

Section A. Distribution of Program Recipients and Expenditures by Type of Student 

 

Taxable and Untaxed Federal Perkins Loan FSEOG FWS Unduplicated

 Income Category Recipients Funds Recipients Funds Recipients Funds Recipients

 Student Type (a) (b) (c) (d) (e) (f) (g)

Undergraduate

 Dependent

1. $0 - $ 5,999 _________ _________ _________ _________ _________ _________ _________

2. $6,000 - $11,999 _________ _________ _________ _________ _________ _________ _________

3. $12,000 - $23,999 _________ _________ _________ _________ _________ _________ _________

4. $24,000 - $29,999 _________ _________ _________ _________ _________ _________ _________

5. $30,000 - $41,999 _________ _________ _________ _________ _________ _________ _________

6. $42,000 - $59,999 _________ _________ _________ _________ _________ _________ _________

7. $60,000 - $69,999 _________ _________ _________ _________ _________ _________ _________

8. $70,000 - $79,999 _________ _________ _________ _________ _________ _________ _________

9. $80,000 - $89,999 _________ _________ _________ _________ _________ _________ _________

10. $90,000 - $99,999 _________ _________ _________ _________ _________ _________ _________

11. $100,000 and over _________ _________ _________ _________ _________ _________ _________

Undergraduate 

Independent

12. $0 - $ 1,999 _________ _________ _________ _________ _________ _________ _________

13. $2,000 - $ 3,999 _________ _________ _________ _________ _________ _________ _________

14.. $4,000 - $ 7,999 _________ _________ _________ _________ _________ _________ _________

15. $8,000 - $11,999 _________ _________ _________ _________ _________ _________ _________

16. $12,000 - $15,999 _________ _________ _________ _________ _________ _________ _________

17. $16,000 - $19,999 _________ _________ _________ _________ _________ _________ _________

18. $20,000 - $24,999 _________ _________ _________ _________ _________ _________ _________

19. $25,000 - $29,999 _________ _________ _________ _________ _________ _________ _________

20. $30,000 - $34,999 _________ _________ _________ _________ _________ _________ _________

21. $35,000 - $39,999 _________ _________ _________ _________ _________ _________ _________

22. $40,000 and over _________ _________ _________ _________ _________ _________ _________

23. Graduate/Professional _________ _________ does not apply does not apply _________ _________ _________

 

24. TOTAL (fields 1-23) _________ _________ _________ _________ _________ _________ _________

25. Total less-than-full-time

 students

 (from fields 1-23) _________ _________ _________ _________ _________ _________ _________

26. Total “Automatic” Zero

 EFC students

 (from fields 1-23) _________ _________ _________ _________ _________ _________ _________ 
OMB no 1845-0030

Expires 06/30/2013

FISAP Version: DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

Fiscal Operations Report, Part VI (continued)

Name of School _____________________________________________________ 

OPEID Number _________ State _______

Part VI. Program Summary for Award Year July 1, 2012 through June 30, 2013

Section B. Calculating the Administrative Cost Allowance

Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews)

Step 1. Calculate the amount spent in 2012-2013 on which the administrative cost allowance is based.

1. Total compensation in FWS (amount from Part V, Section C, Field 12) $____________

2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 7) +$____________

3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 12) +$____________

4. Total amount spent (fields 1 + 2 + 3) $____________

Step 2. Calculate the administrative cost allowance. 

Schools whose total amount spent was $2,750,000 or less 

5. Enter total amount spent (Field 4) $____________

6. Multiply x 0.05

7. Total administrative cost allowance—go to Step 3 $____________

Schools whose total amount spent was more than $2,750,000 but less than $5,500,000

8. Enter total amount spent (Field 4) $____________

9. Subtract - $ 2,750,000

10. Expenditures over $2,750,000 (Field 8 - Field 9) $____________

11. Multiply x 0.04

12. Administrative cost allowance on expenditures over $2,750,000 (Field 10 x Field 11) $____________

13. Add administrative cost allowance on expenditures of $2,750,000 ($2.75 million x .05) +$ 137,500

14. Total administrative cost allowance (Field 12 + Field 13)—go to Step 3 $____________

Schools whose total amount spent was $5,500,000 or more 

15. Enter total amount spent (Field 4) $____________

16. Subtract - $ 5,499,999

17. Expenditures of $5,500,000 or more (Field 15 - Field 16) $____________

18. Multiply x 0.03

19. Administrative cost allowance on expenditures of $5,500,000 or more (Field 17 x Field 18) $____________

20. Add administrative cost allowance on expenditures less than $5,500,000 (($2.75 million x .05) + Field 12) +$ 247,500

21. Total administrative cost allowance (Field 19 + Field 20)—go to Step 3 $____________

Step 3. Decide how much administrative cost allowance your school claimed. 

22. How much administrative cost allowance did your school claim? (The amount may be the same or less

 than the amount calculated in Step 2.) $____________

23. How much administrative cost allowance did your school claim in each program? 

 (a) Federal Perkins Loan (must be the same as Part III, Section B, Field 8) $____________

 (b) FSEOG (must be the same as Part IV, Section D, Field 15) $____________

 (c) FWS (must be the same as Part V, Section D, Field 15) $____________