Economic Development Administration
GPRA Data Collection Form
Trade Adjustment Assistance Centers
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Date ___________________________________________________________________
Recipient Name ___________________________________________________________________
Full Address ___________________________________________________________________
Authorized Contact ___________________________________________________________________
Telephone ____________________________ Fax ______________________________
Email (not optional) ___________________________________________________________________
EDA Investment Trade Adjustment Assistance Investments
Project Number ___________________________________________________________________
Award Date ___________________________________________________________________
Description of Activities: Trade Adjustment Assistance Center
Data Collection Period:
There is a two-year lag between the date the assistance was provided and the date the results are
reported because the majority of the benefits resulting from TAAC assistance will not be immediately realized. TAACs
must report on assistance provided during their investment award period two years prior to the current federal fiscal year.
(Example: In FY 2017, a TAAC receiving an investment award on January 1, 2015, the recipient must report on assistance
provided to clients from January 1, 2015 to December 31, 2015.)
1. Trade Adjustment Assistance Centers
a. The number of clients for which there is an approved AP, that have commenced
with at least 1 (one) contractually-covered project by a consultant during the
look-back period. A client is counted only once irrespective of the number
of projects implemented. ______________
b. The number of clients counted in 1.a. above that have completed their
project. ______________
c. The number of clients counted in 1.b. above that have not only completed their
project but have testified that the project has been completed to their
satisfaction (i.e., goals of the project have been met). ______________
d. Amount of increased sales or revenues achieved by TAAC clients ______________
resulting from the TAAC assistance reported in 1.a.
(base report on information provided by clients)
e. Estimated number of jobs created or retained by TAAC clients resulting ______________
from the TAAC assistance reported in 1.a.
(base report on information provided by clients)
f. Attach a list of clients that achieved the expected results for the technical assistance provided by the
TAAC as reported in 1c and provide a very brief description of the technical assistance.
(e.g., Firm: Assistance provided:
ABC, Inc. Developed a web site to accommodate e-commerce
ADE, Llt. Achieved ISO-9000:2000 certification)
g. For TAACs reporting increased sales or revenues totaling $40 million and over, or jobs totaling 500 and over
in 1.d. and 1.e. above, for any single client, complete and attach the TAAC validation form.
OMB Approved ED-918
OMB Control Number 0610-0098
Expires: 11/30/2020
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GPRA DATA COLLECTION INSTRUCTIONS
TRADE ADJUSTMENT ASSISTANCE CENTERS
Headquarters or regional personnel will complete the following information prior to sending the form to the
recipient. The Investment Recipient will update or complete the following as necessary. If there is not sufficient
space on the data collection form, you may use additional pages with the EDA project number, date of award, and
reporting period at the top of each page.
Recipient Name: Legal name of the Recipient.
Full Address: Physical address of the Recipient including city, state and zip. Include mailing address if different.
Authorized Contact: Person to contact regarding this report. Include the telephone number, if different from
Recipient.
Telephone: Telephone number, including area code. Fax: Facsimile number, including area code.
E-mail Address: Internet address of authorized contact using the following format, (name@organization.com).
Project Number: As reflected on the CD-450 and/or CD-451 Notification of Grant Award covering the dates
reflected by the reported data.
Award Date: As reflected on the CD-450 and/or CD-451 Notification of Grant Award covering the dates reflected
by the reported data.
Burden Statement: Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a
penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of
information displays a currently valid OMB Control Number 0610-0098 Expires 11/30/2020. The public reporting burden for this collection is
estimated to average 6 hours per response including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden to: Economic Development Administration, Herbert C. Hoover
Building, Washington, DC, 20230, and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC
20503.
OMB Approved ED-918