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<br /> <br /> <br /> <br /> <br /> <br /> CDBG 2013-2014 <br /> APPLICATION FORM <br /> DUE DATE: 5:00 p.m., January 16, 2013 <br /> 1. ORGANIZATIONAL <br /> A. Department Name: City of Santa Ana - Parks, Recreation and Community Services Agency M-23 <br /> B. Program/Project Name: Senior Health and Nutrition Pro ram <br /> C. Mailing Address: 20 Civic Center Dr., Santa Ana, CA 92702 <br /> E. Contact Name: Juan L. Lara <br /> Title: Community Services Supervisor <br /> Telephone: 714 571-4259 <br /> Fax; 714 547-5673 <br /> E-Mall: jlara@santa-ana.org <br /> II. SERVICE AND FUNDING <br /> A. Identify which eligible activity is being proposed. (example: <br /> Basic Eligible Activity (c) Public Facilities and Basic Eligible Activity (e) Public Service <br /> Improvements. <br /> ? Area-Benefit <br /> ® Limited Clientele-Presumed Beneficiary <br /> B. Identify which national objective will be met. ? Limited Clientele-Greater than 51 % Low-Income <br /> ? Low-Income Housing <br /> ? Job Creation/Retention <br /> 8.1. If Area-Benefit, identify the boundaries of the service area. <br /> B.2. If Limited Clientele-Presumed Beneficiary, Identify the Senior Citizens Presumed Beneficiary <br /> presumed beneficiary category and the estimated number <br /> to benefit from the service 1585 Estimated People to be Served <br /> 8.3. If Limited Clientele-Greater than 51 % Low-Income (LI), Estimated People to be Served <br /> Identify the estimated number to benefit from the service <br /> and of those the percentage expected to be low-income Estimated Percentage of People who are Ll <br /> 8.4. If Low-Income Housing, Identify the estimated number of Estimated number of Housing Units <br /> housing units to be filled with low-income households. <br /> 13.5, If Job Creation/Retention, identify the number of job Created <br /> created and/or retained for low-income individuals Retained <br /> C. Indicate the CDBG funding amount requested. $80,000.00 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> 2 <br /> <br /> 75B-57 <br />