Grant/Cooperative Agreement Administrative Supplement RequestGrant/Cooperative Agreement Administrative Supplement Request Δ X/TwitterThis field is for validation purposes and should be left unchanged.All fields are required unless otherwise stated. All required documents must be attached unless otherwise stated.Requestor InformationGrant/Cooperative Agreement Number:(Required)Name(Required) First Last Title(Required)Principal InvestigatorAuthorized Organization RepresentativeOffice of Sponsored ProgramsTechnical OfficerOther (Explain)Title Other(Required)Email(Required) Phone Number(Required)Type of Administrative Supplement requestPlease ensure that a checkbox is selected and additional fields are displayed. If additional fields are not displayed, refresh the page.Please select all the following reasons that align with your request from the options below: No-Cost Extension Request Principal Investigator Change Period of Performance (POP) change Novation Change of Name Other Administrative Supplements not listed: Prior Approval No-Cost Extension InformationNo-Cost Extension Information1st No-Cost Extension2nd No-Cost Extension3rd No-Cost ExtensionOther No-Cost ExtensionNew Proposed End Date:MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear203020292028202720262025Extension Reason To assure adequate completion of the original scope of work within the funds already made available. Per NASA Grant and Cooperative Agreement Manual 32.0, 2a. No-cost extensions (NCE) or Per 2 CFR 200.308(f)(10) Other. If ‘Other’, please explain. Please limit the reason for the extension to 1000 characters.The recipient may make a one-time no-cost extension, not to exceed 12 months, prior to the established expiration date. Written notification of such an extension, with the supporting reasons and the performance report, must be received by the NASA Grant Officer at least ten days prior to the last day of the period of performance. Failure to submit the necessary documentation and performance report may result in non-acceptance of the request.Please attach the required documents belowUpdated Performance ReportMax. file size: 18 MB. All required reports have been submitted to NASA Shared Services Center. Note: If report is due it shall be submitted through https://www.nasa.gov/grant-cooperative-agreement-research-performance-progress-report-submission/. Yes Attachments Cannot Exceed 18 Megabytes. DO NOT UPLOAD AN ATTACHMENT UNLESS YOU ARE READY TO SUBMIT TO NSSC.*For issues with submission, please contact the NSSC Customer Contact Center by phone at 1-877-677-2123 (1-877-NSSC123) or submit a web inquiry to the NSSC website at: https://www.nasa.gov/centers/nssc/contact-nssc. If calling, please make sure you provide the Grant Number and a short description of the issue; if submitting a web inquiry, please provide the Grant Number, a short description of the issue and any attachments.Principal Investigator ChangeCurrent Principal Investigator First Last Updated Principal Investigator First Last Updated Principal Investigator Email Updated Principal Investigator PhoneUpdated Principal Investigator Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please attach the required documents below per NASA Grant and Cooperative Agreement Manual 32.0(2)(c) and 2 CFR 200.308(f)(2) Change in Principal Investigator/Key Personnel: Approval from Technical Officer:(Required)Max. file size: 18 MB. Principal Investigator Biographical Sketch:Max. file size: 18 MB. https://dm.nssc.nasa.gov/servlet/dm.web.Fetch?did=6984717&gen=$latestCurrent and Pending Support Form:Max. file size: 18 MB. https://dm.nssc.nasa.gov/servlet/dm.web.Fetch?did=6984720&gen=$latest)Grants External webpage where the two forms and other forms for Grantees use are located: https://www.nasa.gov/centers-and-facilities/grants-2/ Attachments Cannot Exceed 18 Megabytes. DO NOT UPLOAD AN ATTACHMENT UNLESS YOU ARE READY TO SUBMIT TO NSSC.*For issues with submission, please contact the NSSC Customer Contact Center by phone at 1-877-677-2123 (1-877-NSSC123) or submit a web inquiry to the NSSC website at: https://www.nasa.gov/centers/nssc/contact-nssc. If calling, please make sure you provide the Grant Number and a short description of the issue; if submitting a web inquiry, please provide the Grant Number, a short description of the issue and any attachments.Period of Performance (POP) changeCurrent Period of PerformanceMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear203020292028202720262025Updated Period of PerformanceMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear203020292028202720262025Approval from Technical Officer:Max. file size: 18 MB. Supporting documentation for reason for period of performance change:Max. file size: 18 MB. Attachments Cannot Exceed 18 Megabytes. DO NOT UPLOAD AN ATTACHMENT UNLESS YOU ARE READY TO SUBMIT TO NSSC.*For issues with submission, please contact the NSSC Customer Contact Center by phone at 1-877-677-2123 (1-877-NSSC123) or submit a web inquiry to the NSSC website at: https://www.nasa.gov/centers/nssc/contact-nssc. If calling, please make sure you provide the Grant Number and a short description of the issue; if submitting a web inquiry, please provide the Grant Number, a short description of the issue and any attachments.NovationCurrent Institution NameUpdated Institution NameCurrent Cage Code & UEIUpdated Cage Code & UEICurrent Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Updated Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please attach the required documents below:Novation Agreement– signed by applicable parties (Excluding AGO – will sign once received at NSSC):(Required)Max. file size: 18 MB. The document describing the proposed transaction, e.g., purchase/sale agreement or memorandum of understanding:(Required)Max. file size: 18 MB. A list of all affected awards between the transferor and the Government, as of the date of sale or transfer of assets, showing for each, as of that date, the: Award number and type; Name and address of the awarding office; Total dollar value, as amended; and Approximate remaining unpaid balance.Choose FileMax. file size: 18 MB. Evidence of the transferee’s capability to perform:Max. file size: 18 MB. Attachments Cannot Exceed 18 Megabytes. DO NOT UPLOAD AN ATTACHMENT UNLESS YOU ARE READY TO SUBMIT TO NSSC.*For issues with submission, please contact the NSSC Customer Contact Center by phone at 1-877-677-2123 (1-877-NSSC123) or submit a web inquiry to the NSSC website at: https://www.nasa.gov/centers/nssc/contact-nssc. If calling, please make sure you provide the Grant Number and a short description of the issue; if submitting a web inquiry, please provide the Grant Number, a short description of the issue and any attachments.Change of NameCurrent Institution NameUpdated Institution NameCurrent Cage Code & UEICurrent Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Updated Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please attach the required documents below:Change of Name Agreement:Max. file size: 18 MB. The document effecting the name change, authenticated by a proper official of the State having jurisdiction:Max. file size: 18 MB. The opinion of the awardee’s legal counsel stating that the change of name was properly effected under applicable law and showing the effective date:Max. file size: 18 MB. A list of all affected awards and purchase orders remaining unsettled between the awardee and the Government showing for each, the: Award number and type; Name and address of the awarding office; Total dollar value, as amended; and Approximate remaining unpaid balance.Choose FileMax. file size: 18 MB. Attachments Cannot Exceed 18 Megabytes. DO NOT UPLOAD AN ATTACHMENT UNLESS YOU ARE READY TO SUBMIT TO NSSC.*For issues with submission, please contact the NSSC Customer Contact Center by phone at 1-877-677-2123 (1-877-NSSC123) or submit a web inquiry to the NSSC website at: https://www.nasa.gov/centers/nssc/contact-nssc. If calling, please make sure you provide the Grant Number and a short description of the issue; if submitting a web inquiry, please provide the Grant Number, a short description of the issue and any attachments.Administrative SupplementsMove Duplicate Settings Delete Administrative Supplement Name:Any additional requirement documentation (if applicable):Attachment:Max. file size: 18 MB. Attachment #2 (Optional):Max. file size: 18 MB. Attachments Cannot Exceed 18 Megabytes. DO NOT UPLOAD AN ATTACHMENT UNLESS YOU ARE READY TO SUBMIT TO NSSC.*For issues with submission, please contact the NSSC Customer Contact Center by phone at 1-877-677-2123 (1-877-NSSC123) or submit a web inquiry to the NSSC website at: https://www.nasa.gov/centers/nssc/contact-nssc. If calling, please make sure you provide the Grant Number and a short description of the issue; if submitting a web inquiry, please provide the Grant Number, a short description of the issue and any attachments.Prior ApprovalConcurrence from Technical OfficerMax. file size: 4 GB. Supporting Documentation for your RequestMax. file size: 4 GB. CAPTCHA
