THE TANGIBLE PERSONAL REPORT - WKU Orgs …orgs.wku.edu/ttas/docs/handouts/2017-09_federal_financial_reports/...PROPERTY REPORT Tangible Personal Property Report ... Closing the Project

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THE TANGIBLE PERSONAL

PROPERTY REPORT Tangible Personal Property Report

SF- 428 Final Report SF-428- B

Disposition Request/Report SF-428- CSupplemental Sheet SF-428S

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PROGRAM INSTRUCTIONS

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PROGRAM INSTRUCTIONSISSUANCE DATE

Federal Reporting Changes; Financial Reports; SF‐425; Cash Transactions; Expenditures; Tangible Personal Property Reports; SF‐428

08/21/2017

SF‐429; Real Property; Facilities; Purchase; Construction; Major Renovation; Reporting

08/21/2017

THE SF‐ 428

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TANGIBLE PERSONAL PROPERTY REPORT

SF‐ 428

• Instructions for Tangible Personal Property

Report: SF-428o This is a standard form to be used by awarding

agencies to collect information related to tangible

personal property (equipment and supplies) when

required by a Federal financial assistance award.

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SF‐ 428

o The form consists of the cover sheet (SF-428) and

three attachments to be used as required:

• Annual Report, SF428-A;

• Final (Award Closeout) Report, SF-428-B; and

• Disposition Request/Report, SF-428-C.

o A Supplemental Sheet, SF-428S, may be used to

provide detailed individual item information.

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SF‐ 428

• Tangible personal property means property of any kind,

except real property, that has physical existence.

• It includes equipment and supplies.

• It does not include copyrights, patents or securities.

• For convenience, throughout this form and its

attachments, the term property will be synonymous with

tangible personal property.

• The terms equipment and supplies will be used when

referring to specific requirements.6

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SF‐ 428

• Property may be provided by the awarding agencyor acquired by the recipient with award funds.

• Federally-owned property consists of items that werefurnished by the Federal government.

• Recipients of Federal assistance awards may berequired to provide Federal awarding agencies withinformation concerning property in their custodyannually, at award closeout or when the property isno longer needed.

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SF‐ 428

• Specific requirements will vary based onaward provisions, the type of property(equipment or supplies) and whether theproperty is Federally-owned.

• This reporting form and its attachments areintended to assist recipients to providenecessary information when it is required.

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SF‐ 428

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Pages of pages

1.Federal Agency and Organization Element to Which Report is Submitted: HHS‐ADMINISTRATION FOR CHILDREN AND FAMILIES

2. Federal Grant or Other Identifying Number Assigned by Federal Agency: 0XCHXXXX

3a. DUNS XXXXX

3b. EIN XXXX

4. Recipient Organization (Name and complete address including zip code) 3. Recipient Organization (name and complete address including zip code): ABC, Inc. Head Start 2300 Jackson, St. Gary, IN 00000

5. Recipient Account or Identifying Number

Optional

6. Attachment (Check applicable) ___ Annual Report (SF‐428‐A) _X_ Final (Award Closeout) Report (SF‐428‐B) X_ Disposition Report/Request (SF‐428‐C)

7. Supplemental Sheet ___Yes ___ No NOTE: If yes, the SF‐428s maybe attached

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SF‐ 428

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8. Comments: Closing the Project Period

9a. Typed or Printed Name and Title of Authorized Certifying Official Larry EvansGoverning Body Chairman

9c. Telephone (area code, number, extension) (555)555.5555

9d. Email address [email protected]

9b. Signature of authorized Certifying Official

Larry Evans

9e. Date report submitted (Month, Day, Year) 12/31/2012

10. Agency use only

TANGIBLE PERSONAL PROPERTY REPORT Final Report SF‐428‐ B

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Final Report SF‐428‐ B

• General Instructions:o This Attachment is to be used by recipients when

required to provide a final property report for

closeout of Federal assistance awards.

o The Attachment allows recipients to request specific

disposition of Federally-owned property and

acquired equipment.

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• The attachment also provides a means for

calculating and transmitting appropriate

compensation to the awarding agency for

residual unused supplies.

• Requirements for final reporting are based

on individual award provisions and the type

of property.13



• Generally, at the end of a Federal

assistance award, recipients are required

to:a. submit a report of Federally-owned property.

b. provide a listing of equipment items, with an acquisition cost of

$5,000 or more, when the awarding agency has reserved the

right to transfer title to the equipment to the Federal Government

or a third party.

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c. compensate the awarding agency for residual

unused supplies with a total aggregate fair market

value greater than $5,000 that are not needed for

any other Federally sponsored programs or

projects.

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Federal Grant or Other Identifying Number Assigned by Federal Agency (Block 2 on SF‐428). 0XCHXXXX

1. Report (Select all that apply) a. ___ Federally‐owned Property (List on Supplemental Sheet SF‐428S orrecipient equivalent and complete Section 2a below.)b. _X__ Acquired Equipment with acquisition cost of $5,000 or more forwhich the awarding agency has reserved the right to transfer title (List onSupplemental Sheet SF‐428S or recipient equivalent and complete Section 2bbelow.)c. _X__ Residual Unused Supplies with total aggregate fair market valueexceeding $5,000 not needed for any other Federally sponsored programs orprojects. (Complete Section 2c below)d. ___ None of the above



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2. Complete relevant section(s) For Agency Use Only

2a. Federally‐owned Property (Select one or more.) (i) ___ Request transfer to Award _______(ii) ___ Request Federal Agency disposition instructions (iii) ___ Other (Provide detail in Block 3 or attach request)

Agency response to requested disposition of Federally owned property: (i) Recipient request approved___ denied ___

(ii) Dispose in accordance with attached instructions ___.


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2b. Acquired Equipment (Select one or more.) (i) ___ Request unconditional transfer of title with no further obligation to the Federal Government. (ii) X Request Federal Agency disposition instructions

Note: If the awarding agency does not provide disposition instructions within 120 days the recipient may continue to use the equipment for Federally supported projects or dispose in accordance with the applicable property standards.

Agency response to requested disposition of acquired equipment:: (i) Recipient request approved___ denied ___ (ii) Dispose in accordance with attached instructions ___

Authorized Awarding Agency Official

Signature: Date:

Name: Phone

Title: E‐mail

Example: Equipment Disposal

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2c. Reportable Residual Unused Supplies (See Next Slide)

(i) __ Sale proceeds or __Estimate of current fair market value $_________

(ii) Percentage of Federal participation…..…………………… ______100%

(iii) Federal share ………………….……………………………… $____________

(iv) Selling and handling allowance ….……………..………….. $____________

(v) Amount remitted to the Federal Government…………… $____________

3. Comments: Requesting instruction to disposal of a 1995 Ford 36 passenger bus with a fair market value of $5,100.00

Agency use only:

Example: Equipment Disposal


• Reportable Residual Unused Supplies.

Indicate whether the supplies have been

sold or if they will be retained for use

solely on non Federally-funded projects.i. Enter the total amount of sales proceeds or an estimate of

the current fair market value if the supplies will be retained.

Note: Fair market value means the best estimate of the gross

sales proceeds if the property were to be sold in a public sale.20

Residual Unused Supplies Instructions



ii. Enter the percentage of Federal Government

participation in the award under which the

supplies were acquired.

iii. Enter the dollar amount of sales proceeds (or

estimate of current fair market value) multiplied by

the percentage of Federal Government

participation listed in (ii).

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iv. If the supplies were sold, enter the amount of sellingand handling expenses. Enter zero if the supplies willbe retained for use on non Federally fundedprojects.

v. Enter the amount of the Federal share in (iii) less theselling and handling expense listed in (iv). Indicatein Block 3 how the funds are being returned to thegovernment (e.g., attached check made out to theAwarding Agency/U.S. Treasury or electronicremission).

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Residual Unused Supplies Instructions



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2c. Reportable Residual Unused Supplies

(i) __ Sale proceeds or _X Estimate of current fair market value $5500.00

(ii) (ii) Percentage of Federal participation…..……………… ____100%

(iii) Federal share ………………….……………………………… $5500.00

(iv) Selling and handling allowance ….……………..………….. $500.00

(v) Amount remitted to the Federal Government…………… $5000.00

3. Comments: Reporting unused supplies

Agency use only:

Example: Residual Unused Supplies


Disposition Request/Report SF‐428‐ C

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• General Instructions:• This Attachment is to be used by recipients when

required to request disposition instructions or toreport disposition of Federally-owned property oracquired equipment under Federal assistanceawards at any time other than award closeout (i.e.,during the award period or after closeout as long asthe Federal government retains an interest in theitem).

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• Recipients provided Federally-owned property for use

under Federal assistance awards are required to request

disposition instructions from the awarding agency when

the Federally-owned property is no longer needed for the

authorized purpose.

• Recipients may be required to request disposition

instructions for equipment acquired with award funds

(acquired equipment) when an item is no longer needed

for use on Federally-sponsored activities.

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• Recipients may also be required to providecompensation to the awarding agency whenacquired equipment is sold or retained for useon activities not sponsored by the Federalgovernment.

• This attachment is intended to assist recipients inproviding appropriate information to theawarding agency.

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• Note: If the Federal awarding agency hasexercised statutory authority to vest title toacquired equipment in the recipient with nofurther obligation to the Federal government,you are not required to request dispositioninstructions or to report disposition (i.e., sale orretention for non Federal use) of those items ofequipment.

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Federal Grant or Other Identifying Number Assigned by Federal Agency (Block 2 of SF‐428): 0XCHXXXX

1. Request Disposition Instructions for:

For Agency Use Only

a. Federally‐owned Property (Select one or more and attach Supplemental Sheet SF‐428S or recipient equivalent) (i) ___Request Federal Agency disposition instructions (ii) ___ Other (Specify in Block 8 “Comments” or attach request)

Agency response to requested disposition of Federally owned property: (i) Recipient request approved___ denied ___. (ii) Dispose in accordance with attached instructions ___.



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b. Acquired Equipment with current fair market value of $5,000 or more (Select one or more and attach Supplemental Sheet SF‐ 428S or recipient equivalent) (i) __ Request approval to trade‐in or sell to offset costs of replacement equipment (ii) X Request Federal Agency disposition instructions

Agency response to requested disposition of acquired equipment: (i) Recipient request approved___ denied ___. (ii) Dispose in accordance with attached instructions ___.

Authorized Awarding Agency Official

Signature: Date:

Name: Phone:

Title: Email:

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2. Report Disposition by Sale or Retention

• a. ___ Retention of acquired equipment for use on non Federally supported

projects

• b. X Sale of acquired equipment (Attach Supplemental Sheet SF‐428S or

recipient equivalent and complete worksheet below)

(i) Sale proceeds (or estimate of current fair market value) $5,000.00

(ii) (ii) Percentage of Federal participation ……………………. _100%

(iii) Federal share ………………….………………………….… $5,000.00

(iv) Selling and handling allowance …….…………………..….... $500.00

(v) Amount remitted to the Federal Government……………$4,500.00

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3. Report Loss, Destruction or Theft of Federally‐owned

Property

___ Loss, Destruction or Theft of Federally‐owned property

(Attach Supplemental Sheet SF‐428S or recipient equivalent

and describe the circumstances in Block 4)

4. Comments



INVENTORY REQUIREMENT

• On December 9, 2011, Policies and Procedures for

Designation Renewal of Head Start and Early Head Start

grantees, became final.

• The regulation includes a provision that Head Start and

Early Head Start grants move from indefinite project

periods to five year project periods.

• All Head Start grants, regardless of competition status,

are undergoing closeout as indefinite project periods

are phased out and five year project periods begin.33

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• Grantee inventories must be submitted to the

responsible awarding agency (ACF).

• Standard Property Reporting Forms SF-428S

and SF-429 Cover Page and Attachment A

may be used to report this information in a

consistent format.

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• Inventories of Supplies by Location and Room and

Equipment/Inventory (SF-428 Cover, SF-428A, and SF-428S)

• Supplies by Location and Room

• Include an inventory of supplies by location and room.

Normally this type of inventory request is made at the

completion of a project or program (see 45 CFR 75.320(d)(2)

however, in order to have a comprehensive inventory

picture of your agency ACF is requesting this information as

part of transaction.35


• For the supplies inventory please includeitems such aso classroom furniture and fixtures,

o computers, both desktop and lap top,

o video and teleconference items,

o cameras,

o smart boards and

o playground items.36

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• Equipment Inventory• Include a copy of your last equipment

inventory which was reconciled to youragency's equipment records: see 45 CFR75.320(d)(2).

• Include a list of all vehicles purchased usingHead Start funds, including make, model, year,capacity, and condition of each vehicle.

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• Federally Owned Property Inventory (SF-429 Cover, SF-429A)

• Include your current inventory of Federally Owned Property

see 45 CFR 75.319.

• Include all facilities in which the Federal Government has a

federal interest.

• Also, include all facilities where Federal Funds were used to

complete major renovations, as well as facilities with long

term lease agreement (exceeds 5 year term or remaining).

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TANGIBLE PERSONAL PROPERTY REPORT Supplemental Sheet SF‐

428S

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Supplemental Sheet SF‐428S

• A. General Instructions

• This is a standard form to be used by

recipients to provide detailed individual item

information in connection with required

reports of tangible personal property under

Federal assistance awards.

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Instructions for Tangible Personal

Property Report: SF‐428S

• GP or ACQ. Enter GP if the item is

Federally-owned property.o Note: Federally-owned property consists of items

furnished by the Federal Government for use on

the award identified in Block 1 or Column a.

o Enter ACQ if the item was acquired with award

funds

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• Identification Number. Enter theo manufacturer’s serial number,

o model number,

o Federal stock number,

o national stock number, or

o other identification number

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• Cond. Code. Enter the applicable condition code

from the following list:

• Code Description

o 1 Excellent. Property that is in new condition or unused

condition and can be used immediately without

modification or repairs.

o 4 Usable. Property which shows some wear, but can be

used without significant repair.43



o 7 Repairable. Property which is unusable in its current

condition but can be economically repaired.

o X Salvage. Property which has value in excess of its

basic material content, but repair or rehabilitation is

impractical and/or uneconomical.

o S Scrap. Property which has no value except for its

basic material content.

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• Disp. Req. Indicate the type of disposition

requested for each item by entering the

corresponding number from Block 2 of the

Final Report Attachment or Block 1 of the

Disposition Request/Report Attachment.

• Not required for Annual Report Attachments.

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Federal Grant or Other Identifying Number Assigned by Federal Awarding Agency (Block 2 of SF‐428) 0XCHXXXX (PART I)

Attachment Type: ____ Annual Report (SF‐428‐A)__X__ Disposition Report/Request (SF‐428‐C)__X__ Final (Award Closeout) Report (SF‐428‐B

Award Number (a)

GP or ACQ (b)

Description of Item (c)

Identification Number (d)

OXCHXXXX/32 GP: Federal PropertyACQ: means Acquired

32 Passenger Bus XXXXXXXX

EQUIPMENT



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Attachment Type (Part II)_X__ Annual Report ___ Final (Award Closeout) Report ___ Disposition Request/Report

Page Of Pages

Acq. Date (e) Cond. Code (f) Acq. Cost (g) Disp. Req. (h)

12/31/2015 4 $10,000.00 N/A

EQUIPMENT



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Federal Grant or Other Identifying Number Assigned by Federal Awarding Agency (Block 2 of SF‐428) (PART I)

Award Number (a)

GP or ACQ (b)

Description of Item (c) Identification Number (d)

• 260 CASES OF CONSTRUCTIONPAPER: COSTS $3200.00

• 30 PLAY GROUNDS SWINGS: $3200.00

RESEDIUAL INVENTOY UNUSED SUPPLIES

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Page Of Pages


TOTAL $6400.00

RESEDIUAL INVENTOY UNUSED SUPPLIES



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Federal Grant or Other Identifying Number Assigned by Federal Awarding Agency (Block 2 of SF‐428) (PART I)

Award Number (a)

GP or ACQ (b)

Description of Item (c) Identification Number (d)

• 15 BICYCLES

• 18 STOVES

• 50 SWINGS

• 25 CUBBIES

• 8 KIDNEY TABLES

RESEDIUAL INVENTOY USED SUPPLIES



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Page Of Pages


RESEDIUAL INVENTOY USED SUPPLIES

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SUBMISSION• Grantees are required to provide Tangible Personal

Property Report SF-428 and SF-428B, and if needed,

SF-428S, not later than 90 days after the close of the

project period.

• Grantees are to scan and upload completed

copies of the SF-428 reports to the specified folders

in the Grant Notes section of Grant Solutions.

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THE REAL PROPERTY

STATUS REPORT SF‐429

How to complete the SF-429: Attachment A (General Reporting);

Attachment B (Request to Acquire, Improve or Furnish) and

Attachment C (Disposition Request)

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DEFINITIONS (Repeat)• Acquisition Cost of Real Property: means the

cost of the asset including the cost to put itin place.

• Conservation Easement: means a voluntaryagreement between a land owner and anorganization that says here are the reservedrights and here are the extinguished rights.o Reserved rights could be the right to sell the

property or the right to give it away.o An extinguished right could be the right to

subdivide (or to divide a large property intomany small lots).”

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DEFINITIONS (Repeat)• Encumber: means to burden with a legal

claim (as a mortgage)• Parcel: A plot of land, usually a division of a

larger area.• Real Property: means land, including land

improvements, structures and appurtenances(right-of-way) thereto, excluding movablemachinery and equipment.

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SF‐429 Cover Page

• SF-429 Cover Page mustaccompany all reports andrequests.o The cover page provides recipient

(grantee) information. Include the SF-429 cover page when submitting eachform.

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Page: of : Pages

1. Federal Agency and Organizational Element to Which Report is Submitted: 1. Federal Agency and Organizational Element: HHS‐ADMINISTRATION FOR CHILDREN AND FAMILIES

2. Federal Grant(s) or Other Identifying Number(s) Assigned by Federal Agency(ies): 0XWHXXXX

3. Recipient Organization (name and complete address including zip code): ABC, Inc. Head Start 2300 Jackson, St. Gary, IN 00000

4a. DUNS Number:XXXXX

4b. EIN: XXXX 5. Recipient Account or Identifying Number:

Optional

6. Contact Person for this Report: Name: Mike JonesPhone: (555)555.5555Email: [email protected]: (555)555.5551

7. Report End Date (MM/DD/YYYY): 12/31/2016

8. Real Property Status Report – Attachments: [check the applicable block(s)]: X : Attachment A (General Reporting) attached X : Attachment B (Request to Acquire, Improve or Furnish) attached X : Attachment C (Disposition Request) attached

REAL PROPERTY STATUS REPORT SF‐429 (COVER PAGE)

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REAL PROPERTY STATUS REPORT SF‐429 (COVER PAGE) 9. Comments (attach additional sheets if necessary): Provide anyspecial notes or comments regarding the real property being reported orthe report itself in this block.Do Not include issues related to General Reporting; Request to Acquire, Improve or Furnish or Disposition RequestIf a negative report (no change in real property status) is being submittedfor all parcels of real property, enter the term “Negative” in this block.If there have been changes with some but not all parcels of real property,identify the parcels with negative status in this block (as follows:“Negative status for the following Properties:”) and provide the relatedattachment(s) for each parcel with changes to report.

10. Certification: I certify to the best of my knowledge andbelief that all information presented in this report is true,correct and complete and constitutes a material representationof fact upon which the Federal government may rely.

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11a. Typed or Printed Name and Title of Authorized Certifying Official: NAME: Larry EvansTITLE: Governing Body ChairmanThe authorized certifying official mustsign here certifying to the factspresented in the report.

A copy of the governing body’sauthorization for the certifyingofficial to sign official documentson behalf of their organization as anofficial representative must be onfile in the recipient’s office.

11c. Telephone (area code, number, extension): (555)555.5555

11d. Email Address: [email protected]

11b. Signature of Authorized Certifying

Official: Larry Evans11e. Date Report Submitted (MM/DD/YYYY): 01/03/2017

12. Agency use only59

Real Property Status Report

ATTACHMENT A (General Reporting) SF‐

429‐A

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SF‐429‐A General Reporting

• SF-429-A General Reporting must be

submitted annually on the same date the

grantee’s annual SF-425 Federal Financial

Report for the budget period is due.

o A separate Attachment A is required for

every parcel of real property subject to a

federal interest as defined in 45 CFR § 1305.2.61

Real Property Status Report ATTACHMENT A (General Reporting) SF‐429‐A

Real Property Details. Provide the requested information in subsections 13through 18 of AttachmentA for each parcel of real property being reported.Use a separate sheet to report information on each parcel of real propertyunder the Federal Financial Assistance award identified in section 2.If a section does not apply, enter “N/A.” Below is a summary of the requiredinformation to be provided for each subsection of AttachmentA:

13. Period and type of Federal Interest (MM/DD/YYYY): From: 12/23/2016To: 12/22/2046__X_Acquisition __X_ Renovation __X_ Construction __X_ Government Furnished Property Enter the period, established in the award document, during which Federalinterest in the real property begins (i.e., From) and ends (i.e., To) using(MM/DD/YYYY) format. [ex., From: 03/23/2005 To: 03/22/2025].This period may exceed the grant award performance period in those instanceswhere Federal interest continues beyond the end of the current award.In some instances the end date for the period of Federal interest may not bedefined by a specific date.If that is the case, enter the beginning date along with a statement to indicate theplanned or uncertain end date (ex. “From: 03/23/2005 To: Expiration of FederalInterest”). 62

14a. Description of Real Property. Describe the type of real property beingreported (i.e., land, building, etc.) and provide a useful description of thereal property (i.e., building number 17 at the National Research Center,Chapel Hill, NC).If the real property is being renovated or altered, also describe the nature ofthe work (i.e., major renovation of building 17, wing c).

14b. Address of Real Property. Enter the legal description and completeaddress for each parcel of real property being reported including the• street, city, state, county/parish, country, zip code, and• physical location if an address is not available

o (i.e., latitude, longitude,o lot number, parcel number, etc.).

NEXT SLIDE INCLUDES MORE DETAIL REGARDING THEADDRESSNOTE: PARCEL NUMBER 13‐DIGTIT NUMBER THAT ACOMMUNITY’S TAX ASSESSOR ASSIGNS.Also, indicate zoning information related to the real property (i.e., mixeduse, residential, commercial, etc.).

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Where an address is not available, or more precisionis required, geographic coordinates may be used.Locational data should be recorded with a GlobalPositioning System (GPS) device set to NAD 83, orWGS 84 datum using either of the followingcoordinate reference systems:• United States National Grid (USNG) using the fullgrid zone designation and a minimum of eightdigits.

• Decimal degrees latitude and longitude, with atleast 6 decimal places and a minus (‐) to show westlongitude or south latitude.

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14c. Land Acreage or Square Units: Enter the size of the land or the size of the land on which the real property is located in terms of measured acreage or square units (i.e., 1.5 acres, 0.8 sq. km., etc.). Enter Amount:__30 acres_____Identify the unit of measure. Use only one option, either acres, square kilometers, square feet, or square meters. Select units: _X_ Acres __Square Feet __Square Kilometers __ Square Meters

14d. Gross and Usable Square Footage/Meters (i.e., of building, house, etc.): Enter the gross and usable square footage/meters for each structure (i.e., of the building, house, etc.) being reported. Enter Amounts: Gross __27,000_______ Usable _25,000______Identify the unit of measure. Select only one, either square feet or square meters. Select Units: _X_ Square Feet __Square Meters 65

14e. EXAMPLE I

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14e. Real Property Ownership Type(s):_X__A. Owned ___ B. Co‐Owned ___ C. Fee Simple ___ D. Corporate ___ E. Joint Tenancy ___ F. Partnership ___ G. Limited Liability Partnership ___ H. Co‐Operative ___ I. Government Furnished Property ___ J. Other (Describe):___________________________________________________ Check the applicable box(es) to indicate the real property ownership type(s).If more than one type is applicable, check all that apply. If the ownershiptypes listed do not apply, check “J. Other” and describe the ownershiparrangement. Example of Other: Conservation Easement

14f. Real Property Cost: $4,000,000.00 Share Percentage 80%: Federal Share: $ $4,000,000.00 [80%] Non‐Federal Share: $ $1,000,000.00 [20%] Total (Federal and Non‐Federal Share): $5,000,000.00 [100%] Enter the total cost of the real property acquired (purchase price only) orimproved, including the following data.If multiple Federal agencies are contributing to the acquisition orimprovement of the real property, attach a separate sheet to identify eachagency and their contribution using the following format: 67

1. Amount provided by the Federal government (i.e.,Federal Share of Property Cost based on the Federal shareof the total cost of the program or project),

2. Share percentage provided by the Federal government(i.e., Federal Share Percentage of Property Cost based onthe Federal share of the total cost of the program orproject),

3. Amount provided by the recipient or other non‐Federalentities (i.e., non‐Federal Share of Property Cost),

4. Share percentage provided by the non‐Federal entities,(i.e., non‐Federal Share Percentage of Property Cost),

5. Total cost (i.e., Sum of Federal and non‐Federal Share ofthe Property Cost), and Total share percentage (i.e., sumof share percentages of Federal and non‐Federal Share ofthe Property

6. Cost must equal 100%).68

HEAD START OR EARLY HEAD START PROGRAM

DESCRIPTION AMOUNT SHARE PERCENTAGE

Amount/Share percentageprovided by the Federalgovernment

$4,000,000.00 80%

Amount/Share percentageprovided by the recipient orother non‐Federal entities(i.e., non‐Federal Share ofProperty Cost)

$1,000,000.00 20%

Total cost/share percentage $5,000,000.00 100%

EXAMPLE I: SINGE FEDERAL FUNDING SOURCE

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14e. EXAMPLE II

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14e. Real Property Ownership Type(s):___A. Owned ___ B. Co‐Owned ___ C. Fee Simple ___ D. Corporate ___ E. Joint Tenancy X_ F. Partnership ___ G. Limited Liability Partnership ___ H. Co‐Operative ___ I. Government Furnished Property ___ J. Other (Describe):___________________________________________________ Check the applicable box(es) to indicate the real property ownership type(s). Ifmore than one type is applicable, check all that apply. If the ownership typeslisted do not apply, check “J. Other” and describe the ownership arrangement.Example of Other: Conservation Easement

14f. Real Property Cost: $2,500,000.00 Share Percentage 50%: Federal Share: $ $2,500,000.00 [50%] Non‐Federal Share: $ $2,500,000.00 [50%] Total (Federal and Non‐Federal Share): $5,000,000.00 [100%] Enter the total cost of the real property acquired (purchase price only) orimproved, including the following data.If multiple Federal agencies are contributing to the acquisition or improvementof the real property, attach a separate sheet to identify each agency and theircontribution using the following format:

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$500,000.00 10%


$125,000.00 2.5%

Total cost/share percentage $625,000.00 12.5%

EXAMPLE II: MULTIPLE FEDERAL FUNDING SOURCE

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FEDERAL FUNDED HOUSING PROGRAM



$2,000,000.00 40%


$2,375,000.00 47.5%

Total cost/share percentage $4,375,000.00 87.5%

EXAMPLE II: MULTIPLE FEDERAL FUNDING SOURCE

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14g. Has a deed, lien, covenant, or other related documentation beenrecorded to establish Federal interest in this real property?_X__ Yes ___ No ___ N/ACheck either “yes” or “no” to indicate if the documentation has beenrecorded. If the awarding agency has not imposed the requirement torecord Federal interest in the real property, check “NA”.If yes (unless previously reported), describe the instrument used (i.e.,deed, lien, covenant, etc.) and enter the date (01/04/2007) andjurisdiction (Arlington, VA County Clerk’s office, Deed book #54987,page 234) in which it was recorded.• The recordation of Federal interest in real property must be reported

by no later than the next scheduled reporting date after the realproperty has been acquired, improved or donated, or as directed bythe awarding agency in the award document.

• The recipient must maintain records of the recordation of Federalinterest in real property and make such records available upon therequest of the Federal government.

74

14h. Has Federally required insurance coveragebeen secured for this real property? _X_ Yes ___ NoCheck either “yes” or “no” to indicate if Federallyrequired insurance has been secured for the realproperty.The recipient must maintain records of theinsurance coverage that has been secured for thereal property and make the records available uponthe request of the Federal government.Note: Recipients must provide insurance coveragefor any real property acquired under a Federalfinancial assistance award that is, at a minimum,equivalent to insurance coverage that the recipientprovides for other real property they own.

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14i. Are there any Uniform Relocation Act (URA) requirements applicable to this real property? _X_Yes ___ No If the acquisition or development of the real property involvedthe movement of any person permanently from real property orthe movement of personal property from real property directlybecause of acquisition, rehabilitation, or demolition for anactivity undertaken with Federal assistance, the UniformRelocation Act (URA) requirements may apply. Indicate if the Actapplies by checking “yes or no”.If the Act does apply, the recipient must maintain records ofcompliance and make such information available upon therequest of the Federal government.The Uniform Relocation Act states “To provide for uniform andequitable treatment of persons displaced from their homes,businesses, or farms by Federal and federally assisted programsand to establish uniform and equitable land acquisition policiesfor Federal and federally assisted programs”. 76

14j. Are there any environmental compliancerequirements related to the real property? _X_ Yes___ NoIf yes, describe them (attach additional sheets ifnecessary): Example: Asbestos exposure to thechildren and staff in the last 12 months. Theagency has eliminated the risk of asbestosexposure, by removing all such products in thefacility.The recipient must maintain records of compliancewith all environmental requirements related to thereal property and make such information availableupon the request of the Federal government.

77

14k. In accordance with the National HistoricPreservation Act (NHPA), does the property possesshistoric significance, and/or is it listed or eligible forlisting in the National Register of Historic Places? ___Yes _X__ No If yes, describe them (attach additionalsheets if necessary): In accordance with Section 106 of theNational Historic Preservation Act (NHPA), does theproperty possess historic significance, and/or is it listed oreligible for listing in the National Register of HistoricPlaces?Describe any historical significance, National Register ofHistoric Places listing or eligibility for such listing, relatedto the real property.Note, any property listed in, or eligible for listing in theNational Register of Historic Places is considered historic.

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79

Section 106 protections also extend to properties thatpossess significance but have not yet been listed orformally determined eligible for listing.The National Historic Preservation Act (NHPA)states “the spirit and direction of the Nation arefounded upon and reflected in its historic heritage;the historical and cultural foundations of theNation should be preserved as a living part of ourcommunity life and development; and historicproperties significant to the Nationʹs heritage arebeing lost or substantially altered, ofteninadvertently, with increasing frequency”.

15. Has a significant change occurred with the realproperty, or is there an anticipated change expectedduring the next reporting period? ___ Yes _X_ NoCheck the applicable block to indicate either “yes” or“no.”If a significant change has occurred (or is anticipated tooccur during the next reporting period), such as a majorbuilding renovation or remodeling, damage to the realproperty due to an act of God (flood, hurricane,earthquake, etc.) or other significant change that wouldaffect the value of the property, describe the change.Attach additional sheets if necessary.Note: If a significant change has occurred, 14f. should berecalculated to reflect the change in Federal interest, ifany.

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16. Real Property Disposition Status: Check the appropriate block (A – F) to indicate the type of disposition status being reported, if any. _X__ A. Sold ___ B. Transferred to different award ___ C. Used in other Federally sponsored project/program ___ D. Transferred title ___ E. Retained Title ___ F. N/A

i. If the Federal agency provided the recipient withdisposition instructions to sell or retain title to the realproperty, enter the amount of funds owed to the Federalgovernment. Enter the amount of funds owed to theFederal government as compensation for the Federalinterest in the real property if the awarding agency eitherdirected the recipient to sell or granted them permissionto retain title to the real property._______$200,000.00_________________________________ 81

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ii. If applicable, enter the amount of any netproceeds from the sale of the real property anddescribe how the proceeds were distributed. Ifapplicable, enter the amount of any net proceedsfrom the sale of the real property and indicate if theywere returned to the Federal government, used as anoffset toward the cost of acquiring replacement realproperty for the project or program, or used to offsetthe original cost of the real property if the award isstill active. If not applicable enter“NA.”________________________________________________________________________________________

iii. If the Federal agency directed the recipient totransfer title to the real property, enter the amount offunds the Federal agency owes. If the recipient wasdirected to transfer title to either the Federal agency orto a third party identified by the Federal agency, enterthe amount of funds the Federal agency owes therecipient as compensation for their interest in the realproperty (i.e., the percentage of the recipient’sparticipation in the project cost multiplied by the fairmarket value of the real property at the time ofdisposition). ___________________________________

83

17. Indicate the cumulative energy consumption for the previous12 months:Cumulative Energy Use may be obtained from the facility utilitybills or outreach to the utility provider. Depending on the locality,the bill may include only the current month or may include thetotal for the 12 months prior and post project completion.When the grantee is one tenant in a multi‐tenant facility ANDseparate utility metering is not in place, pro rata estimating isappropriateThe anticipated energy consumption, post completion for newconstruction and renovation projects, should be available in theproject plan.Use of the Portfolio Manager tool, a free application, is encouraged for the tracking of energy consumption data. (http://www.energystar.gov/index.cfm?c=evaluate_performance.bus_portfoliomanager) A. Electric (kWh)_12000_____ or (Btu) _________ B. Petroleum (Gal) __10,000__ C. Natural Gas (cu ft) ________D. Other (Specify)_______

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18. Remarks. Enter any explanations deemednecessary or information required by the Federalagency including any remarks that the recipientwould like to make to address issues that are notaddressed elsewhere in this report.Attach additional sheets if necessary. _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

85


No Property Attachment A (SF‐429A)

86

SF‐429‐A No Property• SF-429-A No Property must be

submitted annually on the samedate the grantee’s annual SF-425Federal Financial Report for thebudget period is due.o A separate Attachment A is required when there

is no real property.87

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Real Property Status Report ATTACHMENT A (General Reporting) SF‐429‐A

Real Property Details. Provide the requested information in subsections 13through 18 of AttachmentA for each parcel of real property being reported.Use a separate sheet to report information on each parcel of real propertyunder the Federal Financial Assistance award identified in section 2.If a section does not apply, enter “N/A.” Below is a summary of the requiredinformation to be provided for each subsection of AttachmentA:

13. Period and type of Federal Interest (MM/DD/YYYY): From: To:___Acquisition ___ Renovation ___ Construction ___ Government Furnished Property Enter the period, established in the award document, during which Federalinterest in the real property begins (i.e., From) and ends (i.e., To) using(MM/DD/YYYY) format. [ex., From: 03/23/2005 To: 03/22/2025].This period may exceed the grant award performance period in those instanceswhere Federal interest continues beyond the end of the current award.In some instances the end date for the period of Federal interest may not bedefined by a specific date.If that is the case, enter the beginning date along with a statement to indicate theplanned or uncertain end date (ex. “From: 03/23/2005 To: Expiration of FederalInterest”).

88

14a. Description of Real Property. Describe the type of real property beingreported (i.e., land, building, etc.) and provide a useful description of thereal property (i.e., building number 17 at the National Research Center,Chapel Hill, NC).If the real property is being renovated or altered, also describe the nature ofthe work (i.e., major renovation of building 17, wing c).

14b. Address of Real Property. Enter the legal description and completeaddress for each parcel of real property being reported including the street,city, state, county/parish, country, zip code, and physical location if anaddress is not available (i.e., latitude, longitude, lot number, parcel number,etc.).N/AAlso, indicate zoning information related to the real property (i.e., mixeduse, residential, commercial, etc.).

89

14c. Land Acreage or Square Units: Enter the size of the land or the size of the land on which the real property is located in terms of measured acreage or square units (i.e., 1.5 acres, 0.8 sq. km., etc.). Enter Amount:_______Identify the unit of measure. Use only one option, either acres, square kilometers, square feet, or square meters. Select units: __ Acres __Square Feet __Square Kilometers __ Square Meters

14d. Gross and Usable Square Footage/Meters (i.e., of building, house, etc.): Enter the gross and usable square footage/meters for each structure (i.e., of the building, house, etc.) being reported. Enter Amounts: Gross _________ Usable _______Identify the unit of measure. Select only one, either square feet or square meters. Select Units: __ Square Feet __Square Meters 90

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14e. Real Property Ownership Type(s):___A. Owned ___ B. Co‐Owned ___ C. Fee Simple ___ D. Corporate ___ E. Joint Tenancy ___ F. Partnership ___ G. Limited Liability Partnership ___ H. Co‐Operative ___ I. Government Furnished Property ___ J. Other (Describe):___________________________________________________ Check the applicable box(es) to indicate the real property ownership type(s).If more than one type is applicable, check all that apply. If the ownershiptypes listed do not apply, check “J. Other” and describe the ownershiparrangement. Example of Other: Conservation Easement

14f. Real Property Cost: Share PercentageFederal Share: $ [%] Non‐Federal Share: $ [%] Total (Federal and Non‐Federal Share): [%]

91

14g. Has a deed, lien, covenant, or other relateddocumentation been recorded to establish Federalinterest in this real property?___ Yes ___ No ___ N/ACheck either “yes” or “no” to indicate if thedocumentation has been recorded. If the awardingagency has not imposed the requirement to recordFederal interest in the real property, check “NA”.

92

14h. Has Federally required insurance coveragebeen secured for this real property? __ Yes ___ NoCheck either “yes” or “no” to indicate if Federallyrequired insurance has been secured for the realproperty.The recipient must maintain records of theinsurance coverage that has been secured for thereal property and make the records available uponthe request of the Federal government.Note: Recipients must provide insurance coveragefor any real property acquired under a Federalfinancial assistance award that is, at a minimum,equivalent to insurance coverage that the recipientprovides for other real property they own.

93

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14i. Are there any Uniform Relocation Act (URA) requirements applicable to this real property? __ Yes ___ No If the acquisition or development of the real propertyinvolved the movement of any person permanently fromreal property or the movement of personal property fromreal property directly because of acquisition, rehabilitation,or demolition for an activity undertaken with Federalassistance, the Uniform Relocation Act (URA) requirementsmay apply. Indicate if the Act applies by checking “yes orno”.If the Act does apply, the recipient must maintain records ofcompliance and make such information available upon therequest of the Federal government.

94

14j. Are there any environmental compliancerequirements related to the real property? __Yes ___ NoIf yes, describe them (attach additionalsheets if necessary): The recipient mustmaintain records of compliance with allenvironmental requirements related to the realproperty and make such information availableupon the request of the Federal government.

95

14k. In accordance with the National HistoricPreservation Act (NHPA), does the property possesshistoric significance, and/or is it listed or eligible forlisting in the National Register of Historic Places? ___Yes ___ No If yes, describe them (attach additionalsheets if necessary): In accordance with Section 106 of theNational Historic Preservation Act (NHPA), does theproperty possess historic significance, and/or is it listed oreligible for listing in the National Register of HistoricPlaces?Describe any historical significance, National Register ofHistoric Places listing or eligibility for such listing, relatedto the real property.Note, any property listed in, or eligible for listing in theNational Register of Historic Places is considered historic.

96

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15. Has a significant change occurred with the realproperty, or is there an anticipated change expectedduring the next reporting period? ___ Yes __ NoCheck the applicable block to indicate either “yes” or“no.”If a significant change has occurred (or is anticipated tooccur during the next reporting period), such as a majorbuilding renovation or remodeling, damage to the realproperty due to an act of God (flood, hurricane,earthquake, etc.) or other significant change that wouldaffect the value of the property, describe the change.Attach additional sheets if necessary.Note: If a significant change has occurred, 14f. should berecalculated to reflect the change in Federal interest, ifany.

97

16. Real Property Disposition Status: Check the appropriate block (A – F) to indicate the type of disposition status being reported, if any. ___ A. Sold ___ B. Transferred to different award ___ C. Used in other Federally sponsored project/program ___ D. Transferred title ___ E. Retained Title ___ F. N/A

i. If the Federal agency provided the recipient withdisposition instructions to sell or retain title to the realproperty, enter the amount of funds owed to the Federalgovernment. Enter the amount of funds owed to theFederal government as compensation for the Federalinterest in the real property if the awarding agency eitherdirected the recipient to sell or granted them permissionto retain title to the real property.____________________________________________

98

99

ii. If applicable, enter the amount of any netproceeds from the sale of the real property anddescribe how the proceeds were distributed. Ifapplicable, enter the amount of any net proceedsfrom the sale of the real property and indicate if theywere returned to the Federal government, used as anoffset toward the cost of acquiring replacement realproperty for the project or program, or used to offsetthe original cost of the real property if the award isstill active. If not applicable enter“NA.”________________________________________________________________________________________

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iii. If the Federal agency directed the recipient totransfer title to the real property, enter the amount offunds the Federal agency owes. If the recipient wasdirected to transfer title to either the Federal agency orto a third party identified by the Federal agency, enterthe amount of funds the Federal agency owes therecipient as compensation for their interest in the realproperty (i.e., the percentage of the recipient’sparticipation in the project cost multiplied by the fairmarket value of the real property at the time ofdisposition). ___________________________________

100

17. Indicate the cumulative energy consumption for the previous12 months:Cumulative Energy Use may be obtained from the facility utilitybills or outreach to the utility provider. Depending on the locality,the bill may include only the current month or may include thetotal for the 12 months prior and post project completion.When the grantee is one tenant in a multi‐tenant facility ANDseparate utility metering is not in place, pro rata estimating isappropriateThe anticipated energy consumption, post completion for newconstruction and renovation projects, should be available in theproject plan.Use of the Portfolio Manager tool, a free application, is encouraged for the tracking of energy consumption data. (http://www.energystar.gov/index.cfm?c=evaluate_performance.bus_portfoliomanager) A. Electric (kWh)______ or (Btu) _________ B. Petroleum (Gal) _______ C. Natural Gas (cu ft) ________D. Other (Specify)_______

101

18. Remarks. Enter any explanations deemednecessary or information required by the Federalagency including any remarks that the recipientwould like to make to address issues that are notaddressed elsewhere in this report.Attach additional sheets if necessary. __No Property for which to Report____________________________

102

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ATTACHMENT B (Request to Acquire,

Improve or Furnish) SF‐429‐B

103

SF‐429‐B Request to Acquire,

Improve, or Furnish

• SF-429-B Request to Acquire, Improve, orFurnish must be submitted along with theadditional information required by 45 CFR §1303 Subpart E whenever a grantee isseeking ACF approval to use Head Startfunds to engage in purchase, construction,or major renovation of facilities as defined in45 CFR § 1305.2.

104

SF‐429‐B Request to Acquire,

Improve, or Furnisho Information included in SF-429-B can be

cross-referenced if also required by 45 CFR §1303 Subpart E.

o A request to acquire property includes theuse of Head Start funds to engage in allpurchase activities defined in 45 CFR §1305.2, including payments made insatisfaction of a mortgage or other loanagreement.

105

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Real Property Status Report ATTACHMENT B

(Request to Acquire, Improve or Furnish) SF‐429‐B

Real Property Details. Complete the applicable information insubsections 13a. through 15. of Attachment B for each parcel ofreal property for which the recipient is requesting the authorityto acquire, improve, or be provided as Government FurnishedProperty (GFP).This attachment should only be used if the applicable programauthority or budget allows recipients to acquire, improve orfurnish real property.Use a separate sheet for each parcel of real property under theFederal financial assistance award identified in section 2.With the exception of 15, all sections are required to becompleted for all requests. Below is a summary of the requiredinformation to be provided for each subsection of Attachment B:

106

13a. Description of Real Property. Describe the type of real propertybeing reported (i.e., land, building, etc.) and provide a usefuldescription of the real property (i.e., building number 17 at theNational Research Center, Chapel Hill, NC). If the real property isbeing renovated or altered, also describe the nature of the work (i.e.,major renovation of building 17, wing c).

13b. Address of Real Property. Enter the legal description andcomplete address for each parcel of real property being reportedincluding the street, city, state, county/parish, country, zip code, andphysical location if an address is not available (i.e., latitude,longitude, lot number, parcel number, etc.).NEXT SLIDE INCLUDES MORE DETAIL REGARDING THEADDRESSNOTE: PARCEL NUMBER13‐DIGTIT NUMBER THAT ACOMMUNITY’S TAX ASSESSOR ASSIGNS.Also, indicate zoning information related to the real property (i.e.,mixed use, residential, commercial, etc.).

107

Where an address is not available, or more precisionis required, geographic coordinates may be used.Locational data should be recorded with a GlobalPositioning System (GPS) device set to NAD 83, orWGS 84 datum using either of the followingcoordinate reference systems:• United States National Grid (USNG) using the fullgrid zone designation and a minimum of eightdigits.


108

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14a. Describe the intended use of the realproperty and how it will benefit the program:Describe how the recipient intends to use the real propertythat they want to acquire, improve or furnish to support theprogram under which it is being funded.Describe how the acquisition, improvement or furnishing (asapplicable) of the real property will benefit the program inquantifiable terms (ex., lower cost than renting or purchasingwith a comparison of the two, improved service deliveryusing benchmarks to demonstrate anticipatedimprovements, etc.). Attach additional sheets if necessary.

The facility will be used to provide Head Startservices to children enrolled in a center‐baseoption. The agency will own the propertyeliminating the rental costs of a facility.

109

14b. Real Property Ownership Type(s):Check the applicable box(es) to indicate the realproperty ownership type(s). If more than one typeis applicable, check all that apply. If the ownershiptypes listed do not apply, check “J. Other” anddescribe the ownership arrangement. Example ofOther: Conservation Easement_X__ A. Owned ___ B. Co‐Owned ___ C. FeeSimple ___ D. Corporate ___ E. Joint Tenancy ___F. Partnership ___ G. Limited LiabilityPartnership ___ H. Co‐Operative ___ I.Government Furnished Property ___ J. Otherescribe):___________________________

110

14c. Proposed Acquisition Date (MM/DD/YYYY): 09/01/2017Using (MM/DD/YYYY) format, enter the proposed date for the real property acquisition or improvement, or the date the recipient would like the government to furnish real property.

111

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14d. Land Acreage or Square Units: Enter the size of the land or the size of the land on which the real property is located in terms of measured acreage or square units (i.e., 1.5 acres, 0.8 sq. km., etc.). Enter Amount:____30 acres___Identify the unit of measure. Use only one option, either acres, square kilometers, square feet, or square meters. Select units: _X_ Acres __Square Feet __Square Kilometers __ Square Meters

14e. Gross and Usable Square Footage/Meters (i.e., of building, house, etc.): Enter the gross and usable square footage/meters for each structure (i.e., of the building, house, etc.) being reported. Enter Amounts: Gross __27,000______ Usable __25,000__ Identify the unit of measure. Select only one, either square feet or square meters. Select Units: _X_ Square Feet __Square Meters 112

14f. Appraised Value (Valuation): $4,000,000.00 Share Percentage 80%: Federal Share: $ $4,000,000.00 [80%]Non‐Federal Share: $ $1,000,000.00 [20%]

Total (Federal and Non‐Federal Share): $5,000,000.00 [100%]

Enter the appraised value (valuation) of the realproperty to be acquired (purchase price only), or thecost of proposed improvements, including thefollowing.If multiple Federal agencies will contribute to theacquisition or cost to improve the real property, attach aseparate sheet to identify each agency and theircontribution using the format :

113

1. Amount to be provided by the Federal government (i.e., FederalShare of Appraised Property Value or estimated improvement costbased on the Federal share of the total cost of the program or project),2. Share percentage to be provided by the Federal government (i.e.,Federal Share Percentage of Appraised Property Value or estimatedimprovement cost based on the Federal share of the total cost of theprogram or project),3. Amount to be provided by the recipient or other non‐Federalentities (i.e., non‐Federal Share of Appraised Property Value orestimated improvement cost),4. Share percentage to be provided by the non‐Federal entities, (i.e.,non‐Federal Share Percentage of Appraised Property Value orestimated improvement cost),5. Total cost (i.e., sum of Federal and non‐Federal Share of theAppraised Value or estimated improvement cost of the property),and6. Total share percentage (i.e., sum of share percentages of Federaland non‐Federal Share of the Appraised Property Value or estimatedimprovement cost).

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Federal Share/Percentage ofAppraised Property Value orestimated improvement cost

$4,000,000.00 80%

Recipient Share/Percentageof Appraised Property Valueor estimated improvementcost

$1,000,000.00 20%



115

14g. Are there any Uniform Relocation Act (URA)requirements applicable to this real property? _X__ Yes___ NoIf the acquisition or development of the real propertythat is the subject of this request involves the movementof any person permanently from real property or themovement of personal property from real propertydirectly because of acquisition, rehabilitation, ordemolition for an activity undertaken with Federalassistance, the Uniform Relocation Act (URA)requirements may apply.Indicate if the Act does apply by checking “yes or no.”If the Act does apply, the recipient must maintain recordsof compliance and make such information available uponthe request of the Federal government.

116

14h. Are there any environmental compliancerequirements related to the real property? _X_ Yes ___ NoIf yes, describe them (attach additional sheets if necessary):Check either “yes” or “no” to indicate if there are anyenvironmental compliance requirements related to the realproperty.Describe any environmental compliance requirementsrelated to the real property.Example: Asbestos exposure to the children and staff inthe last 12 months. The agency has eliminated the risk ofasbestos exposure, by removing all such products in thefacility.The recipient must maintain records of compliance with allrelated environmental compliance requirements and makesuch information available upon the request of the Federalgovernment.

117

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14i. In accordance with the National HistoricPreservation Act (NHPA), does the property possesshistoric significance, and/or is it listed or eligiblefor listing in the National Register of HistoricPlaces? ___ Yes __X_ NoIf yes, describe them (attach additional sheets ifnecessary): In accordance with the Section 106 of theNational Historic Preservation Act (NHPA), does theproperty possess historic significance, and/or is itlisted or eligible for listing in the National Register ofHistoric Places?Describe any historical significance, NationalRegister of Historic Places listing or eligibility forsuch listing, related to the real property.

118

119

Note, any property listed in, or eligible for listing in theNational Register of Historic Places is considered historic.Section 106 protections also extend to properties that possesssignificance but have not yet been listed or formallydetermined eligible for listing. The National HistoricPreservation Act (NHPA) states “the spirit and direction ofthe Nation are founded upon and reflected in its historicheritage; the historical and cultural foundations of theNation should be preserved as a living part of ourcommunity life and development; and historic propertiessignificant to the Nationʹs heritage are being lost orsubstantially altered, often inadvertently, with increasingfrequency”.

14j. Does the proposed action employ green/sustainablepractices (check all that apply)?A._X__ Integrated Design Principles? includes a

collaborative, integrated planning and designprocess and commissioning.(https://www.wbdg.org/design/engage_process.php).

B. _X__ Enhances Indoor Environmental Quality? includes‐ventilation and thermal comfort,‐moisture control,‐day lighting,‐low‐emitting materials,‐protection of indoor air quality during construction,and‐environmental tobacco smoke control(http://www.wbdg.org/design/ieq.php).

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121

C. _X__ Protects and Conserves Water (anticipated water reduction)? includes potable and potable indoor water (htp://www.wbdg.org/design/dd_plumbingeng.php), outdoor water in landscape, irrigation, and storm runoff (http://www.wbdg.org/design/dd_landscapearch.php), process water, and water‐efficient products such as EPA Water Sense products (http://www.epa.gov/watersense).

D. _X__ Reduces Environmental Impact of Materials? includes recycled content (www.epa.gov/cpg), bio‐based content (www.usda.gov/biopreferred), environmentally preferable products (www.wbdg.org/design/greenspec.php), water and materials management, and elimination of ozone depleting compounds (http://www.wbdg.org/design/greenspec.php).

E. _X_ Optimizes Energy Performance (anticipated energy reduction)? includes energy efficiency (http://www.wbdg.org/references/mou_ee.php) (http://www.wbdg.org/design/dd_hvaceng.php) that takes into account intended use, occupancy, plug loads, on‐site renewable energy, measurement/verification, benchmarking, and where available using Energy Star® (http://www.energystar.gov/index.cfm?fuseaction=find_a_product) and Department of Energy‐designated energy efficient products (http://www1.eere.energy.gov/femp/technologies/eep_purchasingspecs.html).

122

14k. What was the cumulative energy consumption for the facility in the past 12months?:Complete the appropriate block(s) (A – D) to indicate the actual cumulativeenergy consumption for the property during pervious 12 months.If this is a request to be furnished real property (GFP), unless you already have theinformation, insert “NA” in block D.Cumulative Energy Use may be obtained from the facility utility bills or outreachto the utility provider.Depending on the locality, the bill may include only the current month or mayinclude the total for the 12 months prior and post project completion.When the grantee is one tenant in a multi‐tenant facility AND separate utilitymetering is not in place, pro rata estimating is appropriateThe anticipated energy consumption, post completion for new construction andrenovation projects, should be available in the project plan.Use of the Portfolio Manager tool, a free application, is encouraged for thetracking of energy consumption data.(http://www.energystar.gov/index.cfm?c=evaluate_performance.bus_portfoliomanager)NOT AVAILABLE UNTIL JUNE 2018A. Electric (kWh)_12000_____ or (Btu) _________ B. Petroleum (Gal) __10,000__ C. Natural Gas (cu ft) ________D. Other (Specify)_______

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14l. What is the anticipated cumulative energy usefor the 12 months following completion of theproposed acquisition/construction/renovationproject?A. Electric (kWh)_11000_____ or (Btu) _________ B. Petroleum (Gal) __9,000__ C. Natural Gas (cu ft) ________D. Other (Specify)_______ Complete the appropriate block(s) (A – D) toindicate the anticipated cumulative energy use forthe property after the property is acquired,constructed, renovated or furnished as GFP.

124

15. Remarks. Enter any explanations deemednecessary or information required by the Federalagency including any remarks that the recipientwould like to make to address issues that are notaddressed elsewhere in this request. Attachadditional sheets ifnecessary._______________________________________________________________________________________________________________________________________________________________________________

125


ATTACHMENT C (Disposition or

Encumbrance Request) SF‐429‐C

126

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SF‐429‐C Disposition or Encumbrance Request

• SF-429-C Disposition or Encumbrance Request

must be submitted at closeout and whenever a

grantee is seeking ACF approval to sell, transfer,

or encumber property subject to a federal

interest, including the refinancing of existing

indebtedness and subordination of a federal

interest to the rights of a lender under 45 CFR §

1303.51. 127

SF‐429‐C Disposition or Encumbrance Request

o SF-429-C implements the requirements for grantees makingrequests for disposition of real property under 45 CFR § 75.318.

o Any use of real property subject to a federal interest ascollateral for a loan or mortgage requires prior approval, andan encumbrance includes the use of Head Start funds to makepayments for a previously purchased facility under 45 CFR §1303.41 and any use of property subject to a federal interest ascollateral for future borrowing.

o ACF-IM-HS-12-08 remains in effect and provides a simplifieddisposition process for older modular units.

128

Real Property Status Report ATTACHMENT C

(Disposition or Encumbrance Request) SF‐429‐C

Real Property Details. Complete the applicable informationin subsections 13a. through 16. of Attachment C for eachparcel of real property for which the recipient is requestingdisposition/encumbrance or other instructions.Use a separate sheet to request disposition/encumbrance orother instructions on each parcel of real property under theFederal financial assistance award identified in section 2.If a section does not apply, enter “N/A.”Included is a summary of the required information to beprovided for each subsection of Attachment C:

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13a. Description of Real Property. Describe the type of realproperty that is the subject of this request (i.e., land, building,etc.) and a useful description of the real property (i.e., buildingnumber 17 at the National Research Center, Chapel Hill, NC).

13b. Address of Real Property. Enter the legal description andcomplete address for each parcel of real property including thestreet, city, state, county/parish, country, zip code, and physicallocation if an address is not available (i.e., latitude, longitude,lot number, parcel number, etc.).NEXT SLIDE INCLUDES MORE DETAIL REGARDINGTHE ADDRESSNOTE: PARCEL NUMBER13‐DIGTIT NUMBER THAT ACOMMUNITY’S TAX ASSESSOR ASSIGNS.Also, indicate zoning information related to the real property(i.e., mixed use, residential, commercial, etc.).

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Where an address is not available, or more precision isrequired, geographic coordinates may be used.Locational data should be recorded with a GlobalPositioning System (GPS) device set to NAD 83, orWGS 84 datum using either of the followingcoordinate reference systems:• United States National Grid (USNG) using the fullgrid zone designation and a minimum of eightdigits.


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13c. Land Acreage or Square Units: Enter Amount:_____30 acres______Select units: _X_ Acres __Square Feet __Square Kilometers __ Square Meters Enter the size of the land or the size of the land on which the realproperty is located in terms of measured acreage or square units(i.e., 1.5 acres, 0.8 sq. km., etc.).Identify the unit of measure. Use only one option, either acres,square kilometers, square feet, or square meters.

13d. Gross and Usable Square Footage/Meters (i.e., of building, house, etc.): Enter Amounts: Gross __27,000_________ Usable __25,000_______ Select Units: _X_ Square Feet __Square Meters Enter the gross and usable square footage/meters for eachstructure (i.e., of the building, house, etc.) being reported. Identifythe unit of measure.Select only one, either square feet or square meters.

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14a. Disposition Preference or Encumbrance Request[Check one]:_X__A. Sell ___B. Transfer to different award ___C. Use inother Federally sponsored project/program ____D. Transfertitle ___E. Retain Title ___F. Encumber PropertyCheck the appropriate block (A – F) to indicate the type ofdisposition/encumbrance instruction preference beingrequested. The award document will indicate the dispositionoption(s) available.The recipient may not request a disposition preference that isnot already allowed under the award.Agencies will respond timely to all requests via letter,electronic mail and/or other appropriate means.

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14b. If this is a request to transfer Federal Interest toa different award, specify the proposed grantnumber and funding agency:If the recipient is proposing to transfer the Federalinterest to a different award, specify the grantnumber and funding agency for the award to whichthe recipient is proposing to transfer the interest.The Head Start Program is proposing to transfer theFederal Interest to grant number 0521WH‐2222. TheAdministration for Homeland Security shall be theagency funding the program.

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14c. If this is a request to use the real property in otherFederal‐sponsored projects/activities, describe the proposeduse of the real property:If the recipient is proposing to use the real property toprovide services or facilities for other Federal‐sponsoredprojects or activities, identify the other Federal projects oractivities and how the real property will be utilized.Also, describe any impact expected on the host Federal projector activity due to the proposed additional use of the realproperty. Attach additional sheets if necessary.The Head Start center will be used by the Adult Day Careprogram to provide setting services from 7:00PM to 12:00AMdaily.The use of the facility by the Adult Day Care program willhave no impact on the provision of Head Start services.

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14d. If this is a request to transfer title, identify the proposed receiving entity: If applicable, provide contact information for the proposed receiving entity.The Tile shall e transferred to ABC Health Center of Jones County

14e. Appraised Value (Valuation): $4,000,000.00 Share Percentage 80%: Federal Share: $ $4,000,000.00 [80%]Non‐Federal Share: $ $1,000,000.00 [20%]Total (Federal and Non‐Federal Share): $5,000,000.00 [100%]

Enter the appraised value (valuation) of the real property to beacquired (purchase price only), or the cost of proposedimprovements, including the following.If multiple Federal agencies will contribute to the acquisition orcost to improve the real property, attach a separate sheet toidentify each agency and their contribution using the format :

1. Amount to be provided by the Federal government (i.e., FederalShare of Appraised Property Value or estimated improvement costbased on the Federal share of the total cost of the program orproject),2. Share percentage to be provided by the Federal government (i.e.,Federal Share Percentage of Appraised Property Value or estimatedimprovement cost based on the Federal share of the total cost of theprogram or project),3. Amount to be provided by the recipient or other non‐Federalentities (i.e., non‐Federal Share of Appraised Property Value orestimated improvement cost),4. Share percentage to be provided by the non‐Federal entities, (i.e.,non‐Federal Share Percentage of Appraised Property Value orestimated improvement cost),5. Total cost (i.e., sum of Federal and non‐Federal Share of theAppraised Value or estimated improvement cost of the property),and6. Total share percentage (i.e., sum of share percentages of Federaland non‐Federal Share of the Appraised Property Value or estimatedimprovement cost)

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Federal Share/Percentage ofAppraised Property Value orestimated improvement cost

$4,000,000.00 80%

Recipient Share/Percentageof Appraised Property Valueor estimated improvementcost

$1,000,000.00 20%



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14f. Are there any Uniform Relocation Act(URA) requirements applicable to this realproperty? ___ Yes __X_ NoIf the acquisition or development of the real propertyinvolved the movement of any person permanentlyfrom real property or the movement of personalproperty from real property directly because ofacquisition, rehabilitation, or demolition for an activityundertaken with Federal assistance, the UniformRelocation Act (URA) requirements may apply. Indicateif the Act does apply by checking “yes or no”. If the Actdoes apply, the recipient must maintain records ofcompliance and make such information available uponthe request of the Federal government.

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14g. Are there any environmental compliancerequirements related to the real property? ___ Yes _X__No If yes, describe them (attach additional sheets ifnecessary):Check either “yes” or “no” to indicate if there are anyenvironmental compliance requirements related to thereal property.Describe any environmental compliance requirementsrelated to the real property.The recipient must maintain records of compliance withall environmental requirements related to the realproperty and make such information available upon therequest of the Federal government.Attach additional sheets if necessary.

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14h. In accordance with the National Historic Preservation Act(NHPA), does the property possess historic significance, and/or is itlisted or eligible for listing in the National Register of HistoricPlaces? ___ Yes _X__ NoIf yes, describe them (attach additional sheets if necessary): Inaccordance with the Section 106 of the National Historic PreservationAct (NHPA), does the property possess historic significance, and/oris listed or eligible for listing in the National Register of HistoricPlaces?Describe any historical significance, National Register of HistoricPlaces listing or eligibility for such listing, related tothe real property.Note, any property listed in, or eligible for listing in the NationalRegister of Historic Places is considered historic. Section 106protections also extend to properties that possess significance buthave not yet been listed or formally determined eligible for listing.

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14.i. If this is a request to encumber the property, identify the party or parties to whom the property is proposed to be encumbered and attach related information: Identify the party/parties to whom the property is proposed to be encumbered and attach the proposed form and terms of encumbrance, along with a copy of any proposed subordination, inter‐creditor agreement, or other documentation to protect the interests of the U.S. Government in case of default.

15. If this is a request for a release from the obligation to report on the real property, describe the reasons for the request. Describe the recipient’s reasons for requesting a release from the obligation to report. Examples of acceptable reasons include but are not limited to expiration of Federal interest or the real property being disposed of in accordance with agency direction. Attach additional sheets if necessary.

16. Remarks. Enter any explanations deemed necessary or information required by the Federal agency including any remarks that the recipient would like to make to address issues that are not addressed elsewhere in this request.Attach additional sheets if necessary. 142

SUBMISSION• Effective for budget periods beginning on or

after May 1, 2016, all grantees, including

those with no covered real property, are

instructed to prepare and submit SF-429 with

Attachment A on an annual basis at the

same time as their annual SF-425 Federal

Financial Report is due.

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Documents

THE TANGIBLE PERSONAL REPORT - WKU Orgs …orgs.wku.edu/ttas/docs/handouts/2017-09_federal_financial_reports/...PROPERTY REPORT Tangible Personal Property Report ... Closing the Project