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Application for Federal Assistance SF-424 16. Congressional ' a. Applicant Districts Of: FL-8 * b. Program/Project FL-8 Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment .Ucletr2 fvttacrouent Vir,v. Attachmer; 17. Proposed * a. Start Date: Project: 01/01/2016 * b. End Date: 12/31/2016 18. Estimated Funding ($): * a. Federal * b. Applicant ' c. State * d. Local ' e. Other " f. Program Income *g. TOTAL 65,214.00 65,214.00 130,428.00 * 19. Is Application a. This application b. Program Subject to Review By State Under Executive Order 12372 Process? was made available to the State under the Executive Order 12372 Process for review on is subject to E.O. 12372 but has not been selected by the State for review. is not covered by E.O. 12372. ►� c. Program * 20. Is the Applicant Yes If "Yes", provide Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) No explanation and attach ",,io Atta,.t'imenl Delete Att:ic"ment View 4t.tachrrent 21. *By signing herein are true, comply with any subject me to this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency ** I AGREE ** The list of certifications specific instructions. Authorized Representative: Prefix: Middle Name: * Last Name: Suffix: * First Name: Stan Boling *Title: community Development Director ' Telephone Number: 772-226-1253 Fax Number: * Email: sboling@ircgov. corn * Signature of Authorized Representative: ' Date Signed: 20