0MB Control No 1076-0135 Expiration Date XXXXXXXX

US Department of the Interior Public Law 102-477

Annual Financial Expenditure Report - Version 2

1 Tribeffribal Organization 2 Other Identifying Number Assigned by DOI Miami Tribe of Oklahoma 0SGT925

3 Mailing Address (Provide complete mailing address)

PO Box 1326 Miami OK 74355

4 Submission (Mark One) 5 Final Report for Plan Period

Yes QNoG) Original 0 Revised 0 gtJ 6 Annual Report Period 7 Plan Period Covered by this Report

Ii From 1q 1 15 To 9 30 16 From 10 1 12 To 9 3Q 15

(MonthDayYear) (MonthDayYear) (MonthDayYear) (MonthDayYear)

Column II Column Column III

8 Transactions This Annual Report Previously Reported CumulativeTotal

Period

$ 15361400 -a Total Funds Available $ 360000 -$ 15001400 -

b Cash Assistance Expenditures $ -$ - $ -

$ - $ -c Child Care Services Expenditures $ -

d Education Employment Training and Supportive Services $ 614376 -$ 5066741 - $5681117 -Expenditures

i TANF Purposes 3 and 4 (non-add) $ - $ - $ -

$ -ii Other TANF Assistance (non-add) $ - $ -

e Program Operations Expenditures $ - $ - $ -21 05003 51 08668 3003665

$ - $ -i Child Care Quality Improvement (non-add) $ -

f AdministrationIndirect Cost Expenditures $ - $ - $ -822905 946053123148

g Total Federal Expenditures (Sum oflines b through f) - $ 11735838 -$ 81 93554 - $ 3542284

h Total Unexpended Funds $ 3625562$ 68 07846 $ (3182284)

9 Certification This is to certify that the info1mation reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory requirements which have not been wai~

-a Signature of Tribal Official ~~Lnl~-middot-0 - - -J-7 -

c Date Report Submitted b Type Name and Title ~

122816Doug Lankford d Questions regarding this report - Contact (Type Name Title Phone and Email Address)

Tamra Bro Accounting Manager 918-541-1313 tbromiaminationcom

0MB Control No 1076-0135 Expiration Date XXXXXXXX

US Department of the Interior Public Law 102-477

Annual Financial Expenditure Report- Version 2

l TribeTribal Organization 2 Other Identifying Number Assigned by DOI Miami Tri be of Oklahoma 0SGT925

3 Mailing Address (Provide complete mailing address)

PO Box 1326 Miami OK 74355

4 Submission (Mark One) 5 Final Report for Plan Period

Yes QNoG) Original 0 Revised 0 -

6 Annual Report Period 7 Plan Period Covered by this Report ~

From 1Q 1 115 To 913Q 16 From 1011 115 To 913Q 18 (MonthDayYear) (MonthDayYear) (MonthDayYear) (MonthDayYear)

gii l

Column II Column IllColumn I8 Transactions This Annual Report

Previously Reported CumulativeTotal Period

$ 144600 a Total Funds Available $ - $ 144600 0

b Cash Assistance Expenditures $ - $ $

$ -c Child Care Services Expenditures $ $

d Education Employment Training and Supportive Services $ -$ $

Expenditures

$ - $ -i TANF Purposes 3 and 4 (non-add) $ -

$ - $ -ii Other TANF Assistance (non-add) $ -

$ -$ - $ -e Program Operations Expenditures

$ - $ - $ -i Child Care Quality Improvement (non-add)

$ - $ - $ -f AdministrationIndirect Cost Expenditures

$ $ g Total Federal Expenditures (Sum of lines b through f) $ 00 0

$h Total Unexpended Funds $ $ 144600 1446000

9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best of my knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory requirements which have not been waiv~

a Signature of Tribal Official (middot l~~-f JR -_ 7 - _- -- ~i_

c Date Report Submitted b Type Name and Title -122816Doug Lankford

d Questions regarding this report- Contact (Type Name Title Phone and Email Address)

Tamra Bro Accounting Manager 918-54 1-1313 tbromiaminationcom