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40 <br />40 <br />i <br />Instructions for the SF -424 <br />This is a standard form used by applicants as a required <br />faceshect for pre -applications and applications submitted <br />for Federal assistance. It will be usedby Federal agencies to <br />obtain applicant certification that States which have estab- <br />lislied a review and comment procedure in response to <br />executive order 12372 and have selected the program to be <br />included in their process, have been given an opportunity to <br />review the applicant's submission. . <br />Item I Self-explanatory. <br />Itern 2. Date application submitted to Federal agency (or <br />Slate ifapplicable)and applicant's control number (if <br />applicable). <br />Item 3. State use only (if applicable). <br />ltem4. If thisapplication istocontinueorrcviscanexisting <br />award, enterpresent Federal identifier number. Iffor <br />a new project, leave blank. <br />Item S. Legal name of applicant, name of primary organiza- <br />tional unit which will undertake the assistance activ- <br />ity, complete address of the applicant, and name and <br />telephone number and facsimile number of the per- <br />son to contact on matters related to this application. <br />ItcuiG. Enter Employer Identification Number (EIN) as as- <br />signed by the Internal Revenue Service. <br />Item 7. Enter the appropriate letter in the space provided. <br />Itcing. Check appropriate box and enter appropriateletter(s) <br />in the space(s) provided: <br />- "New" means a new assistance award. <br />• "Cont{nuation" means an extension for an addi- <br />[tonal funding budget period for a project with a <br />projected completion date. <br />"Revision" means any change in the Federal <br />Government's financial obligation or contingent ii - <br />ability from an existing obligation. <br />Previous Ediboru Not Usable <br />Authorized for Local Reproducbm <br />Item 9. Name of Federal agency from which assistance is <br />being requested with this application. <br />[tem 10. The Catalog of Federal Domestic Assistance num- <br />ber is not applicable. Enter the title of the program <br />under which assistance is requested. <br />Item 1l. Enter abricfdescriptivetitle oftheproject. Ifmore <br />than one program is involved, you should append an <br />explanation on a separate Sheet. if appropriate (e.g., <br />construction or real property projects), attach a map <br />showi ng project location. For pre -applications, use <br />separate sheet to provide a summary description of <br />this project.. <br />Item 12. List the local jurisdiction(s) to be served by the <br />project. <br />Item 13. Self-explanatory. <br />Item 14. List the applicant's Congressional Distriictand any <br />District(s) affected by the program or project. <br />Item IS. Not applicable. <br />Item 16. Applicants shouldcontact the State Single Point of <br />Contact (SPOC) for Federal Executive Order 12372 to <br />determine whether the application is subject to the <br />State inter-governrnentalreview process. <br />Item 17. This question applies to the applicant organization. <br />not the person whosignsas the authorized represen- <br />tative. Categories of debt include delinquent audit <br />disallowances, loans and taxes. <br />Item 18. To be signed by the aulhorizedrepresentative ofthe <br />applicant. A copy ofthe governing body's authoriza- <br />t ion for you to sign this application as official repre- <br />sentative must be on file in the applicant's o. -,cc. <br />(Certain Federal agencies may require that this autlto- <br />rization be submitted as part of the application.) <br />Page 2 of 2 <br />term SP 424 (419'2) <br />4teschbod by ofm Circular A-102 <br />