Laserfiche WebLink
'. ^'PLICATION FOR STATE OR FEDERAL AS _ANCC <br />0I'rICE OF THE GOVERNOR, CRIMINAL JUSTICE Divisl01 <br />! 1. For CJD Use Only <br />3, a. Dale Submitted <br />2. FederaUSlate Program Claselfkcalion (For CJD Use On <br />i 1Y). 4, a. Dale Received by State/COG <br />5. Applicant Information <br />a. Legal Name: <br />C. Organizational Unit <br />b. Applicant Identifier <br />b. Slate Application IdenUri r <br />D. ) Address (y've street or P. O, BOX, cit), s(afo, and zip code d <br />' Name, Ieiephone, and lax nuFarea �Code). <br />rson to be contacted <br />concerning this application (giv <br />* • "� ' `^ ayee Identification Nu ' <br />7. Type of Applicant (ontor(Ire appropriate /a(for(n box) <br />A. State N. Indepndent School fl. Coun Dialrld N <br />Application: <br />I. Slate Controlld Institutlon of Nigher Leaming <br />C. Municipal J. Pr"le Unhrovotp <br />D. Township K Indian Tribe <br />O New Continuation E. Interstate L. IndMdual <br />L., <br />F. Inlermunicipal M. Prl—le Nonpfum Corporation <br />G. SpecialDlslrlcl N <br />Other (apeciryy <br />f continuation, enter year of funding <br />�. Name of Grantor Agency: <br />. ppcation for Federal Funds: <br />Office of the Governor, Criminal Justice Division <br />Check Catalog of Federal Domestic Assistance Number. <br />P. O. Box 12428 <br />(only one) Austin, Texas 78711 <br />O 10.540 -- juvenile Justice & Delinquency Prevention Act 11• Geographic Areas of Project Activities <br />O 10.575 — Victims of Crime Act <br />(Cities and Counde3) <br />O 16.579- -Texas Narcotics Control Program <br />O 16.580 -1-ligh Intensity Drug Trafficking Program <br />12. Tflto of Project: <br />13. Proposed Project: <br />a. Stall Dale: b, Ending Dale: — — <br />ation for State Funds: <br />.... ............................... ............. ............................... ProPriale fund: (only on- b. It 421 Fund, <br />%ppers <br />nd <br />check priority (on one _ <br />) <br />�Stoppers <br />Assistance Fund <br />O <br />c. Check One :�� <br />O C.J. Planning ❑ Law Enforcement Training <br />Other Fund ` I <br />15, Requested Funding: <br />O Juvenile <br />O Violent Crime Q Drugs ❑ Gangs O Victims O Nonquve nlle <br />a. Federal Grant s <br />1G. Is application subject to review by stale exec uWe order 12372 <br />Funds (CJD) •00 <br />process? <br />. i . .................... .... .......... ............................... <br />b. Slate Grant <br />O YES, this application was provided Review and Comment System <br />P to the Texas R <br />(TRACS) for review on <br />Funds (CJD) 00 <br />! c, Cash Match S. <br />(date) <br />•00 <br />. ...... ......................... <br />O Program Is not covered by E. O, 12372 <br />d. In -land "'" " "" """'° <br />O Program has not been selected by state for review <br />(vOCA t Tro• V only) '� <br />'rr.......only......... <br />............& <br />e. TOTAL ........................................ ............................... <br />17. Is ilia applicant delinquent on any federal debt <br />1 .00 <br />O YES If "Yes" attach an explanation <br />O NO <br />10. To the best of my knowledge and belief, all data in this application is true and correct. The document has been duty authorized by the govemin <br />body of the applicant and the applicant will comply with the attached assurances If the assistance Is awarded. <br />a. Typed Name of Authorized Official <br />b. Title C. Telephone Number __ <br />d, Signature of Authorized Official <br />e. Dale Signed <br />