Public Library Assistance Grant Final Report Form

ALASKA PUBLIC LIBRARY ASSISTANCE GRANT

FINAL REPORT FY2012

DUE: September 1, 2012

1. / Library Name:
2. / Address: / 3. / Phone No:
City: / Zip: / 4. / Fax No:
5. / Contact Person: / 6. / E Mail:
7. / Number of weeks library was open 10 hours or more:
8. / Final Budget Expenditures
(Including encumbered money) / FY2012 Local and Federal Government and Other Funds spent or encumbered by 6/30/12

(Column A)

/ FY2012 Alaska Public Library Assistance
Grant Funds spent or encumbered
by 6/30/12

(Column B)

/ Total of ALL FY2012 funds spent or encumbered by 6/30/12
(Add Column A to Column B)
a. / Personnel
1. / Salaries and Wages
2. / Benefits
3. / Value of Volunteer Labor / Not applicable
b. / Collection / (Library Materials)
1. / Books in Print
2. / Subscriptions in Print
3. / Audiovisuals
4. / Electronic (Digital) Materials and Online Services(No computers or e-readers.)
5. / Initial $500 Spent on Internet Service Provider (ISP) Fees (Report remaining ISP fees on line c-6. below.No computers or e-readers.)
6. / Other Materials(No computers or e-readers.)
c. / Other Expenditures
1. / Building Operations
2. / Furniture, Equipment, Computers, E-Readers
3. / Travel
4. / Supplies
5. / Services (Do NOTInclude Internet service provider fees on this line.)
6. / Internet Service Provider Fees paid beyond $500 total (List first $500 of ISP fees on line b-5 above.)
7. / All Other Unreported Expenditures
d. / Total

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Final Report Page 2

9. / a. / What was the amount of your Assistance Grant for FY2012? (Most libraries received a library assistance grant for $6,500 in FY2012.)
b. / Amount of grant funds spent or encumbered by 6/30/12
(See Column B total above.)
c. / Unspent FY2012 Grant money (Subtract "b" from "a".)

IF YOU HAVE UNSPENT GRANT MONEY, PLEASE CONTACT PATIENCE FREDERIKSEN

AS SOON AS POSSIBLE AT 907-269-6566 OR AT:

10.List any outstanding encumbrances (Only costs for materials, equipment and contractual services may be encumbered):

11.List equipment costing $200 or more purchased with Public Library Assistance Grant Funds:

Name of ItemSerial No.Cost

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Final Report Page 3

12.Please review the plan and objectives outlined in the FY2012 grant application for your library. What was accomplished and how has your community benefited?

13.Describe any significant problems you encountered while providing service to your community:

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Final Report Page 4

14. Please describe your most successful program(s).

Note:Report Must Have BOTH Signatures

This report was prepared by:

For the LibraryFor the Library Board, Municipality,

University, School District, or Association

Print or TypePrint or Type

SignatureSignature

TitleDateTitleDate

Return to: Alaska State Library, 344 W. 3rd Avenue, Suite 125, Anchorage, AK 99501

Questions? Call Patience Frederiksen 1-800-776-6566 or 269-6566