Higher Education Emergency Relief Fund (HEERF) No Cost Extension (NCE) Request Form

Summary

A form titled Higher Education Emergency Relief Fund (HEERF) No Cost Extension (NCE) Request Form, OMB Control Number 1840-0864 with an expiration of 11/30/2023. It says the completed form must be emailed to the institution's HEERF program specialist on or before June 20, 2023, because most HEERF grant performance periods are scheduled to end on June 30, 2023. The Department is prepared to offer first-time extensions to grantees that can show remaining funds will not be used merely to spend unobligated balances, as required by 2 CFR 200.308(e)(2). Awards without approved extensions enter the 120-day grant liquidation phase. Section 1 asks for grantee award information.

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                                                         OMB Control Number 1840‐0864; Expiration 11/30/2023


                          Higher Education Emergency Relief Fund (HEERF)

                          No Cost Extension (NCE) Request Form
This completed form must be emailed to your HEERF program specialist on or before June 20, 2023.

Introduction: Most HEERF grant performance periods are scheduled to end on June 30, 2023.1 The U.S.
Department of Education (Department) is prepared to offer first‐time NCEs to HEERF grantees that can
adequately demonstrate that any remaining HEERF grant funds expended during this additional period
will not be used merely for the purpose of using unobligated balances, as required by 2 CFR §
200.308(e)(2). This form is how the Department will make that determination.
Submission Instructions: The authorized institutional representatives of HEERF grant awards must
complete this form and email a PDF copy to their assigned HEERF program specialist (identified in Box 3
of the HEERF Grant Award Notification (GAN)) on or before June 20, 2023. Early submission is strongly
encouraged in order to avoid any interruption to being able to access to HEERF grant funds. HEERF grant
awards without approved NCEs will enter the 120‐day grant liquidation phase for the first phase of the
grant closeout process.
Section 1: Grantee Award Information: Please provide your institution’s authorized institutional
representatives identified in Box 6 of the GAN in the box below.2

    Institution Name:                                        State Director and/or Authorizing Official Name:


    Institution UEI:                                         Job Title:

    Institution OPEID:                                       Email:

    State:                                                   Phone:



Section 2: NCE Request: Please indicate which NCE(s) you are requesting below.

             ☐ NCE for institutional grant funds (ALNs 84.425F, J, K, L, M, N, S). 3 If granted, institutions will
             be provided an initial 12‐month extension and have until June 30, 2024, to complete HEERF
             grant activities.

             ☐NCE for student grant funds (ALNs 84.425E and Q). If granted, institutions will be provided a
             6‐month extension have until December 31, 2023, to complete disbursements of emergency
             financial aid grants to students. The Department may consider additional extensions as
             necessary.


1
  This form does not apply to HEERF A2 grantees that have received an approved performance period extension to
complete construction projects.
2
  If you are the authorized representative for multiple institutions, please submit this form separately for each
institution given the different needs and plans each institution may have.
3
  Please note that NCEs for the HEERF IREPO program (ALN 84.425P) are reviewed separately and you should
contact your IREPO program specialist.

                                              Department of Education HEERF NCE Request Form – Page 1 of 4
                                                           OMB Control Number 1840‐0864; Expiration 11/30/2023


Section 3: HEERF Grant PR/Award Number Identification: Based on the selection(s) in Section 2, please
provide the PR/Award numbers of the HEERF grants in which you are requesting an NCE.

    1) ________________________                   2) _________________________

    3) ________________________                   4) _________________________

Section 4: NCE Explanation and Plan4:

For institutions requesting an NCE for institutional funds: Please provide the following:

    (1) A brief description of your institution’s reason for requesting the NCE




    (2) A budget narrative and timeline describing how the institution plans to spend the remaining
        balance of your HEERF grant(s)




    (3) Explain how the grant activities and proposed expenditures described in (2) connect to
        preparing, preventing, and responding to COVID‐19.




For institutions requesting an NCE for student grant funds: Please provide the following:

    (1) Explain the barrier(s) that prevented the institution from expending the emergency student
        funds during the initial grant performance period;




4
 If more space is needed to provide adequate responses to these questions, please include your response as a separate
attached PDF file labeled “Section 4—NCE Explanation and Plan”.

                                               Department of Education HEERF NCE Request Form – Page 2 of 4
                                                  OMB Control Number 1840‐0864; Expiration 11/30/2023


    (2) A timeline for when your institution intends to distribute the remaining grant funds to students;




    (3) How those grant amounts will be calculated;




    (4) How the institution plans to prioritize grants to students with exceptional need; and




    (5) How the institution plans to communicate the availability of emergency financial aid grants to
        students.




Section 5: Acknowledgment of HEERF grant program requirements

☐ By checking this box, I acknowledge that any approved NCE period may be subject to restrictions,
heightened program monitoring, or other enforcement actions if my institution has not:

       Submitted all HEERF annual reports
       Publicly posted all HEERF quarterly reports conspicuously on our institution’s website
       Conducted and submitted all required audits, as applicable
       Complied and responded timely to requests and questions from our institution’s HEERF program
        specialist and/or other authorized representatives of the Department

Section 6: Institution Authorized Representative Certification

I, the undersigned authorized representative of the institution requests that the United States
Department of Education to extend the performance period as indicated in Section 2 of this form to
complete HEERF grant activities. I acknowledge that I am a current authorized representative of the
institution as noted on the most recent GAN.

Institution Name: _______________________________________
Authorized Representative (typed name): ______________________________________
Authorized Representative Signature: _____________________________________
Authorized Representative Title: _____________________________________
Date: ___________________

                                        Department of Education HEERF NCE Request Form – Page 3 of 4
                                                    OMB Control Number 1840‐0864; Expiration 11/30/2023


                                          FOR INTERNAL USE ONLY

 ☐ APPROVED                                                  JUSTIFICATION:

 ☐ DENIED

 DATE: ____________________

 HEERF PROGRAM SPECIALIST INITIALS: __________




Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless such collection displays a valid OMB control number. The valid OMB control number
for this information collection is 1840‐0864. Public reporting burden for this collection of information is
estimated to average 30 minutes per response, including time for reviewing instructions, searching
existing data sources, gathering, and maintaining the data needed, and completing and reviewing the
collection of information. The obligation to respond to this collection is voluntary (ARP (Pub. L. 117‐2)). If
you have any comments concerning the accuracy of the time estimate, suggestions for improving this
individual collection, or if you have comments or concerns regarding the status of your request, please
contact Karen Epps, 400 Maryland Avenue, SW, Washington, D.C. 20202.




                                         Department of Education HEERF NCE Request Form – Page 4 of 4


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