Laserfiche WebLink
APPLICATION FORTxCDBG ASSISTANCE <br />OMB Approval No.0348-004J <br />1. TYPE OF SUBMISSION <br />2. DATE SUBMITTED: <br />APPLICANT IDENTIFIER: <br />Apolication: Pre-application: <br />F-I Construction F-I Construction <br />3. DATE RECEIVED BY STATE: <br />STATE APPLICATION IDENTIFIER: <br />F-I Non-Construction F-I Non-Construction <br />4. DATE RECEIVED BY FEDERAL AGENCY: <br />FEDERAL IDENTIFIER: <br />5. APPLICANT INFORMATION: <br />Leoal Name: <br />Oraanizational Unit: <br />Coun <br />and Zip Code) of aRplicant: <br />Address (Citv <br />State <br />Name/Title. Agency or Company, Address. Area Code, Telephone and Fax Numbers, <br />, <br />. <br />, <br />and e-mail address of applicant preoarer: <br />6. EMPLOYER IDENTIFICATION NUMBER (EIN): <br />66. DUNS NUMBER: <br />7. TYPE OF APPLICANT: <br />8. TYPE OF APPLICATION: <br />E] A. Municipal ~ B. County <br />0 New ~ Continuation ~ Revision <br />9. NAME OF FEDERAL / STATE AGENCY: <br />10 CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER• <br />Office of Rural Community Affairs <br />14228 Title: Texas Community Development Block Grant Program (TxCDBG) <br />11. PROJECT TYPE: <br />11 a. NPE OF APPLICATION: <br />Community Development Fund <br />12. TARGET AREA(S) AFFECTED BY THE PROJECT: <br />11 APPLICANTS FISCAL YEAR: <br />Beginning Date: Ending Date: <br />14. CONGRESSIONAL DISTRICTS: fiepresentative: Senate: Congress: <br />15. ESTIMATED FUNDING: <br />16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS <br />A. TxCDBG REQUEST: <br />FEDERAL <br />B <br />Yes the preapplication / application was made available to the State Executive <br />~ <br />: <br />. <br />Order 12372 process for review on: <br />C. STATE: <br />Date: <br />D. APPLICANT: <br />~ No <br />E. LOCAL• <br />F-I Program is not covered by E.O. 72372 -OR- <br />F. OTHER: <br />G. TOTAL: <br />~ Program has not been selected by the State for review <br />17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBP <br />E] Yes. If "Yes", attach an explanation. F] No <br />18. TO THE BEST OF MY KNOWLEDGE AND BELIEF ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY <br />AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE CERTIFICATIONS AND CITIZEN PARTICIPATION PLAN INCLUDED <br />IN THE PROCEDURES SECTION OF THE TxCDBG PROGRAM APPLICATION GUIDE IF THE ASSISTANCE IS AWARDED. <br />oed Name of the Applicant's Authorized Representative• <br />a T <br />h TitiP of the Aaolicant's Authorized Representative• <br />c. Telephone Number <br />v <br />d Signature of the Applicant's Authorized Representative• <br />DatelTime Field <br />Previous Editions Not Usable STANDARD FORM 424 (REV-4-88) <br />Page 3 of 16 <br />- 000091, <br />