TN 30 (03-02)
DI 39506.220 Preparation of Form SSA-4513 Addendum
A. Procedure - form heading
Enter the official name of the agency, State, date prepared, fiscal year for which you are reporting, and the period beginning October 1 of that fiscal year through the end of the calendar quarter for which you are reporting.
B. Procedure - line item reporting
Include pertinent information that applies to the indirect cost calculation (e.g., rate, base, exclusions, etc.). Attach the most current indirect cost agreement if approved since submission of prior SSA-4513. (See DI 39506.300 for additional instructions regarding State Indirect Cost Agreements.)
1. Indirect cost
This line should reflect the total cumulative amount obligated for indirect costs within the Federal fiscal year. The calculation should reflect the base multiplied by the indirect cost rate--plus any other charges not included within the base and rate.
2. Indirect rate
The indirect rate should reflect the percentage authorized in the State department or parent agency's approved indirect cost proposal.
The base should reflect total amount of obligations included in the base per approved indirect cost agreements, statewide cost allocation agreements, etc.
Base Exclusions (if applicable)
Show the amount obligated for equipment if not already included in the base.
b. Fringe benefits
Show the amount obligated for fringe benefits if not already included in the base.
Show the amount obligated for all other costs if not already included in the base.
C. Procedure - remarks section
Enter any pertinent remarks applicable for Forms SSA-4513 and SSA-4513 Addendum (e.g., status of unliquidated obligations, explanation of any adjustments) and/or include additional attachments (e.g., copy of indirect cost agreement, etc.).