Single Audit Component Checklist - CensusS... · · 2018-03-22Form SF-SAC Worksheet & Single...
Transcript of Single Audit Component Checklist - CensusS... · · 2018-03-22Form SF-SAC Worksheet & Single...
Form SF-SAC Worksheet & Single Audit Component Checklist For Audits With Fiscal Periods Ending in 2013
Enter and Submit Form SF-SAC data and Single Audit package only at:
- 1 -
AUDIT COMPONENTS REQUIRED FOR SINGLE AUDIT SUBMISSION:
Single Audit Component Checklist
Attention: Please review your audit report to make sure that Personally Identifiable Information, or PII, is not included. Examples of PII are, but not limited to, Social Security Numbers, account numbers, vehicle identification numbers, copies of cancelled checks, student names, dates of birth, personal addresses or personal phone numbers.
___________________________________________________________________________________________
Please enter the starting pdf file page number for each of the following components. If auditor reports have been completed, then list the starting page number of the combined report for each corresponding report on the checklist. If a component is not required, enter 'N/A' instead of a page number. Each component on the checklist must have a numeric page number or 'N/A' listed.
The following is a key for the Component Checklist * = Required (cannot be blank or 'N/A'). ** = Required if prior audit findings exist. *** = Required if findings exist. Note: These codes do not apply to a program specific audit..
Page Number Component
* Financial Statement(s) §__ .310(a)
* Opinion on Financial Statements §__ .505(a)
* Schedule of expenditures of Federal Awards §__ .310(b)
* Opinion or Disclaimer of Opinion on Schedule of Federal Awards §__ .505(a)
* A-133 Report on Internal Control §__ .505(b) (major programs)
* A-133 Report on Compliance §__ .505(c) (major programs)
* GAS Report on Internal Control §__ .505(b)
* GAS Report on Compliance §__ .505(c)
* Schedule of Findings and Questioned Costs §__ .505(d)
** Summary Schedule of Prior Audit Findings §__ .315(b)
*** Corrective Action Plan (if findings) §__ .315(c)
FORM SF-SAC 12/31/2013 U.S. Dept. of Comm. - Econ and Stat Admin. - U.S. Census Bureau
OMB No. ACTING AS COLLECTING AGENT FOR OFFICE OF MANAGEMENT AND BUDGET
PART I: GENERAL INFORMATION REPORT ID: VERSION: 1. Fiscal Period End Date 2. Type of Circular A-133 audit
__ __ / __ __ /__ __ __ __ Single Audit
MM / DD / YYYY Program-specific audit
3. Audit Period Covered Annual
Biennial
Other- If Other, Number of months:
4. Auditee Identification Numbersa. Auditee Employer Identification Number (EIN) d. Auditee Data Universal Numbering System (DUNS) Number
__ __ - __ __ __ __ __ __ __ __ __ - __ __ __ - __ __ __ __
b. Are multiple EINS covered in this report? e. Are multiple DUNS covered in this report? Yes If Yes, complete Part I, Item 4c: Yes If Yes, complete Part I, Item 4f:
Auditee EIN Continuation Sheet Auditee DUNS Continuation Sheet.
No No5. Auditee Information 6. Primary Auditor Informationa. Auditee name a. Audit Firm/Organization Name
b. Auditee address (Number and street) b. Audit Firm/Organization EIN__ __ - __ __ __ __ __ __ __
c. Audit Firm/Organization address
Auditee City Audit Firm/Organization City
Auditee State Audit Firm/Organization State
Auditee ZIP Code Audit Firm/Organization ZIP Code
c. Auditee Contact Name d. Primary Auditor Contact Name
Auditee Contact Title Primary Auditor Contact Title
d. Auditee Contact Telephone e. Primary Auditor Contact Telephone
e. Auditee Contact Fax f. Primary Auditor Contact FAX
f. Auditee Contact E-mail g. Primary Auditor Contact E-mail
7. Was a secondary auditor used? Yes- If Yes, Complete Part I, Item 8 on the
Secondary Auditor Contact Information Sheet No
Data Collection Form for Reporting onAUDITS OF STATES, LOCAL GOVERNMENTS AND NON-PROFIT ORGANIZATIONS
For Fiscal Year Ending Dates in 2013, 2014, or 2015
DRATT
AFTRAF
DR
e. AYes
6FAFRA
DRFTFTFFT - -
NOT OTOT
NONelephone
TNO
FOROR FORFOF
F
SUB
NONSIO
N
SSIOSS
MISBMIS
UBMSUS
ring System (DUN
- __ __ __
vered in this reete Part I, Item
e DUNS Continuat
ary Auditor Infdit Firm/Orga
b. Audit Firm
c. AudS
NSIO
BMBSU
Form SF-SAC REPORT ID: VERSION:PART II: FINANCIAL STATEMENTS (To be completed by auditor)1.Type of audit reportMark either: Unmodified Opinion OR ANY COMBINATION OF: Qualified opinion
Adverse opinion Disclaimer of opinion
2. Is a "going concern" emphasis-of-matter paragraph included in the audit report? Yes No
3. Is a significant deficiency disclosed? Yes No
4. Is a material weakness disclosed? Yes No
5. Is a material noncompliance disclosed? Yes No
1. Does the auditor's report include a statement that the auditee's financial statements include departments, agencies, or other organizational units expending $500,000 or more in Federal awards that have separate A-133 audits which are not included in this audit? (AICPA Audit Guide) Yes No
2. What is the dollar threshold to distinguish Type A and Type B programs? (OMB Circular A-133 § _.520(b)) $ _______________________
3. Did the auditee qualify as a low-risk auditee? (§_.530) Yes No
4. Were Prior Audit Findings related to direct funding shown in the Summary Schedule of Prior Audit Findings? (§_.315(b)) Yes No
98 U.S. Agency for International Development 17 Labor10 Agriculture 09 Legal Services Corporation23 Appalachian Regional Commission 43 National Aeronautics and Space Administration11 Commerce 89 National Archives and Records Administration94 Corporation for National and Community Service 05 National Endowment for the Arts12 Defense 06 National Endowment for the Humanities84 Education 47 National Science Foundation81 Energy 07 Office of National Drug Control Policy66 Environmental Protection Agency 59 Small Business Administration39 General Services Administration 96 Social Security Administration93 Health and Human Services 19 U.S. Department of State97 Homeland Security 20 Transportation14 Housing and Urban Development 21 Treasury03 Institute of Museum and Library Science 64 Veterans Affairs15 Interior 00 None16 Justice OTHER - SPECIFY:
PART III: FEDERAL PROGRAMS (To be completed by auditor)
5. Indicate which Federal Agency(ies) have current year audit findings related to direct funding or prior audit findings shown in the Summary Schedule of Prior Audit Findings related to direct funding. Mark (X) all that apply or None .
DRAFTTFTAF
DRAFnt that the audgencies, or o
0 or more in Feh are not incl
by auditor)AFTAF
- - --
NOTNOT NO
s related to r Audit F
ederal Ageum
TNO
FORROR FOF
and Type B pr
auditee? (§_
RFOF
SUBMISSIO
NNONSIO
SSMIS
BMSUBM
No
No
l awards this
BM
NNSIO
SSMIS
BMS
MISMIS
(a)
(b)
(d)
(e)
(f)(g
)(h
)(i)
(j)(k
)
Row Number
Federal Agency Prefix 1
CFDA Extension 2
Amou
nt e
xpen
ded
($)
Research & Development
Loan/Loan Guarantee
ARRA 3
Direct award
Major program
Number of Audit Findings
(Y/N
)(Y
/N)
(Y/N
)(Y
/N)
(Y/N
)
$
.00
4 If
maj
or p
rogr
am is
mar
ked
"yes
," e
nter
onl
y on
e le
tter
(U =
Unm
odifi
ed o
pini
on, Q
= Q
ualif
ied
opin
ion,
A =
Adv
erse
opi
nion
, D =
Disc
laim
er o
f opi
nion
) cor
resp
ondi
ng to
the
type
of a
udit
repo
rt in
the
adja
cent
box
. If
maj
or p
rogr
am is
mar
ked
"No,
" lea
ve th
e ty
pe o
f aud
it re
port
box
bla
nk.
PART
III:
FED
ERAL
PRO
GRAM
S - C
ontin
ued
If yes, type of audit report on Major Program 4
3 A
mer
ican
Rec
over
y an
d Re
inve
stm
ent A
ct o
f 200
9 (A
RRA)
.
MAJ
OR
PRO
GRAM
REPO
RT ID
:
V
ERSI
ON
:
Nam
e of
Fed
eral
pro
gram
(c)
CFDA
Num
ber
6. F
EDER
AL A
WAR
DS E
XPEN
DED
DURI
NG
FISC
AL Y
EAR
FORM
SF-
SAC
2 O
r oth
er id
entif
ying
num
ber w
hen
the
Cata
log
of F
eder
al D
omes
tic A
ssist
ance
(CFD
A) n
umbe
r is n
ot a
vaila
ble.
(See
inst
ruct
ions
- Ite
m 6
)
1Se
e Ap
pend
ix 1
of i
nstr
uctio
ns fo
r val
id F
eder
al A
genc
y tw
o-di
git p
refix
es.
TOTA
L FE
DERA
L AW
ARDS
EXP
ENDE
D
DRAFT
DRDRARAFAFTT
DRDRRARAAFAFFTTTRAAFT - - -
NOT
f Fed
eral
pro
gra
FORFOFORORR FOFOORORRROR
SUBMISSIO
N
SSUUBMBMMISSSSS
pe o
f aud
it re
port
of
aud
it re
port
SSSUUUBBMBMBMMIMISIS
UBSS
BMISSSS
N
(a)
(b)
(d)
(e)
(f)(g
)(h
)(i)
(j)(k
)
Page 3 Row Number
Federal Agency Prefix
CFDA Extension
Audi
t Fin
ding
Re
fere
nce
Num
ber
Type
(s) o
f Co
mpl
ianc
e Re
quire
men
t(s)
1
Modified Opinion
Other Matters
Material Weakness
Significant Deficiency
Other Findings2
Questioned Costs
(YYY
Y-##
#)
(Y/N
)(Y
/N)
(Y/N
)(Y
/N)
(Y/N
)(Y
/N)
A
. Ac
tiviti
es A
llow
ed o
r Una
llow
edF.
Equ
ipm
ent a
nd re
al p
rope
rty
man
agem
ent
K. R
eal p
rope
rty
acqu
isitio
n an
d re
loca
tion
assis
tanc
e
B
. Al
low
able
cos
ts/c
ost p
rinci
ples
G. M
atch
ing,
leve
l of e
ffort
, ear
mar
king
L. R
epor
ting
C
. Ca
sh m
anag
emen
tH.
Per
iod
of a
vaila
bilit
y of
Fed
eral
fund
sM
. Sub
reci
pien
t mon
itorin
g
D
. Dav
is-Ba
con
Act
I. P
rocu
rem
ent a
nd su
spen
sion
and
deba
rmen
tN
. Sp
ecia
l tes
ts a
nd p
rovi
sions
E
. El
igib
ility
J. P
rogr
am in
com
eP.
Oth
er
2 T
here
are
9 v
alid
com
bina
tions
of "
Com
plia
nce
Find
ings
," "I
nter
nal C
ontr
ol F
indi
ngs,
" and
"Oth
er F
indi
ngs"
for e
ach
Fede
ral p
rogr
am w
ith fi
ndin
gs.
(See
inst
ruct
ions
- Ite
m 7
)
Nam
e of
Fed
eral
pro
gram
1 E
nter
the
lett
er(s
) of a
ll ty
pe(s
) of c
ompl
ianc
e re
quire
men
t(s)
that
app
ly to
aud
it fin
ding
s (i.e
., no
ncom
plia
nce,
sign
ifica
nt d
efic
ienc
y (in
clud
ing
mat
eria
l wea
knes
ses,
), qu
estio
ned
cost
s, fr
aud,
and
oth
er it
ems r
epor
ted
unde
r §__
.510
(a))
repo
rted
for e
ach
Fede
ral p
rogr
am.
This
page
is n
ot re
quire
d if
no fi
ndin
gs a
re re
port
ed o
n Pa
rt
III, I
tem
6k.
Thes
e co
lum
ns a
re p
opul
ated
aut
omat
ical
ly fr
om P
art I
II,
Item
6, c
olum
ns a
, b, a
nd c
on
row
s with
find
ings
.Fo
r eac
h aw
ard
with
find
ings
, one
row
is c
reat
ed fo
r eac
h fin
ding
repo
rted
on
Part
III,
Item
6k.
7. F
EDER
AL A
WAR
D FI
NDI
NGS
FORM
SF-
SAC
REPO
RT ID
:
V
ERSI
ON
:
(c)
Part
III:
FED
ERAL
PRO
GRAM
S - C
ontin
ued
Com
plia
nce
Find
ings
2
Inte
rnal
Co
ntro
l Fi
ndin
gs2
DRAFT
DRRAAFTFTm
plia
nqu
irem
ent(
s)
DRRARARARAAAFFTFTTTTT
RAAFTT -
NNOTOT NOT FOR
FOORR
Find
inen
ce N
um #)
FOORORR OR
SUBMISSIO
N
SSUUBMIISSIO
N
ce
ludi
ng m
ater
i
SSSUSUUBUBUBUBBBMMMII
N
UBBMISIS
FORM SF-SAC REPORT ID: VERSION: CERTIFICATIONS
Auditee Certification Statement Auditor StatementThis is to certify that, to the best of my knowledge and belief, the auditee has: (1) engaged an auditor to perform an audit in accordance with the provisions of OMB Circular A-133 for the period described in Part I, Items 1 and 3; (2) the auditor has completed such audit and presented a signed audit report which states that the audit was conducted in accordance with the provisions of the Circular; and (3) the information included in Parts I, II, and III of this data collection form is accurate and complete. I declare that the foregoing is true and correct.
The data elements and information included in this form are limited to those prescribed by OMB Circular A-133. Except for Part III, Items 4, 5, 6a-6h, and, when audit findings are reported, 7a-7c, the information included in Parts II and III of this form was transferred from the auditor's report(s) for the period described in Part I, Items 1 and 3, and is not a substitute for such reports. The auditor has not performed any auditing procedures since the date of the auditor's report(s). A copy of the reporting package required by OMB Circular A-133, which includes the complete auditor’s report(s), is available in its entirety from the auditee at the address provided in Part I of this form. As required by OMB Circular A-133, the information in Parts II and III of this form was entered in this form by the auditor based on information included in the reporting package. The auditor has not performed any additional auditing procedures in connection with the completion of this form.
Auditee Certification Auditor Signature(Date of Electronic Signature ) (Date of Electronic Signature )
Name of certifying official
Title of certifying official
DRAFTFTFTAFAFTAF
RAFAFRA
Auditor Signa
AFTFTFAFRA
- om
NOT FOR SUBMIS
SION
MISMIBMBM
UBMUB
ckage ge ete auditor’s ete auditor’s
the address the address Circular A-133, theircular A-133, t
tered in this form tered in this forreporting packageorting package
auditing procedurauditing proceform.m.
(Date of ElectroniMISMIUB
FORM SF-SAC REPORT ID: VERSION:
List the multiple Employer Identification Numbers (EINs) covered in this report.--
------------------------
PART I, Item 4c. AUDITEE EIN CONTINUATION SHEET (FROM PART I, ITEM 4b)
TFTFTAFT
RAFRA
DRADRDDDDRAFFTTFT
FTAF
RARADRDD
- - --
NOTTOTOTOTTTOT OT
RROR OR
FOFOFFFORRROROFOFF
MISSIO
N
MMBMBMUB
SUBSUSUS
MI
SUUBMMBMUBUB
SUSUS
REPORT ID: VERSION:
- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -
FORM SF-SACPART I, Item 4f. AUDITEE DUNS CONTINUATION SHEET (FROM PART I, ITEM 4e)List the multiple DUNS covered in this report.
DRAFT TFTRARAF
DRDRARADD
----DRRAAFTTTFTFT
AFRARA
DRDD
- - -
NOT TOTOTTOTOT FORROROR FOFOOFF
-
-FOORRRROROFOFF
SUBMISSIO
N
IMIUBM
SUBS
MI
SSUBMIMIMBMUBUB
SUSS
REPO
RT ID
:
V
ERSI
ON
:Pa
rt I,
Item
8, S
ECO
NDA
RY A
UDI
TORS
' CO
NTA
CT IN
FORM
ATIO
N
Audi
tor F
irm n
ame
Audi
tor E
INAu
dito
r add
ress
(Num
ber
and
stre
et)
City
Stat
eZI
PCo
ntac
t Nam
eTi
tle
Audi
tor
cont
act
tele
phon
e Au
dito
r co
ntac
t FAX
Audi
tor c
onta
ct E
-mai
l(a
)(b
)(c
)(d
)(e
)(f)
(g)
(h)
(i)(j)
(k)
FORM
SF-
SAC
DRAFT
DDDRDRARAAFDD
AFDDDRDRRARAAAF
-
NOTNNONONOTOTTT OT
NNNNONOOTOTTT FOR FFFOFORORRORRFFFOFOORORRR
SUBMISSIO
N
SS