Economic Development Administration
GPRA Data Collection Form
University Centers
Date ___________________________________________________________________
Recipient Name ___________________________________________________________________
Full Address ___________________________________________________________________
Authorized Contact ___________________________________________________________________
Telephone ____________________________ Fax ______________________________
Email (not optional) ___________________________________________________________________
EDA Investment Technical Assistance - University Center
Investment Number ___________________________________________________________________
Award Period ___________________ to _________________
Description of Activities: Technology _____ Economic Development _____
Recipients are required to report the following:
a. Number of University Center (UC) clients provided 8 or more hours of technical assistance. __________
(count only clients who received UC technical assistance; count only once even if client received assistance for more than one task)
b. Number of UC clients reported as taking action as a result of the assistance provided by UC __________
c. Number of those actions taken by UC clients reported in b that achieved the expected results. __________
(Please attach a list of clients and actions that achieved expected results)
d. Number of jobs created or retained as a result of c. ______________
e. Amount of private sector investment generated as a result of c. ______________
f. Amount of public sector investment generated as a result of c. ______________
g. Other economic benefits resulting from technical assistance (
written examples, dollar amounts can be included as part
of the example
h. Categorize type of assistance provided:
(one client may receive more than one type of assistance; count only once even if client received assistance for more than one
Quantity Quantity
Economic development plan ____ Partnership Strategies ____
Strategic partnering to Project Management ____
Public-or private sector entities ____ GIS Service ____
Client Services ____ Studies ____
Technology Transfer ____ Business Sector Services ____
OMB Approved ED-917
OMB Control Number 0610-0098
Expires: 11/30/2020
PART I: To be completed by Regional personnel. Recipient should review the information and make changes
where necessary.
The Investment Recipient will complete the indicated section. If there is not sufficient space on the data collection
form, you may use additional pages with the EDA investment number, date of award, and reporting period at the top
of each page.
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 UC assistance will not be immediately
realized. UCs must report outcomes associated with the EDA investment awarded two years prior to the current
federal fiscal year. The report is due at the EDA regional office not later than 10 calendar days after the two-year
award anniversary. (Example: A UC that received an investment award on January 1, 2016, must report on assistance
provided to clients from January 1, 2016 to December 31, 2017 not later than January 10, 2018.)
Taking an action as a result of the assistance facilitated means to implement an aspect of the technical assistance
provided by the University Center in one or several areas: economic development initiatives and training session
development; linkages to crucial resources; economic development planning; project management; community
investment package development; geographic information system services; strategic partnering to public- or private-
sector entities; increased organizational capacity; feasibility plans; marketing studies; technology transfer; new
company, product, or patent developed; and other services.
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 7 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
OMB Approved ED-917