Form SF-SAC Worksheet & Single Audit Component Checklist For Audits With Fiscal Periods Ending in 2010, 2011 and 2012
Enter and Submit Form SF-SAC data and Single Audit package only at:
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AUDIT COMPONENTS REQUIRED FOR SINGLE AUDIT SUBMISSION:
Single Audit Component Checklist
Attention: Please review your audit report to make sure that Personally Identifiable Information, or PII, is not included. Examples of PII are, but not limited to, Social Security Numbers, account numbers, vehicle identification numbers, copies of cancelled checks, student names, dates of birth, personal addresses or personal phone numbers. ___________________________________________________________________________________________
Please enter the starting pdf file page number for each of the following components. If auditor reports have been completed, then list the starting page number of the combined report for each corresponding report on the checklist. If a component is not required, enter 'N/A' instead of a page number. Each component on the checklist must have a numeric page number or 'N/A' listed.
The following is a key for the Component Checklist
* = Required (cannot be blank or 'N/A').
** = Required if prior audit findings exist.
*** = Required if findings exist.
Note: These codes do not apply to a program specific audit..
Page Number Component
* Financial Statement(s) §__ .310(a)
* Schedule of expenditures of Federal Awards §__ .310(b)
** Summary Schedule of Prior Audit Findings §__ .315(b)
* Opinion on Financial Statements §__ .505(a)
* A-133 Report on Internal Control §__ .505(b) (major programs)
* GAS Report on Internal Control §__ .505(b)
* A-133 Report on Compliance §__ .505(c) (major programs)
* GAS Report on Compliance §__ .505(c)
* Schedule of Findings and Questioned Costs §__ .505(d)
*** Corrective Action Plan (if findings) §__ .315(c)
* Opinion or Disclaimer of Opinion on Schedule of Federal Awards §__ .505(a
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SF-SAC(I)(4-15-2010)
U.S. DEPARTMENT OF COMMERCEEconomics and Statistics Administration
U.S. CENSUS BUREAUInstructions for Form SF-SAC,Reporting on Audits of States, Local Governments and Non-Profit Organizations
For Fiscal Periods Ending in2010, 2011 OR 2012
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of informationunless it displays a valid OMB control number. The valid OMB control number for this information collection is OMB No.0348-0057. The time required to complete this data collection form is estimated to average 59 hours for large auditees(i.e., auditees most likely to administer a large number of Federal awards) and 17 hours for all other auditees. Theseamounts reflect estimates of reporting burden on both auditees and auditors relating to the Form SF-SAC, including thetime to review instructions, obtain the needed data, and complete and review the information.
Circular A-133 §__. 320(b) requires auditees to submit acompleted Form SF-SAC, along with one completereporting package in accordance with the June 26, 2007Federal Register notice, to the Federal clearinghousedesignated by OMB (currently the U. S. Census Bureau).The reporting package is defined in §__. 320(c) of the Circular.Auditees are also required to send a copy of the reportingpackage (or written notification of no findings) (§__. 320(e)) toany pass-through entity from which they receive Federal funds.Submissions to a pass-through entity should not include theForm SF-SAC.
Auditees should not submit a reporting package or FormSF-SAC if their A-133 audit report is included in anotherauditee’s report. Example: If the audit of a state university’sFederal awards is included in the statewide single audit reportand Form SF-SAC, the university should not submit a reportingpackage or Form SF-SAC to the Federal clearinghouse.
This Form SF-SAC version, dated 04-15-2010 should beused for audits covering fiscal periods ending in 2010,2011 and 2012. This Form is only available for submissionon the Federal Audit Clearinghouse (FAC) Web site(http://harvester.census.gov/fac/). Submissions covering fiscalperiods with end dates prior to January 1, 2008 must use oneof the earlier versions of Form SF-SAC available on theFederal Audit Clearinghouse (FAC) Web site(http://harvester.census.gov/fac/). The form dated 8-6-2008must be used for audits covering 2008 and 2009. The formdated 5-2004 must be used for audits covering fiscal periodsending in 2004, 2005, 2006 or 2007. The form dated 3-20-2001must be used for audits covering fiscal periods ending in 2001,2002 or 2003.
Audit threshold for Federal expenditures is $500,000 ormore per year. Beginning with 2004 audit year submissions,the Office of Management and Budget (OMB) Circular A-133(Circular), “Audits of States, Local Governments, and Non-ProfitOrganizations,” requires non-Federal entities that expend$500,000 or more in a year in Federal awards to have an auditconducted in accordance with the Circular. For prior audit years,1997-2003, the audit threshold for Federal expenditures is$300,000 or more per year.
SUBMISSION TO THE FEDERAL AUDITCLEARINGHOUSE – Auditees are required to use theon-line Internet submission option available on theFAC Web site. The only approved Form SF-SAC format is aform created using the on-line Internet Data Entry Systemoption on the FAC web site. The FAC Web site is located at:http://harvester.census.gov/fac/. Click the appropriate link forForm SF-SAC options.
ELECTRONIC FORM INSTRUCTIONS – Beginning withaudits with Fiscal periods ending in 2008, all Form SF-SAC andAudit submissions must be made on the Internet. Both theauditor’s and auditee’s email addresses must be used tocreate a Form SF-SAC, attach the Single Audit and to createthe electronic certifications and signatures. Further instructionsare available on-line. Begin the Form SF-SAC athttp://harvester.census.gov/fac/collect/ddeindex.html.
Spreadsheet files for reporting the multiple Employer Identification Numbers (EINs), multiple Data UniversalNumbering System (DUNS) numbers, Federal awards andaudit finding data can be uploaded into the on-line InternetData Entry System.
Prior to completing Form SF-SAC on-line, review thestep-by-step instructions available on the FAC Web site.Auditees must enter their Form SF-SAC data using the InternetData Entry System. After the form passes all edits, anelectronic image file containing the reporting package must beattached. Submit and sign the Form with electronic signatures.Submission of anything other than a completed form andreporting package will not be accepted.
Revision – Submit audit revisions using the same report usedto create the initial form on-line. After logging into the originalreport, follow the revision instructions on the main menu.
Form Due Date: The audit shall be completed and the datacollection form and reporting package shall be electro-nically transmitted within the earlier of 30 days after receipt ofthe auditor’s report(s), or nine months after the end of theaudit period, unless a longer period is agreed to in advance bythe Federal cognizant or oversight agency for audit.
The SF-SAC is not to be used by commercial (for profit) ornon-United States auditees. Commercial (for profit) andforeign organizations should see the Federal awarding agencycontact for audit report submission instructions.
WHAT’S NEW:
Reporting of American Recovery and Reinvestment Actof 2009 (ARRA) expenditures. Expenditures occurring infiscal years ending in 2010, 2011 and 2012 must be identified asRecovery or Non-Recovery Act funds. A new column has beenadded to Page 3 Item 9 that will identify these expenditures. If aCFDA program involves the expenditure(s) of both RecoveryAct and non-Recovery Act funding, each must be listed on aseparate line.
WHO TO CONTACT WITH QUESTIONSFor questions related to specific Federal awards, pleasecontact the Federal agency from which the award originated.For technical audit questions, please contact the auditee’sFederal cognizant or oversight agency. Appendix III of the“OMB Circular A-133 Compliance Supplement” containsFederal agency contact information for A-133 audits. AppendixIII of the Compliance Supplement is accessible via the Internetat www.whitehouse.gov/OMB/grants. For questions concerningthe submission process or the form, contact the FAC(1.800.253.0696). Information can also be found on the FACWeb site (http://harvester.census.gov/fac/).
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Note: Instructions for uploading additional EINs areincluded in the on-line instructions available on the FACWeb site.
(d) Data Universal Numbering System (DUNS) Number –The Data Universal Numbering System (DUNS) number isa unique nine-digit identification sequence assigned byDun & Bradstreet (D&B) (available from the D&B DUNSregistration hotline at 866-705-5711). A DUNS number isrequired when applying for a Federal grant on Grants.govor any other application method. All auditees who submita Form SF-SAC are requested, but not required to reportthe DUNS number on Part I, Item 4d, 4e, and 4f of theForm SF-SAC. For more information go tohttp://fedgov.dnb.com/webform.
If “Y” is marked, enter the DUNS numbers of thecomponent entities in Part I, Item 4(f). Part I, Item 4(f)must contain an entry other than the one entered in 4(d).If “N” is marked in 4(e), leave Part I, Item 4(f) blank.
Auditees who process Federal awards for componententities expending Federal awards should mark Item 5(e)“Yes” and list the DUNS numbers of the componententities in Part 5(f) on the continuation sheet on Page 4 ofthe Form.
(a-e) Enter auditee contact information. Department ofHousing and Urban Development project numbers areoptional, and may be included with the auditee name.
Note: Instructions for uploading additional DUNS areincluded in the on-line instructions available on theFAC Web site.
Example 1: Component Unit reporting: The SmithCounty Sheriff’s Office applied for and expended its ownFederal grants using its own DUNS number. However, theSmith County government Finance Office required theSheriff’s Office grants to be reported as a component ofSmith County’s Single Audit. Smith County should enterthe Smith County DUNS number as the principal DUNSnumber in Item 4(d), mark Item 4(e) “Y,” and enter theSmith County Sheriff’s Office DUNS number in Item 4(f).
(f) Enter a valid email address.
(g) A senior representative of the auditee (e.g., ChiefExecutive Officer, Controller, Director of Finance, ChiefFinancial Officer) signs the statement that theinformation on the form is accurate and complete asrequired by §__.320 of the Circular. Provide the printedname and title of the signatory and the date ofsignature.
(a) Primary Employer Identification Number (EIN) –Enter the Auditee’s Employer Identification Number (EIN),the nine-digit taxpayer identification number assigned bythe Internal Revenue Service (IRS). If the auditee wasassigned multiple EINs, enter the primary EIN. Also, usingthe spaces provided, enter the primary EIN on the top ofeach page of the form.
Item 2 – Type of Circular A-133 Audit – Mark (X) theappropriate box. ’__.200 of the Circular requires non-Federalentities that expend $500,000 or more in a year in Federalawards to have a single audit conducted in accordance with’__.500, except when they elect to have a program-specific auditconducted in accordance with ’__.235.
Item 3 – Audit Period Covered – Mark the appropriate box.Annual audits cover 12 months and biennial audits cover 24months. If the audit period covered is neither annual norbiennial, mark “Other” and provide the number of months(excluding 12 and 24) covered in the space provided.
Item 4 – Auditee Identification Numbers
(b) Are Multiple EINs Covered in this Report? Mark (X) theappropriate box to indicate if the auditee (or components ofan auditee covered by the audit) was assigned more thanone EIN by the IRS. (Example: A Statewide audit coversmany departments, each of which may have its own EIN.)
(c) List the multiple EINs covered in this report – If Part I,Item 4(b) is marked “Yes” list the additional EIN numbersfor all entities covered by the audit in Item 4(c). An EINshould be considered covered in this report if this report isintended to satisfy the entity’s or component’s (e.g., StateAgency, sub-entity) single audit requirement. Do notinclude separate EINs for any component that did notreceive, expend, or otherwise administer Federal awards.Do not include the primary EIN in Item 4(c) of thecontinuation list.
Item 5 – Auditee Information
Example 2: Non-component Unit reporting: TheJones County Sheriff’s Office applied for and expendedFederal grants using its own DUNS number. The JonesCounty Sheriff’s Office prepared and submitted anindependent Single audit. The Jones County Sheriff’sOffice should enter its DUNS number as the principalDUNS number in Item 4(d), and mark Item 4(e) “N.”
Example 3: Financial Administration: A StateUniversity system audit covers the Federal awardexpenditures of every campus in the system. EachUniversity or campus in the system applied for andexpended its own direct Federal grants using its ownDUNS number. The State Board of Education served onlyas a conduit for the disbursement of Federal awards toeach University and campus. The audit of the StateUniversity system should list the payee’s (State Board ofEducation) DUNS number as the primary DUNS numberin Item 4(d), mark Item 4(e) “Yes,” and list the DUNSnumbers for each campus listed in the original grantapplications in Item 4(f).
Note: Forms missing either a legible auditeesignature, date of signature, printed name or printedtitle will be rejected.
(f) List the multiple DUNS numbers covered in thisreport – If Part I, Item 4(e) is marked “Yes,” list theadditional DUNS numbers on Item 4(f) of the continuationsheet on page 4 of the Form SF-SAC. Report a DUNSnumber in Item 4(f) if it identifies a component entity(e.g., State Agency, sub-entity) of the auditee with Federalawards expended during the fiscal period included in theaudit. Do not include separate DUNS numbers for anycomponent entity that did not expend or otherwiseadminister Federal awards. The order of the DUNSlistings is not important.
DESCRIPTION OF FORM
PART I – GENERAL INFORMATION
The auditee completes this section (except Items 4 and 7) andsigns and dates the certification statement provided in Item6(g). The auditor completes Item 7 and signs and dates thestatement provided in Item 7(g).
Item 1 – Fiscal Period Ending Date For This Submission
Enter the last day of the fiscal period covered by the audit.The 2010 form applies to all audits covering fiscal periodsending in the 2010, 2011 or 2012 calendar years. The 2008Form applies to all audits covering fiscal periods ending in the2008 or 2009 calendar years.
(e) Are multiple DUNS numbers covered in this report?Mark (X) the appropriate “Y” for yes or “N” for No box toindicate if a component entity (e.g., State agency,sub-entity) expending Federal awards is covered in theaudit report.
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(g) The auditor listed in Part I, Item 6(a) is the same auditorthat signs the auditor statement.
Item 7 – Add Optional Secondary Auditor Information?
If secondary audit organizations were used to conduct theaudit work, and the primary auditor chooses to include contactinformation for the secondary auditors, mark (x) “Y” for yes.Otherwise, mark “N” for no.
Item 8 – Secondary Auditor Information (Optional)
(a-e) If Part I, Item 7 is marked “Y,” enter the name and con-tact information of the secondary auditor organization(s)used to conduct the audit work.
(f) Enter a valid email address.
Note: Only the primary auditor will sign the certificationstatement.
PART II – FINANCIAL STATEMENTS
The auditor completes this section of the form. All informationfor this section should be obtained from the opinion on thefinancial statements and reports in accordance with theGovernment Auditing Standards (GAS) related to the financialstatement audit.
Item 1 – Type of Audit Report. If the audit report for thefinancial statements as a whole is unqualified, mark box 1“Unqualified opinion.” If the audit report for the financialstatements is other than unqualified, mark box(es) 2 “Qualifiedopinion,” 3 “Adverse opinion,” and/or 4 “Disclaimer ofopinion,” as applicable.
Audits of state and local governments often result in theauditor providing multiple opinions on various opinion unitswithin the financial statements. In situations where there areunqualified opinions on some opinion units and modifiedopinions or disclaimers of opinions on others, multiple boxesshould be checked in response to this question. For example,if the financial statements for an auditee include a qualifiedopinion for one opinion unit, a disclaimer of opinion for asecond opinion unit, and unqualified opinion on the remainingopinion units, then mark boxes 2 and 4, but not 1 and 3. Box 1is only marked for an unqualified opinion on the financialstatements as a whole or when unqualified opinions areprovided on all opinion units.
Item 2 – Is a “going concern” explanatory paragraphincluded in the audit? Mark either “Y” for yes or “N” for noto indicate the existence of a “going concern” explanatoryparagraph in the audit report.
According to AICPA Audit Guide “Government AuditingStandards and Circular A-133 Audits”, if the audit of Federalawards did not encompass the entirety of the auditee’soperations expending Federal awards, the operations that arenot included should be identified in a separate paragraphfollowing the first paragraph of the report on major programs.In Part III, Item 1, mark either “Yes” or “No” to indicate thepresence of such a paragraph for any departments, agencies,or other organizational units not included in the audit, whichexpended $500,000, or more in Federal awards during the fiscalperiod.
Item 2 – What is the dollar threshold to distinguish TypeA and Type B programs? Enter the dollar threshold used todistinguish between Type A and Type B programs as definedin ’__.520(b) of the Circular. The dollar threshold must be$300,000 or higher. Round to the nearest dollar.
Item 3 – Did the auditee qualify as a low-risk auditee?Mark either “Y” for yes or “N” for no to indicate if the auditeequalifies as a low-risk auditee under ’__.530 of the Circular.
Item 4 – Is a significant deficiency disclosed for anymajor program? Mark either “Y” for yes or “N” for no toindicate if the Schedule of Findings and Questioned Costsinclude any significant deficiencies in internal control for majorprograms (Circular ’__.510 (a)(1)).
Item 5 – Is any significant deficiency reported for anymajor program as a material weakness? If Item 4 is marked“N,” skip Item 5. If Item 4 is marked “Y,” mark Item 5 either“Y” or “N” to indicate if any significant deficiencies included inthe Schedule of Findings and Questioned Costs are materialweaknesses (Circular ’__.510 (a)(1)).
Item 6 – Are any known questioned costs reported? Markeither “Y” for yes or “N” for no to indicate if the Schedule ofFindings and Questioned Costs discloses any knownquestioned costs (Circular ’__.510 (a) (3) or (4)).
Item 7 – Were Prior Audit Findings related to directfunding shown in the Summary Schedule of Prior AuditFindings? Mark either “Y” for yes or “N” for no to indicate ifthe Summary Schedule of Prior Audit Findings reports thestatus of any audit findings relating to direct Federal awardsexpended. If “Y”, identify the Federal agency (ies) with priordirect findings in Part III, Item 8.
Item 3 – Is a significant deficiency disclosed? Mark either“Y” for yes or “N” for no to indicate the disclosure of a“significant deficiency.”
Item 8 – Indicate which Federal agency (ies) havecurrent year audit findings related to direct funding orprior audit findings shown in the Summary Schedule ofPrior Audit Findings related to direct funding. Mark (X)the Federal agency (ies) only if the Schedule of Findings andQuestioned Costs discloses audit findings relating to directFederal awards expended, OR, the Summary Schedule of PriorAudit Findings reports the status of any audit findings relatingto direct Federal awards expended.
Item 4 – Is any significant deficiency reported as amaterial weakness? If Item 3 is marked “N,” skipItem 4. If Item 3 is marked “Y,” mark Item 4 either “Y” or “N”to indicate if any significant deficiencies are material weaknes-ses (Circular §__.505 (d)(1)).
Item 5 – Is a material noncompliance disclosed? Markeither “Y” for yes or “N” for no to indicate the disclosure of a“material noncompliance.”
PART III – FEDERAL PROGRAMS
The auditor completes this section of the form.
Item 1 – Does the auditor’s report include a statementthat the auditee’s financial statements includedepartments, agencies, or other organizational unitsexpending $500,000 or more in Federal awards thathave separate A-133 audits which are not included inthis audit (AICPA Audit Guide, Chapter 12)?
Item 6 – Primary Auditor Information
The primary auditor completes this item.
(a-e) Enter the name and contact information of the primaryauditor that conducted the audit in accordance with theCircular. The auditor name may represent a solepractitioner, certified public accounting firm, Stateauditor, etc. Where multiple audit organizations are usedto conduct the audit work, only the lead or coordinatingauditor shall provide its information in Item 6(a-f). Theother auditors may enter their contact information inPart I, Items 8a-f.
(f) Enter a valid email address.
Note: Instructions for uploading secondary auditorcontact information is included in the on-lineinstructions available on the FAC Web site.
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Item 9 – Federal Awards Expended During Fiscal Year –List each program for which Federal awards were expended inthe same order as shown in the Schedule of Expenditures ofFederal Awards. List individual programs in each row.
Break out clusters, with the exception of R&D, and list eachindividual program on a separate line. Report the R&D cluster atthe same level of detail as the Schedule of Expenditures ofFederal Awards.
The information to complete columns (a), (b), (c), (d), (e) and (f)is obtained from the Schedule of Expenditures of FederalAwards. The information to complete columns (g) and (h) isobtained from the Schedule of Findings and Questioned Costsprepared by the auditor. Note that Item 9 includes the requiredinformation for each Federal program presented in the Scheduleof Expenditures of Federal Awards (and notes thereto), regard-less of whether audit findings are reported. If additional linesare needed, photocopy page 3 and attach the additional page(s)to the form, and enter the total expenditures for all pages in the“Total Federal Awards Expended” block on the last page.
CFDA Number – Federal Agency Prefix and Extension
Most common Federal awards are listed in the Catalog ofFederal Domestic Assistance (CFDA). A CFDA number consistsof a two-digit prefix, and a three-digit extension separated bya period. If this information is unavailable, consult the Federalawarding agency or pass-through entity to obtain this number.The CFDA catalog is available on the Internet at:http://www.cfda.gov. If the Federal program does not have aCFDA number, follow the specific instructions below.
Column (a) Federal Agency Prefix – Enter the first twodigits of the CFDA number. The CFDA prefix identifies theawarding Federal Agency listed in Appendix 1. If the FederalAgency does not have a CFDA prefix, use one of the prefixes(noted with an asterisk) assigned for reporting purposes only.
Column (b) CFDA Extension – The period is automaticallyassumed and should not be entered on the form.
9 3 CT-654321-B
Programs with No CFDA Number, Contract Numberor Grant Number
If the program does not have a CFDA number, a contractnumber, or grant number, enter the Federal agency’stwo-digit prefix (as listed in Appendix 1) in the first twospaces. In the extension box, enter “UNKNOWN.”
Example: A U. S. Agency for InternationalDevelopment program with no CFDA number orcontract number would be entered as:
8 4 UNKNOWN
CFDA Number
FederalAgencyPrefix 1 Extension 2
9. FEDERAL AWARDS . . .
Note: CFDA prefixes may not always be the same as theprefixes listed in Appendix I. If an award has a CFDAnumber, use that number. If the program does not havea CFDA number, use the prefix from Appendix I.
Programs with a CFDA NumberIf the Federal program is listed in the CFDA, enter thenumber from the Catalog.
In the first two spaces, enter the first two digits of theCFDA number assigned to the Federal award. In theextension box, enter the last three digits of the CFDAnumber.
Column (c) – Research and Development – Mark either “Y”for yes or “N” for no to indicate if the Federal program is aResearch and Development (R&D) program as defined in§__.105 of the Circular by marking (X) in the appropriate boxto indicate either “Y” or “N”. When a CFDA program consistsof part R&D and part non-R&D, list the R&D expenditure detailon one line and the non-R&D expenditure detail on a secondline.
Researchand
develop-ment
FederalAgencyPrefix 1
Extension 2
9. FEDERAL AWARDS EXPENDED DURING FISCAL YEAR
(a) (b) (c)
CFDA Number
(e)
Name of FederalProgram
WIA Youth Activities
WIA Youth Activities
YN
1
2 x
17 . 259
17 . 259
YN
1
2
x
Example: The U. S. Department of Education program84.033 would be entered as
8 4 033
Programs with No CFDA Number, but AwardHas a Contract or Grant Number
If the Federal program is not listed in the CFDA or hasno CFDA number, enter the Federal Agency’s two-digitprefix as listed in Appendix 1. If the Federal Agency isnot listed in Appendix 1, enter “99” for ”Miscellaneous.”In the extension box, enter the contract or grant numberfrom the Federal Agency (up to fifty digits, letters orcharacters).
Example: A U. S. Department of Health and HumanServices program with no CFDA number but with acontract number of “CT-654321-B” would be entered as:
Notes: (1) Some CFDA prefixes are used by more than oneFederal Agency. Enter the same CFDA prefix used on theFederal award application. If the auditor identified auditfinding(s) for a direct award, identify the specific Federalagency from which the award originated. (2) Three separateagencies use the CFDA numbers beginning with “45.” If oneof those agencies has current year findings related to directfunding or prior audit findings related to direct awards in theSummary Schedule of Prior Audit Findings related to directfunding, mark the box next to an agency using either an“03,” “05,” or “06” prefix from Appendix I. (3) See theHistorical index on the CFDA website (http://www.cfda.gov/)for information regarding the reporting of awards granted bythe Federal Emergency Management Agency, now part ofthe Department of Homeland Security.
Only one copy of the reporting package is required tobe submitted to the Clearinghouse. The auditee mustsubmit only one reporting package (as defined in ’__.320(c))to the FAC. The Clearinghouse will copy and distribute therequired audit reporting packages to Federal agencies per’__.320(d) of the Circular.
Note: Auditors may upload this page via an electronicspreadsheet when using the on-line data entry option.Instructions for this option are included in the on-lineinstructions available on the FAC Web site.
ARRA(d)
YNYN
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Column (h) – Major program – Indicate if the Federalprogram is a major program, as defined in ’__.520 of theCircular by marking (X) in the appropriate box to indicateeither “Y” or “N”.
SF-SAC(I) (4-15-2010) Page 5
DirectAwards
FederalAgencyPrefix 1
Extension 2
9. FEDERAL AWARDS EXPENDED DURING FISCAL YEAR
(a) (b) (g)
CFDA Number
(c)(d)(e)(f)
YN
1
2
x47 . 076
47 . 076
YN
1
2 x
Item 10 – Audit Findings
The rows of Item 10 directly correspond to matching rows inItem 9. The information to complete columns (a) and (b) isobtained from the Schedule of Findings and QuestionedCosts prepared by the auditor. If the Schedule of Findingsand Questioned Costs does not identify audit findings for aspecific row, the auditor should enter “O” for item (a) and“N/A” for item (b). Audit findings affecting more than onemajor program should be listed for all major programsaffected.
Column (a) – Type(s) of Compliance Requirement(s) –Using the list provided on the form in footnote 4 on page 3,enter the letter(s) that correspond to the type(s) ofcompliance requirement(s) applicable to the audit findings(i.e., noncompliance, significant deficiencies (includingmaterial weaknesses), questioned costs, fraud, and otheritems reported under ’__.510(a)) reported for each Federalprogram. Do not list all types of compliance requirementsthat were tested. Normally, audit findings will be covered bythe 14 types of compliance requirements described in Part 3of the “OMB Circular A-133 Compliance Supplement.” Ifthere is an audit finding, but it is not covered by one ofthese, enter “P” for “Other.” If there were no audit findings,enter “O” for “None.” Enter the letters only; do not entercommas or spaces.
Column (b) – Audit Finding Reference Number(s) – Enterthe audit finding reference number(s) for audit findings (i.e.,noncompliance, significant deficiencies (including materialweaknesses), questioned costs, fraud, and other itemsreported under ’__.510(a)) in the Schedule of Findings andQuestioned Costs. If no audit findings were reported, enterN/A for “Not applicable” (footnote 5)
Column (g) – Direct Award – Indicate if the award wasreceived directly from a Federal awarding agency by marking(X) in the appropriate box to indicate either “Y” or “N”. Whenan award consists of both direct and indirect (i.e., received bya subrecipient from a pass-through entity) funds, list the directexpenditure detail on one line and the indirect expendituredetail on a second line. When a single audit reporting entityreceives direct awards and transfers them to another part ofthe same single audit reporting entity, these awards shouldstill be reported as direct (e.g., transfers within the single auditreporting entity do not create a recipient/subrecipientrelationship).
Example:
Example: Each major program (row 1 & 2) must have atype of audit report marked. Do not mark the type of auditreport box for non-major programs (row 3), even thosewith findings.
Note: If two lines are listed for the same CFDA numberbecause part of the award is direct and part indirect, theauditor should repeat the major program information oneach line. If the program is not a major program, leave the“Type of Audit Report” box blank.
Column (d) – American Recovery and Reinvestment Actof 2009 (ARRA) –Mark either “Y” for yes or “N” for no toindicate if the Federal program was funded with Recovery Actawards. Single Audits with fiscal year end dates of September30, 2009 and later must identify ARRA expenditures. If a CFDAprogram involves the expenditures of both Recovery andnon-Recovery Act funding, each must be listed on a separateline.
Column (e) – Name of Federal Program – Enter the nameof the Federal program as shown in the CFDA. If the programis not listed in the CFDA, a description of the awardrecognizable by the awarding Federal agency should beentered. The name of the pass-through entity is not requiredfor indirect awards.
Column (f) – Amount Expended – Enter the amount ofexpenditures included in the Schedule of Expenditures ofFederal Awards for each Federal program. Note that amountsshall include the value of Federal awards expended in theform of non-cash assistance, the amount of Federal insurancein effect during the year. To determine if loans or loanguarantees are considered Federal Awards, refer to the annualOMB Circular A-133 Compliance Supplement or the audit’sFederal oversight (or cognizant) agency. Round to the nearestdollar.
Column (i) – If yes, type of audit report – If Part III, Item9(g) “Major program” is marked “Y” for yes, enter one letter(U, Q, A, or D) corresponding to the type of audit report onthe major program in the adjacent box in Column (h). Entereither ‘U’ for Unqualified opinion, ‘Q’ for Qualified opinion, ‘A’for Adverse opinion, or ‘D’ for Disclaimer of opinion. Forclusters, the type of audit report must apply to the program asa whole. Therefore, all programs in a cluster should share thesame type of audit report and each line should be filled incompletely.
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APPENDIX I-AFederal Audit Clearinghouse Federal Agency Two-Digit Prefix List
(Alphabetic Order)
01* African Development Foundation
98 U. S. Agency for International Development
10 Department of Agriculture
23 Appalachian Regional Commission
* Note: These prefixes are not assigned by the Catalog of Federal Domestic Assistance, and are only used for OMB Circular A-133 reporting purposes only.
88 Architectural & Transportation BarriersCompliance Board
PREVIEW
ONLY
61* International Trade Commission
90 Japan & U.S. Friendship Commission
16 Department of Justice
17 Department of Labor
09* Legal Services Corporation
42 Library of Congress
99* Miscellaneous
43 National Aeronautics & Space Administration
89 National Archives & Records Administration
92 National Council on Disability
44 National Credit Union Administration
05* National Endowment for the Arts
06* National Endowment for the Humanities
68 National Gallery of Art
46 National Labor Relations Board
47 National Science Foundation
77 Nuclear Regulatory Commission
07* Office of National Drug Control Policy
27 Office of Personnel Management
70 Overseas Private Investment Corporation
08* Peace Corps
86 Pension Benefit Guaranty Corporation
57 Railroad Retirement Board
85 Scholarship Foundations
58 Securities and Exchange Commission
59 Small Business Administration
60 Smithsonian Institution
96 Social Security Administration
19 Department of State
62 Tennessee Valley Authority
20 Department of Transportation
21 Department of the Treasury
64 Department of Veterans Affairs
13 Central Intelligence Agency
11 Department of Commerce
29 Commission on Civil Rights
78 Commodity Futures Trading Commission
87 Consumer Product Safety Commission
94 Corporation for National and Community Service
12 Department of Defense
90 Delta Regional Authority
90 Denali Commission
84 Department of Education
90 Election Assistance Commission
81 Department of Energy
66 Environmental Protection Agency
30 Equal Employment Opportunity Commission
32 Federal Communications Commission
33 Federal Maritime Commission
34 Federal Mediation and Conciliation Service
18 Federal Reserve System
36 Federal Trade Commission
39 General Services Administration
40 Government Printing Office
93 Department of Health and Human Services
97 Department of Homeland Security
14 Department of Housing and Urban Development
03* Institute of Museum and Library Services
91 United States Institute of Peace
04* Inter-American Foundation
15 Department of the Interior
7
PREVIEW
ONLY89 National Archives & Records Administration
90 Delta Regional Authority
90 Denali Commission
90 Election Assistance Commission
90 Japan & U.S. Friendship Commission
91 United States Institute of Peace
92 National Council on Disability
93 Department of Health and Human Services
94 Corporation for National and Community Service
96 Social Security Administration
97 Department of Homeland Security
98 U. S. Agency for International Development
99* Miscellaneous
SF-SAC(I) (4-15-2010) Page 7
APPENDIX I-BFederal Audit Clearinghouse Federal Agency Two-Digit Prefix List
(Numeric Order)
* Note: These prefixes are not assigned by the Catalog of Federal Domestic Assistance, and are only used for OMB Circular A-133 reporting purposes only.
88 Architectural & Transportation BarriersCompliance Board
01* African Development Foundation
03* Institute of Museum and Library Services
04* Inter-American Foundation
05* National Endowment for the Arts
06* National Endowment for the Humanities
07* Office of National Drug Control Policy
08* Peace Corps
09* Legal Services Corporation
10 Department of Agriculture
11 Department of Commerce
12 Department of Defense
13 Central Intelligence Agency
14 Department of Housing and Urban Development
15 Department of the Interior
16 Department of Justice
17 Department of Labor
18 Federal Reserve System
19 Department of State
20 Department of Transportation
21 Department of the Treasury
23 Appalachian Regional Commission
27 Office of Personnel Management
29 Commission on Civil Rights
30 Equal Employment Opportunity Commission
32 Federal Communications Commission
33 Federal Maritime Commission
34 Federal Mediation and Conciliation Service
36 Federal Trade Commission
39 General Services Administration
40 Government Printing Office
42 Library of Congress
43 National Aeronautics & Space Administration
44 National Credit Union Administration
46 National Labor Relations Board
47 National Science Foundation
57 Railroad Retirement Board
58 Securities and Exchange Commission
59 Small Business Administration
60 Smithsonian Institution
61* International Trade Commission
62 Tennessee Valley Authority
64 Department of Veterans Affairs
66 Environmental Protection Agency
68 National Gallery of Art
70 Overseas Private Investment Corporation
77 Nuclear Regulatory Commission
78 Commodity Futures Trading Commission
81 Department of Energy
84 Department of Education
85 Scholarship Foundations
86 Pension Benefit Guaranty Corporation
87 Consumer Product Safety Commission
8
NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION
NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION NOT FOR SUBMISSION
Data Collection Form for Reporting on AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS
for Fiscal Year Ending Dates in 2010, 2011, or 2012
FORM SF-SAC(4-15-2010)
U.S. DEPT. OF COMM.– Econ. and Stat. Admin.– U.S. CENSUS BUREAU
GENERAL INFORMATION (To be completed by auditee, except for Items 6, 7, and 8)
Fiscal period ending date for this submission Type of Circular A-133 audit Audit period covered
Program-specific auditAnnual Other – MonthsBiennial
PART I
5.
2. 3.
Yesb. No
AUDITEE INFORMATION 6.
Primary auditor contact telephone
Primary auditor contact FAX
Primary auditor contact E-mail
Name
Title
City
ZIP + 4 Code
// 2
1
2
3
1 2
Month Day Year
Complete this form, as required by OMB Circular A-133, "Audits of States, Local Governments, and Non-Profit Organizations."
OMB No. 0348-0057
b.
d.
e.
f.
Auditee namea.
Auditee address
Auditee contactc.
Auditee contact telephone
Name
Title
(Number and street)
City
State
b.
d.
e.
f.
( ) –
( ) –
( ) –
4. Auditee Identification Numbers
ACTING AS COLLECTING AGENT FOR OFFICE OF MANAGEMENT AND BUDGET
g. g.
Single audit
_ZIP + 4 Code _
_d. Data Universal Numbering System (DUNS) Number
1
__ _Primary Employer Identification Number (EIN)a.
Yese. No1 2
c. f.
Base prints black SF-SAC, page 1, Pantone 100 Yellow, 20% tone
AUDITOR STATEMENT – The data elements and informationincluded in this form are limited to those prescribed by OMBCircular A-133. The information included in Parts II and III of theform, except for Part III, Items 7, 8, and 9a-9g, was transferredfrom the auditor’s report(s) for the period described in Part I, Items1 and 3, and is not a substitute for such reports. The auditorhas not performed any auditing procedures since the date of theauditor’s report(s). A copy of the reporting package required byOMB Circular A-133, which includes the complete auditor’sreport(s), is available in its entirety from the auditee at the addressprovided in Part I of this form. As required by OMB Circular A-133,the information in Parts II and III of this form was entered in thisform by the auditor based on information included in the reportingpackage. The auditor has not performed any additional auditingprocedures in connection with the completion of this form.
Are multiple EINs covered in this report?
If Part I, Item 4b = "Yes," complete Part I, Item 4c on the continuation sheet on Page 4.
AUDITEE CERTIFICATION STATEMENT – This isto certify that, to the best of my knowledge and belief, theauditee has: (1) engaged an auditor to perform an auditin accordance with the provisions of OMB Circular A-133for the period described in Part I, Items 1 and 3; (2) theauditor has completed such audit and presented a signedaudit report which states that the audit was conducted inaccordance with the provisions of the Circular; and, (3)the information included in Parts I, II, and III of thisdata collection form is accurate and complete. I declarethat the foregoing is true and correct.
Auditee contact E-mail
Auditee contact FAX
Primary auditor contact
State
Primary auditor address (Number and street)
Primary auditor name
PRIMARY AUDITOR INFORMATION (To be completed by auditor)
If Part I, Item 4e = "Yes," complete Part I, Item 4f on the continuation sheet on Page 4.
Are multiple DUNS covered in this report?
a.
c.
1.
( ) –
7a. Add Secondary auditor information? (Optional)
Yes No1 2
b. If "Yes," complete Part I, Item 8 on the continuationsheet on page 5.
Auditee certification
Name of certifying official
Title of certifying official Auditor certification Date
Date
DRAFT
9
Is a significant deficiency disclosed for any major program? (§ ___ .510(a)(1))
Page 2 FORM SF-SAC (4-15-2010)
Type of audit report
Unqualified opinion OR
Qualified opinion
1.
Adverse opinion Disclaimer of opinion
Is a significant deficiency disclosed? Yes No – SKIP to Item 53.
Is any significant deficiency reported as a material weakness? Yes4.
Is a material noncompliance disclosed? Yes No5. 1
1
1
1
Primary EIN:
43
2
2
No2
PART II FINANCIAL STATEMENTS (To be completed by auditor)
2
Is a "going concern" explanatory paragraph included in the audit report? Yes2. 1 No2
Indicate which Federal agency(ies) have current year audit findings related to direct funding or prior audit findings shownin the Summary Schedule of Prior Audit Findings related to direct funding. (Mark (X) all that apply or None)
8.
Agriculture
Commerce
DefenseEducationEnergyEnvironmental Protection Agency
Health and Human Services
Housing and UrbanDevelopment
InteriorJusticeLabor
National Science Foundation
Social SecurityAdministration
U.S. Department of StateTransportationTreasury
Veterans Affairs
98
43
Small BusinessAdministration
National Endowment for the Arts
National Aeronautics andSpace Administration
Corporation for Nationaland Community Service
17
64
16
15
14
93
66
81
84
12
94
11
10 05
47
59
96
19
20
21
Institute of Museum andLibrary Services
03
Office of National DrugControl Policy
07
89 National Archives andRecords Administration
General Services Administration39
National Endowment for the Humanities
06
Other – Specify:
Did the auditee qualify as a low-risk auditee? (§___ .530) Yes No3. 1 2
Were Prior Audit Findings related to direct funding shown in the Summary Schedule of Prior Audit Findings? (§___.315(b))
7.Yes No1 2
$2. What is the dollar threshold to distinguish Type A and Type B programs?(OMB Circular A-133 §___ .520(b))
PART III FEDERAL PROGRAMS (To be completed by auditor)
Are any known questioned costs reported? (§ ___ .510(a)(3) or (4)) Yes No6. 1 2
Is any significant deficiency reported for any major program as a material weakness? (§ ___ .510(a)(1))
5.1 Yes 2 No
4. 1 Yes 2 No –SKIP to Item 6
1. Does the auditor’s report include a statement that the auditee’s financialstatements include departments, agencies, or other organizational unitsexpending $500,000 or more in Federal awards that have separate A-133audits which are not included in this audit? (AICPA Audit Guide, Chapter 12) Yes No1 2
None00
U.S. Agency for Inter-national Development
Appalachian RegionalCommission
23
Legal Services Corporation09
_
Homeland Security97
Base prints black SF-SAC, page 2, Pantone 100 Yellow, 20% tone
Mark either:
any combination of:
DRAFT
10
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FORM SF-SAC (4-15-2010) Page 3
1 2
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1 2
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Y N1 2
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. . . . . . . . . .
_
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Base prints black SF-SAC, page 3, Pantone 100 Yellow, 20% tone
A3
(d) Y N
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DRAFT
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cov
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FORM SF-SAC (4-15-2010)Page 4
c.
Prim
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EIN
:
1 2 3 4 5 6 7 8 9 10
11
12
13
14
15
f.Li
st t
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over
ed in
the
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_ _ _ _ _ _ _
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16
18
19
20
17
_ __ _ _ _ _ _ _ _ _ _ _ _
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
38
39
40
37
_ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ _
41
42
43
44
45
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47
48
49
50
51
52
53
54
55
56
58
59
60
57
1 2 3 4 5 6 7 8 9 10
11
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17
21
22
23
24
25
26
27
28
29
30
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32
33
34
35
36
38
39
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37
_
DRAFT
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FORM SF-SAC (4-15-2010) Page 5
8.
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