Attachment 1 -Standard Form 424A.pdf
PDF 44 KB Posted
- Attached to
- Integrated Health Initiative (IHI) Activity
- Opportunity number
- 72030625RFA00001
About this file
This is Standard Form 424A (Budget Information for Non-Construction Programs), which is a required federal form for grant applications. The form is divided into six sections: Section A (Budget Summary) for recording grant program details and estimated unobligated funds; Section B (Budget Categories) for itemizing costs across object class categories including personnel, fringe benefits, travel, equipment, supplies, contractual, construction, and other direct/indirect charges; Section C (Non-Federal Resources) for detailing applicant, state and other funding sources; Section D (Forecasted Cash Needs) for quarterly breakdowns; Section E (Budget Estimates) for future funding periods; and Section F (Other Budget Information) for direct/indirect charges and remarks.
This blank template form is associated with USAID's Integrated Health Initiative (IHI) Activity grant opportunity (72030625RFA00001) focused on increasing access to health services in five Afghan provinces. The form is authorized by OMB through February 28, 2025 (OMB Number 4040-0006) and follows Circular A-102 requirements. Grant applicants must use this standardized form to present their detailed budget information in a consistent format for agency review.
Attachment 1 -Standard Form 424A
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Text version
SECTION A - BUDGET SUMMARY
BUDGET INFORMATION - Non-Construction Programs OMB Number: 4040-0006 Expiration Date: 02/28/2025
Grant Program Function or
Activity
(a)
Catalog of Federal Domestic Assistance
Number (b)
Estimated Unobligated Funds New or Revised Budget
Federal (c)
Non-Federal (d)
Federal (e)
Non-Federal (f)
Total (g)
5. Totals
4.
3.
2.
1. $ $ $ $
Standard Form 424A (Rev. 7- 97) Prescribed by OMB (Circular A -102) Page 1
SECTION B - BUDGET CATEGORIES
7. Program Income
d. Equipment
e. Supplies
f. Contractual
g. Construction
h. Other
j. Indirect Charges
k. TOTALS (sum of 6i and 6j)
i. Total Direct Charges (sum of 6a-6h)
(1)
Authorized for Local Reproduction Prescribed by OMB (Circular A -102) Page 1A
Standard Form 424A (Rev. 7- 97)
GRANT PROGRAM, FUNCTION OR ACTIVITY
(2) (3) (4) (5)
Total6. Object Class Categories
a. Personnel
b. Fringe Benefits
c. Travel
SECTION D - FORECASTED CASH NEEDS
14. Non-Federal
SECTION C - NON-FEDERAL RESOURCES
(a) Grant Program (b) Applicant (d) Other Sources(c) State (e)TOTALS
$8.
9.
10.
11.
12. TOTAL (sum of lines 8-11)
15. TOTAL (sum of lines 13 and 14)
13. Federal
Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter
FUTURE FUNDING PERIODS (YEARS)
SECTION F - OTHER BUDGET INFORMATION
SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT
Authorized for Local Reproduction
$16.
17.
18.
19.
20. TOTAL (sum of lines 16 - 19)
21. Direct Charges: 22. Indirect Charges:
23. Remarks:
(a) Grant Program (b)First (c) Second (d) Third (e) Fourth
Standard Form 424A (Rev. 7- 97) Prescribed by OMB (Circular A -102) Page 2
File details come from the government source that posted it. Updated .