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

CategoryAmount in (a)(1) institutional dollarsAmount in (a)(2) dollars, if applicableAmount in (a)(3) dollars, if applicableExplanatory Notes
Campus safety and operations.20
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.000
Replacing lost revenue from academic sources.3000
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.).3000
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.000
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.00
Other Uses of (a)(1) Institutional Portion funds.40
Other Uses of (a)(2) or (a)(3) funds, if applicable.500
Quarterly Expenditures for Each Program0118,8120
Total of Quarterly Expenditures118,812
Total of Quarterly Expenditures
Explanatory Notes_Campus safety and operations.2
Explanatory Notes_Replacing lost revenue from academic sources.3
Explanatory Notes_Other Uses of (a)(1) Institutional Portion funds.4
Explanatory Notes_Other Uses of (a)(2) or (a)(3) funds, if applicable.5
Explanatory Notes_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.
Explanatory Notes_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
Explanatory Notes_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.
Explanatory Notes_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.
Amount in (a)(3) dollars, if applicable_Quarterly Expenditures for Each Program
Amount in (a)(3) dollars, if applicable_Campus safety and operations.2
Amount in (a)(3) dollars, if applicable_Replacing lost revenue from academic sources.3
Amount in (a)(3) dollars, if applicable_Other Uses of (a)(2) or (a)(3) funds, if applicable.5
Amount in (a)(3) dollars, if applicable_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.
Amount in (a)(3) dollars, if applicable_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
Amount in (a)(3) dollars, if applicable_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.
Amount in (a)(3) dollars, if applicable_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.
Amount in (a)(2) dollars, if applicable_Quarterly Expenditures for Each Program
Amount in (a)(2) dollars, if applicable_Campus safety and operations.2
Amount in (a)(2) dollars, if applicable_Replacing lost revenue from academic sources.3
Amount in (a)(2) dollars, if applicable_Other Uses of (a)(2) or (a)(3) funds, if applicable.5
Amount in (a)(2) dollars, if applicable_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.
Amount in (a)(2) dollars, if applicable_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
Amount in (a)(2) dollars, if applicable_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.
Amount in (a)(2) dollars, if applicable_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.
Amount in (a)(1) institutional dollars_Quarterly Expenditures for Each Program
Amount in (a)(1) institutional dollars_Campus safety and operations.2
Amount in (a)(1) institutional dollars_Replacing lost revenue from academic sources.3
Amount in (a)(1) institutional dollars_Other Uses of (a)(1) Institutional Portion funds.4
Amount in (a)(1) institutional dollars_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.
Amount in (a)(1) institutional dollars_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
Amount in (a)(1) institutional dollars_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.
Amount in (a)(1) institutional dollars_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.

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).