SH15-035 FFY15-HSGP - Laserfiche WebLink

Home Browse Search

Darren HigasNyama Commander (509)962-7057 October 6,2015 STEP YES STOP no further NO s your grant agreement less than $25,000?analysis needed,GO to Step 2 GO to Steo 6 Y STEP 2 n your preceding fiscal year,did your YES NO STOP,no further organization receive 80%or more of its annua GO to STEP 3 |analysis needed,GO to gross revenues from federal funding?Y Step 6 STEP 3 n your preceding fiscal year,did your YES NO STOP,no further organization receive $25,000,000 or more in GO to STEP 4 analysis needed GO tofederalfunding?Step 6 STEP 4 Does the public have access to information about YES STOP,no further NO the total compensation*ofsenior executives in anaiysis needed,GO to STEP 5yourorganization?)GO to steo 8 STEP 5 Name:Executive #1 --Totaf Compensation amount 5 Name:Executive #2 Total Compensation amount:$ Name:Executive #3 --------- Total Compensation amount 5 Name:Executive #4 Total Compensation amount S Name:Executive #5 Total Compensation amount $ STEP $ ~ if your organization does not meet these criteria,specífcally identify below g criteria that is not met for your organization:For Example:"Our orqanization received ess than $25,000." We did not receive over 80%or more of its annual gross revenues from federal funds Signature:Date: *Total compensation refers to: •Salary and bonuses •Awards of stock,stock options,and stock appreciation rights •Other compensation including,but not limited to,severance and termination payments •Life insurance value paid on behalf of the employee Additional Resources: http://www.whitehouse.gov/omblopen http://www.brsa.gov/grants/ffata.html http://www.qpo.qov/fdsys/pkqlFR-2010-09-14/odf/2010-22TO5.pdf http://www.qrants.gov/ Page 1 of 3