ARS Agreements

Forms

Note: All forms are available in .pdf format (unless otherwise noted). If you require the Acrobat Reader, download it here.

Certifications

Form	Description
AD-1047	Certification regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions
AD-1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I – For Grantees Other Than Individuals
AD-1050	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative II – For Grantees Who are Individuals
	Certification/Disclosure Requirements Related to Lobbying
SEB-102	Conflict of Interest Certification
REE-26	Certification Regarding Performing Organization Type

Management and Financial Reports

Form	Description	Format
ARS-157	RSA Management Report Template	XLS
	Incoming Agreement Report Requirements	DOC
REE-FSR	USDA, REE Financial Status Report (Only used on Incoming (soft) Funds) Instructions for REE-FSR	PDF
REE-FSR		DOC
SF-269	Financial Status Report (long form)
SF-269A	Financial Status Report (short form)
REE-269	Cooperative Agreement Financial Status Report	PDF
REE-269	Cooperative Agreement Financial Status Report	XLS

SF-425	Federal Financial Report (long form) Instructions for SF-425, Federal Financial Report	(PDF) (Excel)
SF-425A	Federal Financial Report (short form) Instructions for SF-425A, Federal Financial Report	(PDF) (Excel)

Payment/Reimbursement

Form	Description	Format
SF-270	Request for Advance of Reimbursement
	Invoice Template for Trust Fund Cooperative Agreement	DOC
	Sample Invoice Template for Trust Fund Cooperative Agreement	DOC

Budget

Form	Description	Format
REE-454	Cooperative Agreement Budget	PDF
		XLS
REE-455	Grant and Assistance Type Cooperative Agreement Budget	PDF
		XLS

Closeout

Form	Description	Format
	Financial Closeout Checklist Incoming Funds Agreement	DOC

Statement of Work Templates for AIMS

Type of Agreement	Format
Non Funded Cooperative Agreement	DOC
Specific Cooperative Agreement	DOC
Reimbursable and Trust Fund Cooperative Agreement	DOC
Research Support Agreement	DOC
Standard Cooperative Agreement	DOC

Other Forms

Form	Description	Format
AD-475A	“AND JUSTICE FOR ALL” Poster	PDF
	Letter of Justification For Non-Competitive Awards	DOC
REE- 451	Extramural Agreement form for the Standard Cooperative Agreement	XLS

Last updated: 01/18/2013