75B - PH - CDBG PROGRAM 13-14 - Laserfiche WebLink

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