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40 i MInstructions forthuSF-424 This is a standard form used by applicants as a required faceslreet for pre -applications and applications submitted for Federal assistance. It will be used by Federal agencies to obtain applicant certification that States which have estab- lished a review and comment procedure in response to executive Order 12372 and have selected the program lobe included in their process, have been given an opportunity to review the applicant's submission. . Item I Self-explanatory. Item 2. Date application submitted to Federal agency (or Slate if applicable) and appl icant's control number (if applicable). Item 3. State use only (if applicable). Item 4. If this application is to coati nue or revise an existing award, enterpresentFederal identifier number. If for a new project, leave blank. IIem5. Legal name of applicant, name of primary organiza- t ions l unit which wilt undertake the assistance activ- ity, complete address of the applicant, and name and telephone number and facsimile number of the per- son to contact on matters related to this application. Ilcnt 6. Enter Employer Identification Number (EIN) as as- signed by She Internal Revenue Service. Item 7. Enter the appropriate letter in the space provided. [icing. Check appropriate box and enterappropriatelettcr(s) in the space(s) provided: - "New" means a new assistance award • "Conlinuation" means an extension for an addi- tional funding budget period for a project with a projected completion date. "Revision" means any change in the Federal Government's financial obligation or Contingent li- ability from an existing obligation. t'tav*us Editions Not Usable AutMnZad lot Local Roproducbon Item 9. Name of Federal agency from which assistance is being requested with this application. Item 10. The Catalog of Federal Domestic Assistance num bcr is not applicable. Enter the title of the program under which assistance is requested. Item 11. Enter a brief descriptive title of the project, If more titan one program is involved, you should append an explanation on a separate sheet. If appropriate (e. g., construction or real property projects), attach a map showing project location. For pre -applications, use a separate sheet to provide a summary description of this project. Item 12. List the local jurisdiction(s) to be served by the project. Item 13. Self-explanatory. Item 14. List the applicant's Congressional District and any District(s) affected by the program or project. Item 15. Not applicable. ltem 16. Applicants should contact the State Single Point of Contact (SPDC) for Federal Executive Order 1x372 to determine whether the application is subject to the State inter -governmental review process. Item 17. This question applies to the applicant organization, not the person who signs as the authorized represen- tative. Categories of debt include delinquent audit disallowances, loans and taxes. [tem 18. To be signed by the authorized representative of the applicant. A copy of the governing body's authors. t - tion for you to sign this application as official repre- sentative must be on file in the applicant's office. (Certain Federal agencies may require that this attiho- rization be submitted as part of the application.) Pltto a of 2 lotm SF41 i ON2j prpseribed by CM8 Circular A -roe