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INSTRUCTIONS FOR THE SF-42A
<br />Public reporting burden for this co,,ection of inlicirrnition is estimabs to average 60 rrznutes iper,,nespcnse, including time ftr reviemrg MbtrL:tions, search n9
<br />existing data sources, gatsring and maintaining the data needtid, anew cornic*1ing, and rev,*Mng t,,e collectc,,7 of inflorm3tor, . Send ccirnments regarding ve
<br />&urden eszima:e or a -yover aspect of thisociiection of infomnaiion ircludingsuggesticnsfcrreducing this pj,,-der, to the Office of Mainagemeni an,., Budge:
<br />Faperwvrk Rec. :tion Project, f.1346-0041), Washington, DC 2ND?.
<br />PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET- SEND IT TO THE ADDRESS PROVIDED
<br />BY THE SPONSORING AGENCY. i
<br />TL,i, is a s-azdazd for in (imzhadiag -.he couninuatior. sLeer) rec�xuved for use as a cv.-ei -.heet for sub=ss.on of prespphcatmus and app: CanoLs a ad
<br />related mfcrmaticr. uLder 4isz&-e::o3ztai prozr=s, Some of the:te=a are reqitne-1 and icirne are optional at tLe discretion offhe applicant or the Federal
<br />agency (agpacyj, Required :teens are :dernfed with an asterisk, or. *:ie fom =d are specified in ,he himuctiem;i below. In addition to tLe, mistructions
<br />providAd below. oppa:aars rxnir consultspnicy iumzuctions to detelmkie spe-nc r,-q=E-r3An1S
<br />Iten
<br />Er•r
<br />y�
<br />i tepi
<br />E-ntry:
<br />1.
<br />Type of Submission: �Requr): Select one ripe of in
<br />IC,
<br />Name Of Federal Agency: flRequired, Enter the narns of the
<br />aTocriclance vvzr, zgericy ristructions.
<br />reperal agency ftrn wla.i:h issistan,:e s being rcqueste: with
<br />■ Preao;9ication
<br />this appicatisri,
<br />• AppAzation
<br />!I.
<br />Catalog Of Federal Domestic Assistance NurnbeoTitW
<br />Enter the C-3taic-, of -:edera Cz rest . Assistan,:e riuri:�r a %-
<br />of the .7, cigr3r, unci, w-linich asss"Ancs is rez,,ested, as
<br />Lund 'in. he iccrograrri amno-,.�,noe meri, f3c'C Cat4,
<br />• Changed:Correcred Applicatc�7 - 1" ,*quested by the 3gierVY, Q•9CK
<br />;4 :his submission s to c, ange or correct a -,reyce�sly submitted
<br />app cation, ''finless requesie,: by the agency, 3picftaits may not
<br />A .jse -his -o submit changes after the clicsing date.
<br />'7.
<br />Type of Application: (Req�lredj Select one type 4 applicalic'! in
<br />12,
<br />Funding Opportunity Numberffitle- 'Red ,red) E rter the
<br />accordance vpith age... nstructions.
<br />Funding Cippercunity 14-mbe-,.r and the of v^e cpV unity Linde',
<br />Ness = -.An applicalion "t is being to ar, age\!,cyfor the
<br />�rst,irnie,
<br />wnic.,!, assista, ce is recuis*ed, as found n, Jie program
<br />annc-,j n c eme nt.
<br />13.
<br />petition Identification NumberfTifle: E-Erter the
<br />'or a pre,*st wah a projecleo comp eticin date. -h ---s can include
<br />renevorals.
<br />Rev,sicin he Fede-3 3icivernment's fianc=>.!;
<br />Compet-ion Identification NU inber and title of the cor-,petition
<br />under vvmch assistance is recl.ested. F app, . icab,e,
<br />cb - Vtcn or scniinge-i :ability from an existing obligation, f a
<br />revisaan, entef the appropriate etted ' s). More thar one inay be
<br />selected, if `CtlieCis selemec, clease spectj in text hex prov.;.,ad.
<br />A Increase Award B. Decreasekvoarc
<br />I- increase Curatcii D. Decrease r Duravon
<br />E. Cther ispezi
<br />Ik
<br />Areas Affected By Project: List the areas or entities using
<br />the categories (e.g., cities, cc,,mes, states, etc., scec-"fed in
<br />agercy nst".c`1'0nSL Use the con-linur.ion sheet to enter
<br />aftJonal areas, it neeze•,,.
<br />3.
<br />Date Received: Leave iris field bfa,,*. This date will be assigned by the
<br />I!,
<br />Descriptive Title of Applicant's Project: :.Req, re-d) Eller a
<br />Fede,ra agency.
<br />brief descriptive title of tare prc;ercn apprc;nze, atzacr a
<br />map showing project location ile,g_ const,,.�ctiipn cr rea,
<br />pro,.;" proj ects). For preaopc1,--.,,-xions, attach 3 s.=rmari
<br />Applicant Identifier: Enter the ently identif*° ass.,Ved by the Federal
<br />agency, is a^ y, c r appillcant's ov*ol number, if
<br />descriloton, of the.vojeat
<br />52
<br />Federal ral En tity Identifier: Enter the nw. nbe- asst d to your
<br />IC,
<br />Congressional Districts Of (Required; I @a. Enter the
<br />organizatic- by the Federal Agency, if any.
<br />apip�kan' i's Congresvoral Dis"xct, 3nd, Ili:, Einter ail Cs*rztils
<br />affected by the program car Enter in t',eform3t 2
<br />characters State Abpre,,r,31jcn - i characte°s Dist° ct N'turter,
<br />e,g- CA-C;,i5�r California 51" dirt -,zt, Ca,1fcrn4 12r'
<br />district, Nr-- 103 fc?,, Norte Carolina's t_,V c,strk=
<br />5b.
<br />Federal Award Identifier- For n&w appbaaborts leave b4arx. For 3
<br />cominuanDn or reeision, to an existing award, enter the previous "y
<br />assigned Fsceral award identf r nurnber. J a thangedicorrectea
<br />application, enter the Federal loentifier in accordance witn age,7,,.-y.
<br />, rfstructicins.
<br />. If a,: congress B ial dist,,cts in i state a,-e affected, enter
<br />.all' for the disirct number, e.g- MD-ail k4 ail
<br />:,v-gressionai districts m Mari and,
<br />. F iaticriedde, .e, all districts within ail states are arffe- wtst
<br />enter 1E -ail,.
<br />6.
<br />Date Rec*iveA by State: Leave this field biank, This date ,. 41 be
<br />assigned by the State, if applicable.
<br />T.
<br />State Application Identifier: Leave ,his field blank. 71is dentler w#11
<br />c,e assigned by the State, if applicabW
<br />. I"he programi`pro�ee, �s outside the US, enter 0-%1113.
<br />S.
<br />Applicant Information Enter the following r, aecvaance kv-Ah agency
<br />nsrruc,.icns:
<br />a. Legal Name.,. (Required: Enter the legal rame of appikant ilia: will
<br />17,
<br />Proposed Project Start and End Dates: iReauired ; Frite,• the
<br />.mcfertake the assstan(>e- act rarity. This is the iama, that it* organization
<br />proposed start date aride-nd date of the prc, ,ect.
<br />n as regisle-ed with the Central Ccn-ractcr Registry. Inforrnaticr, on
<br />�episiefjnq with CCR may be obtained by vskiry the &ants.00v wsbsAe..
<br />b. EmployerfTaxpayeir Numbeir (EINiTIN): (Required; Enter tie
<br />Emp-,oyier or 7aXpayer'dentificaton Numdoer:!EIN or TIN) is assigned by
<br />the lr�rema§ Pe.ye--w,-- Se vice. if your erganizaticri is nci'r the US, erier
<br />44-44444444,
<br />18,
<br />Estimated Funding: (Requireo, ;-:met the amcunt requested
<br />or tc, be mnifluted during the i�st funciiinglbudge, period by
<br />each contribu-or. Value or in: kind Iribu*ions should be
<br />c. Organizational GUNS. (Required) Enter the organization's DJNS or
<br />included on appropriate i `Aes, as applicable J tli* act-cr, will
<br />DUN :+4 numbe• received from Dun and Bradstreet. Informat.ion on
<br />result in ado1W change to an existing zwa.r,::, ndica*e only the
<br />obt&i"g a DJNS number may be obtained by vsiurig the Grants, you
<br />Welisite.
<br />amount cf the change. For d --creases, enc,-se the amoums. in
<br />pan- theses.
<br />d. Address: Enter the complete address as fcAxn: Street add. ess I'--ne
<br />I req-j�redl, City 'Required,), County, State (Required, if ccun:ry is 'S)
<br />1
<br />zlrovmce- Counrvy (Required,% ZiplPostal Code ("Required, I cvj,7i�, S
<br />-
<br />19-
<br />Is Application Subject to Review by State Under Executive
<br />Order 12372 Process? App; 'Cams should contact the State
<br />Singe- Pc in* of Ccr tact fGP0CJ for Federal Exeoutve Order
<br />12372 *o determine whether tre app motion is sul%*ct to •he
<br />-JS1
<br />e. Organizational Unit- Enter the riame of the primary organ zatioral
<br />-,jnit (and department or derision„ if will undenate the
<br />21 B-23
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