OMB Control Number 1840-0849 V.1.1 last updated 9/21/2021 Expires 3/31/2024 Quarterly Budget and Expenditure Reporting for HEERF I, II, and III (a)(1) Institutional Portion, (a)(2), and (a)(3), if applicable Institution Name: ___________________________________________________ Date of Report: ______________ Covering Quarter Ending: ______________ PR/Award Number(s): P425F:_________ P425J: _________ P425K: _________ P425L: _________ P425M: _________ P425N: ________
Total Amount of Funds Awarded: Section (a)(1) Institutional Portion: ____________ Section (a)(2): ____________ Section (a)(3): ___________ Final Report? ☐

Category
	Amount in (a)(1)
institutional dollars
	Amount in (a)(2) dollars, if applicable
	Amount in (a)(3) dollars, if applicable
	Explanatory Notes
	
Providing additional emergency financial aid grants to students.1
					
Providing reimbursements for tuition, housing, room and board, or other fee refunds.
					
Providing tuition discounts.
					
Covering the cost of providing additional technology hardware to students, such as laptops or tablets, or covering the added cost of technology fees.
					
Providing or subsidizing the costs of high‐speed internet to students or faculty to transition to an online environment.
					
Subsidizing off‐campus housing costs due to dormitory closures or decisions to limit housing to one student per room; subsidizing housing costs to reduce housing density; paying for hotels or other off‐campus housing for students who need to be isolated; paying travel expenses for students who need to leave campus early due to coronavirus infections or campus interruptions.
					
Subsidizing food service to reduce density in eating facilities, to provide pre‐packaged meals, or to add hours to food service operations to accommodate social distancing.
					
Costs related to operating additional class sections to enable social distancing, such as those for hiring more instructors and increasing campus hours of operations.

1 To support expenses related to the disruption of campus operations due to coronavirus consistent with applicable law. This includes eligible expenses under a student’s cost of attendance under CARES Act Section 18004(c), or any component of a student’s cost of attendance or for emergency costs that arise due to coronavirus, such as tuition, food, housing, health care (including mental health care), or child care, per Section 314(c) of the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSAA), and Section 2003 of the American Rescue Plan Act of 2021 (ARP).

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OMB Control Number 1840‐0849 V.1.1 last updated 9/21/2021 Expires 3/31/2024

Category
	Amount in (a)(1)
institutional dollars
	Amount in (a)(2) dollars, if applicable
	Amount in (a)(3) dollars, if applicable
	Explanatory Notes
	
Campus safety and operations.2
					
Purchasing, leasing, or renting additional instructional equipment and supplies (such as laboratory equipment or computers) to reduce the number of students sharing equipment or supplies during a class period and to provide time for disinfection between uses.
					
Replacing lost revenue from academic sources.3
					
Replacing lost revenue from auxiliary services sources (i.e., cancelled ancillary events; disruption of food service, dorms, childcare, or other facilities; cancellation of use of campus venues by other organizations, lost parking revenue, etc.).3
					
Purchasing faculty and staff training in online instruction; or paying additional funds to staff who are providing training in addition to their regular job responsibilities.
					
Purchasing, leasing, or renting additional equipment or software to enable distance learning, or upgrading campus wi‐fi access or extending open networks to parking lots or public spaces, etc.
					
Other Uses of (a)(1) Institutional Portion funds.4
					
Other Uses of (a)(2) or (a)(3) funds, if applicable.5
					
Quarterly Expenditures for Each Program
					
Total of Quarterly Expenditures

2 Including costs or expenses related to the disinfecting and cleaning of dorms and other campus facilities, purchases of personal protective equipment (PPE), purchases of cleaning supplies, adding personnel to increase the frequency of cleaning, the reconfiguration of facilities to promote social distancing, etc.
3 Please see the Department’s HEERF Lost Revenue FAQs (March 19, 2021) for more information regarding what may be appropriately included in an estimate of lost revenue. 4 Please post additional documentation as appropriate and briefly explain in the “Explanatory Notes” section. Please note that funds for (a)(1) Institutional Portion may be used to defray expenses associated with coronavirus (including lost revenue, reimbursement for expenses already incurred, technology costs associated with a transition to distance education, faculty and staff trainings, and payroll).
5 Please post additional documentation as appropriate and briefly explain in the “Explanatory Notes” section. Please note that funds for (a)(2) and (a)(3) may be used to defray expenses associated with coronavirus (including lost revenue, reimbursement for expenses already incurred, technology costs associated with a transition to distance education, faculty and staff trainings, and payroll).
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OMB Control Number 1840-0849 V.1.1 last updated 9/21/2021 Expires 3/31/2024 Form Instructions

Completing the Form: On each form, fill out the institution of higher education (IHE or institution) name, the date of the report, the appropriate quarter the report covers (September 30, December 31, March 31, June 30), the 11‐digit PR/Award Number (number is found in Box 2 of your Grant Award Notification (GAN)) for each HEERF grant funding stream as applicable, the total amount of funds awarded by the Department (including reserve funds if awarded), and check the box if the report is a “final report.” Institutions that expended HEERF grant funds during the calendar quarter from January 1 – March 30, 2021 are required to post the quarterly report that involved the expenditure of HEERF II CRRSAA and HEERF I CARES Act funds. The Department did not previously affirmatively indicate this reporting requirement was in place for HEERF II CRRSAA funds. As such, institutions may have until the end of the second calendar quarter, June 30, 2021, to post these retroactive reports if they have not already done so. As of the July 10, 2021 quarterly reporting deadline, institutions are encouraged, but not required to, submit the quarterly reports (this institutional reporting form and the student quarterly report) to the Department by emailing those reports as PDF attachments to HEERFreporting@ed.gov.

In the chart, an institution must specify the amount of expended HEERF I, II, and IIII funds for each funding category: (a)(1) Institutional Portion; (a)(2), and (a)(3), if applicable. (a)(2) funds include Assistance Listing Numbers (ALNs) 84.425J (Historically Black Colleges and Universities (HBCUs)), 84.425K (Tribally Controlled Colleges and Universities (TCCUs)), 84.425L (Minority Serving Institutions (MSIs)), 84.425M (Strengthening Institutions Program (SIP)); (a)(3) funds are for ALN 84.425N (Fund for the Improvement of Postsecondary Education (FIPSE) Formula Grant) and 84.425S (SAIHE). Each category is deliberately broad and may not capture specific grant program requirements. Explanatory footnotes help clarify certain reporting categories. While some itemsin the chart are blocked out, please note that the blocking of such items is consistent with Department guidance and FAQs and is not definitive. Provide brief explanatory notes for how funds were expended, including the title and brief description of each project or activity in which funds were expended. Do not include personally identifiable information (PII). Calculate the amount of the (a)(1) Institutional Portion, (a)(2) and (a)(3) funds in the “Quarterly Expenditures for each Program” row, and the grand total of all three in the “Total of Quarterly Expenditures” row. Round expenditures to the nearest dollar. If there is no expenditure to report for a given cell, fill it with a “0.” Please refrain from using any symbols throughout the form, including but not limited to “>” or “~.”

Posting the Form: This form must be conspicuously posted on the institution’s primary website on the same page the reports of the IHE’s activities as to the emergency financial aid grants to students made with funds from the IHE’s allocation under (a)(1) of the CARES Act, CRRSAA, and ARP (Student Aid Portion) are posted. It must be posted as a PDF. No handwritten or scanned PDFs are allowed. Please refrain from adding additional material to the uploaded form. The PDF	must	be	named	in	the	following	manner:	[8-	digit	OPEID]_[Survey	Name]_[Quarter/Year]_[Date	of	Release].	For	example, 01177600_HEERF_Q32021_101021. The 8-digit OPEID can be found at the DAPIP website or the NCES website. In the event a DUNS number applies to multiple OPEIDs, use the OPEID for the campus with the highest enrollment. The quarter pertains to the calendar year, following the same cadence the reporting periods follows. The date of release should be reported as the deadline for form submission, 10 days after the end of each reporting period. A new separate form must be posted covering each quarterly reporting period (September 30, December 31, March 31, June 30), concluding after either (1) posting the quarterly report ending September 30, 2023 or (2) when an institution has expended and liquidated all (a)(1) Institutional Portion, (a)(2), and (a)(3) funds and checks the “final report” box. IHEs must post this quarterly report form no later than 10 days after the end of each calendar quarter (October 10, January 10, April 10, July 10). Each quarterly report must be separately maintained in a PDF document linked directly from the IHE’s HEERF reporting webpage. Reports must be maintained for at least three years after the submission of the final report per 2 CFR § 200.333. Any changes or updates after initial posting must be conspicuously noted after initial posting and the date of the change must be noted in the “Date of Report” line.

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OMB Control Number 1840-0849 V.1.1 last updated 9/21/2021 Expires 3/31/2024 Paperwork Burden Statement
According to the Paperwork Reduction Act of 1995 (PRA), 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 1840-0849. Public reporting burden for this collection of information is estimated to average 2 hours 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. Under the PRA, participants are required to respond to this collection to obtain or retain benefit. If you have any comments concerning the accuracy of the time estimate or suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, application, or survey, please contact HEERFreporting@ed.gov, U.S. Department of Education, 400 Maryland Avenue, SW, Washington, DC 20202.

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