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Application for Federal Assistance SF-424 <br />16. Congressional Districts Of: <br />' a. Applicant FL-8 ' b. Program/Project FL-8 <br />Attach an additional list of Program/Project Congressional Districts if needed. <br />" AiidAitach ent rD`e'lefe;Atfa`chrneriif: ',ew.Aitachment i <br />17. Proposed Project: <br />' a. Start Date: 01/01/2017 ' b. End Date: 12/31/2017 <br />18. Estimated Funding (S): <br />' a. Federal 66,S83 00 <br />' b. Applicant I <br />` c. State <br />' d. Local 66,S83 00 <br />' e. Other <br />' f. Program Income <br />'g. TOTAL 133,166 00 <br />' 19. Is Application Subject to Review By State Under Executive Order 12372 Process? <br />El a. This application was made available to the State under the Executive Order 12372 Process for review on <br />b Program is subject to E.0 12372 but has not been selected by the State for review <br />® c. Program is not covered by E.0 12372. <br />' 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment) <br />R Yes ®No <br />i <br />If "Yes", provide explanation and attach <br />.���ukcld,AUacliin�entcY • ��D21ete _Attachment ; =Crew=Atlachmeni�>� <br />21. 'By signing this application, I certify (1) to the statements contained in the list of certifications" and (2) that the statements <br />herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances" and agree to <br />comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may <br />subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) <br />® "IAGREE <br />" The list of certifications and assurances, or an intemet site where you may obtain this list, is contained in the announcement or agency <br />specific instructions. <br />Authorized Representative: <br />Prefix: ' First Name: Stan <br />Middle Name: <br />' Last Name: Boling <br />Suffix: <br />'Title: Community Development Director <br />' Telephone Number 772-226-1253 Fax Number <br />'Email: sboling®ircgov.com <br />LsIgnature of Authorized Representative: <br />' Date Signed: <br />44 <br />