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I. <br />A. <br />B. <br />C. <br />E. <br />ill. <br />A. <br />B. <br />8.1 <br />CDBG 2013-2014 <br />APPLICATION FORM <br />DUE DATE: 5:00 P.m., January 16, 2013 <br />ORGANIZATIONAL <br />Department Name: <br />Program/Project Name: <br />Mailing Address: <br />Contact Name: <br />Title: <br />Telephone: <br />Fax: <br />E-Mail: <br />Orange Count Fair Housing Council, Inc. dba Fair Housing Council of O. C. <br />Santa Ana Fair Housing Education, Counseling & Enforcement <br />201 S. Broadway, SantaAna, CA 92701-5633 <br />David Le <br />Program Specialist <br />714-569-0823 x204 <br />714-835-0281 <br />dle fairhousln oc.or <br />SERVICE AND FUNDING <br />Identify which eligible activity is being proposed. (example <br />Basic Eligible Activity (c) Public Facilities and <br />Improvements. <br />Identify which national objective will be met. <br />If Area-Benefit, identify the boundaries of the service area. <br />B.2. If Limited Clientele-Presumed Beneficiary, Identify the <br />presumed beneficiary category and the estimated number <br />to benefit from the service <br />B,3, If"Limited Clientele-Greater than 51% Low-Income (LI), <br />Identify the estimated number to benefit from the service <br />and of those the percentage expected to be low-income <br />8.4, If Low-Income Housing, Identify the estimated number of <br />housing units to be filled with low-income households. <br />B.5. If Job Creation/Retention, identify the number of job <br />created and/or retained for low-income Individuals <br />C. Indicate the CDBG funding amount requested, <br />2 <br />Fair Housing Services: , 24 CFR W0,206(c1 84bleAdmin. <br />? Area-BenefrE_ <br />? Limited Clientele-Presumed Beneficiary <br />® Limited Clientele-Greater than 51 % Low-Income <br />? Low-income Housing <br />? Job Creation/Retention <br />N/A <br />N/A Presumed Beneficiary <br />860 Estimated Reepie H'holds to be Served <br />95% ' Estimated Percentage of People who are LI <br />N/A Estimated number of Housing Units <br />N/A Created 1 Retained <br />$69,300 <br />75B-9