Financial Data for Incoming Interagency Agreements
This form must be used if the government-wide standard IAA forms (FMS Form 7600A/B) are not being used
Interagency Agreement Number:
(Number used by other agency to identify
the IAA, such as the MIPR #):
Funding Information
Requesting Agency Funding Information
Servicing Agency Funding Information
*TAS
ALC
49-00-0001
BETC
COLL
Treasury Agency and Trading Partner
Code
BPN or DUNS
49
74811803
BPN + 4 (Optional)
n/a
Object Class Code (Optional)
4110
Additional Accounting
Classification/Information (Optional)
Fiscal Year Funds Appropriated
Type of Funds (e.g. one-year, twoyear, no-year)
Requesting Agency Funding
Expiration Date
Requesting Agency Funding
Cancellation Date
*No Recovery Act funds will be transferred by other agency
Estimated Agreement Amount:
Total IAA Amount transferred to NSF:
Less ACR (NSF Administrative Fee) 6.36%
6.30%:
Available to Obligate on grant/contract
$ 0.00
$ 0.00
$0.00
-
Billing Information:
 Reimbursement Basis; Seller Initiated IPAC; Billing on a monthly basis
 Other (explain)_________________________________________________________________
NSF will obligate Requesting Agency’s funds within period of availability. NSF will bill and collect for ACR upon obligation of any portion of the
funds and only bill for reimbursement for program support portion after expenditures are submitted by the grantee or contractor.
Statutory Authority:
Requesting Agency's Authority
*If the requesting agency doesn't have a specific statutory authority, it may use the National Science Foundation Act of 1950, as amended
(42 USC 1861-76). Please note: The Economy Act is a law of general applicability that should only be used if there is no statutory authority
more specific than the Economy Act. The NSF Act of 1950 is a more specific statute than the Economy Act, so if there is no other specific
statute available to the requesting agency, it should use the NSF Act of 1950, as amended (42 USC 1861-76).
Servicing Agency's Authority The National Science Foundation must accept funds using the National
Science Foundation Act of 1950, as amended (42 USC 1861-76).
NSF Form 1611 (Revised 10/2014)
Page 1 of 2
Financial Data for Incoming Interagency Agreements
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National Science Foundation Contact information
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Ivonne Garcia, Accountant;
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