Standard Form 269 PDF Details

As a professional, it's important to understand the many forms and documents necessary for success in the workplace. One such form is Standard Form 269 or SF-269, an essential financial report created by the U.S. government used as a tool to make budgeting decisions around federally funded projects more efficient and transparent. In this blog post we'll discuss what SF-269 is, who can use it and how you can best utilize it in your professional life. So let's jump right into what makes this form so important!

QuestionAnswer
Form NameStandard Form 269
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesstandard form 269 financial status report, 11d, standard form 269a financial status report, OMB

Form Preview Example

FINANCIAL STATUS REPORT

(Long Form)

(Follow instructions on the back)

1. Federal Agency and Organizational Element

2. Federal Grant or Other Identifying Number Assigned

OMB Approval

Page of

to Which Report is Submitted

By Federal Agency

No.

 

 

 

 

0348-0039

 

pages

 

 

 

 

 

 

 

 

 

3. Recipient Organization (Name and complete address, including ZIP code)

4. Employer Identification Number

5. Recipient Account Number or Identifying Number

6. Final Report

YES NO

7. Basis

CASH

ACCRUAL

8. Funding/Grant Period (See instructions)

 

 

9. Period Covered by this Report

 

From: (Month, Day, Year)

 

To: (Month, Day, Year)

From: (Month, Day, Year)

 

To: (Month, Day, Year)

 

 

 

 

 

 

 

 

10. Transactions:

 

 

I

II

III

 

 

 

 

Previously Reported

This Period

Cumulative

a.

Total outlays

 

 

 

 

 

 

 

 

 

 

 

 

b.

Refunds, rebates, etc.

 

 

 

 

 

 

 

 

 

 

 

c.

Program income used in accordance with the deduction alternative

 

 

 

d.Net outlays (Line a, less the sum of lines b and c)

Recipient's share of net outlays, consisting of:

e.Third party (in-kind) contributions

f.Other Federal awards authorized to be used to match this award

g.Program income used in accordance with the matching or cost sharing alternative

h.All other recipient outlays not shown on lines e, f or g

i.Total recipient share of net outlays (Sum of lines e, f, g and h)

j.Federal share of net outlays (line d less line i)

k.Total unliquidated obligations

l.Recipient's share of unliquidated obligations

m.Federal share of unliquidated obligations

n.Total Federal share (sum of lines j and m)

o.Total Federal funds authorized for this funding period

p.Unobligated balance of Federal funds (Line o minus line n)

Program income, consisting of:

q.Disbursed program income shown on lines c and/or g above

r.Disbursed program income using the addition alternative

s.Undisbursed program income

t.Total program income realized (Sum of lines q, r and s)

11.Indirect

Expense

a.Type of Rate (Place "X" in appropriate box)

 

PROVISIONAL

PREDETERMINED

FINAL

FIXED

 

 

 

 

 

 

 

b. Rate

 

c. Base

 

d. Total Amount

 

e. Federal Share

 

 

 

 

 

 

 

12.Remarks: Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation.

13.Certification: I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays and unliquidated obligations are for the purposes set forth in the award documents.

Typed or Printed Name and Title

Telephone (Area code, number and extension)

Signature of Authorized Certifying Official

Date Report Submitted

Previous Edition Usable

269-104

Standard Form 269 (Rev. 7-97)

NSN 7540-01-012-4285

 

Prescribed by OMB Circulars A-102 and A-110

 

200-498 P.O. 139 (Face)

 

FINANCIAL STATUS REPORT

(Long Form)

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0039), Washington, DC 20503.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.

Please type or print legibly. The following general instructions explain how to use the form itself. You may need additional information to complete certain items correctly, or to decide whether a specific item is applicable to this award. Usually, such information will be found in the Federal agency's grant regulations or in the terms and conditions of the award (e.g., how to calculate the Federal share, the permissible uses of program income, the value of in-kind contributions, etc.). You may also contact the Federal agency directly.

ItemEntry

1, 2 and 3. Self-explanatory.

4.Enter the Employer Identification Number (EIN) assigned by the U.S. Internal Revenue Service.

5.Space reserved for an account number or other identifying number assigned by the recipient.

6.Check yes only if this is the last report for the period shown in item 8.

7.Self-explanatory.

8.Unless you have received other instructions from the awarding agency, enter the beginning and ending dates of the current funding period. If this is a multi-year program, the Federal agency might require cumulative reporting through consecutive funding periods. In that case, enter the beginning and ending dates of the grant period, and in the rest of these instructions, substitute the term "grant period" for "funding period."

9.Self-explanatory.

10.The purpose of columns, I, II, and III is to show the effect of this reporting period's transactions on cumulative financial status. The amounts entered in column I will normally be the same as those in column III of the previous report in the same funding period . If this is the first or only report of the funding period, leave columns I and II blank. If you need to adjust amounts entered on previous reports, footnote the column I entry on this report and attach an explanation.

10a. Enter total gross program outlays. Include disbursements of cash realized as program income if that income will also be shown on lines 10c or 10g. Do not include program income that will be shown on lines 10r or 10s.

For reports prepared on a cash basis, outlays are the sum of actual cash disbursements for direct costs for goods and services, the amount of indirect expense charged, the value of in-kind contributions applied, and the amount of cash advances and payments made to subrecipients. For reports prepared on an accrual basis, outlays are the sum of actual cash disbursements for direct charges for goods and services, the amount of indirect expense incurred, the value of in-kind contributions applied, and the net increase or decrease in the amounts owed by the recipient for goods and other property received, for services performed by employees, contractors, subgrantees and other payees, and other amounts becoming owed under programs for which no current services or performances are required, such as annuities, insurance claims, and other benefit payments.

ItemEntry

10b. Enter any receipts related to outlays reported on the form that are being treated as a reduction of expenditure rather than income, and were not already netted out of the amount shown as outlays on line 10a.

10c. Enter the amount of program income that was used in accordance with the deduction alternative.

Note: Program income used in accordance with other alternatives is entered on lines q, r, and s. Recipients reporting on a cash basis should enter the amount of cash income received; on an accrual basis, enter the program income earned. Program income may or may not have been included in an application budget and/or a budget on the award document. If actual income is from a different source or is significantly different in amount, attach an explanation or use the remarks section.

10d, e, f, g, h, i and j. Self-explanatory.

10k. Enter the total amount of unliquidated obligations, including unliquidated obligations to subgrantees and contractors.

Unliquidated obligations on a cash basis are obligations incurred, but not yet paid. On an accrual basis, they are obligations incurred, but for which an outlay has not yet been recorded.

Do not include any amounts on line 10k that have been included on lines 10a and 10j.

On the final report, line 10k must be zero.

10l. Self-explanatory.

10m. On the final report, line 10m must also be zero.

10n, o, p, q, r, s and t. Self-explanatory.

11a. Self-explanatory.

11b. Enter the indirect cost rate in effect during the reporting period.

11c. Enter the amount of the base against which the rate was applied.

11d. Enter the total amount of indirect costs charged during the report period.

11e. Enter the Federal share of the amount in 11d.

Note: If more than one rate was in effect during the period shown in item 8, attach a schedule showing the bases against which the different rates were applied, the respective rates, the calendar periods they were in effect, amounts of indirect expense charged to the project, and the Federal share of indirect expense charged to the project to date.

SF-269 Back (Rev. 7-97)