Laserfiche WebLink
DEO <br /> Department of Economic Opportunity—Small Cities Community Development Block Grant Program Form SC-31 <br /> Civil Rights Profile Sheet April, 201 <br /> p 5 <br /> Instructions for Completing Beneficiary Form <br /> For All Subgrants: <br /> Use application survey data or census data,as appropriate, to determine beneficiary information. Complete a copy of <br /> the form below for each activity, except Administration and Engineering. Submit civil rights information with j <br /> executed contract and update the data upon completion of subgrant activities. <br /> 1. Total Beneficiaries in Service Area. Using project data on eligible individuals, enter number of individual <br /> beneficiaries in each population group to be assisted. <br /> 2. LMI Beneficiaries in Service Area: Using project data regarding individuals,enter number of individual LMI <br /> beneficiaries in each population group to be assisted. <br /> ii <br /> For Economic Development Subgrants Only (Should be provided at the time ofgrant completion) <br /> i <br /> 3. Job Applicants: Use job applicant information provided by the employer and enter number of individual job <br /> applicants in each population group to complete. <br /> 4. Job Hires: Use job applicant and hiring information provided by the employer and enter number of job hires <br /> (employees) holding jobs when final job creation requirements have been met. <br /> iFor Housing Subgrants Only: <br /> 5 (Complete column 5 below at closeout using data provided by assisted households.) <br /> I <br /> Activity Name: Service Area 1B - New Sewer Line <br /> Population 1 Total 2.LMI 3 Job 4.Employees 5.Housing <br /> Group Beneficiaries Beneficiaries Applicants Hired Beneficiaries 6.Hispanic l <br /> White 12 12 N/A N/A N/A 8 <br /> i <br /> African American 83 79 N/A N/A N/A N/A <br /> Asian N/A N/A N/A N/A N/A N/A <br /> Native Hawauan/Pacific <br /> Islander N/A N/A N/A N/A N/A N/A <br /> American Indian/Alaskan N/A N/A N/A N/A N/A N/A <br /> Native <br /> Other Multi-Racial 3 3 N/A N/A N/A N/A <br /> Female Head of <br /> Household 13 N/A N/A N/A N/A N/A <br /> Elderly Head of 28 N/A N/A N/A N/A N/A <br /> Household <br /> Handicapped 9 N/A N/A N/A N/A N/A <br /> 2 73C-23.0031, FAC <br />