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Ai <br />do <br />40 <br />B. Administrative Data <br />1. <br />Edward Byrne Memorial State and Local caw <br />Enforcement Assistance Formula Grant Program <br />Project Title (Not to exceed 84 characters, including spaces) <br />PREVENT f <br />2, For Period <br />Period <br />Month <br />Day <br />Year <br />Beginning <br />October <br />01 <br />20DO <br />Ending <br />September <br />30 <br />2061 <br />3. Is the Subgrantee or the Implementing Agency a Member of a Local Criminal Justice Advisory Council or <br />Substance Abuse Policy Advisory Board, Coalition, or Council? (See the Program Announcement for a <br />description of board responsibildies.) X Yes O No <br />C. Fiscal Data <br />1. <br />to orner risen me umec rinancrai vnrc eon r[enni vvnirenr w. <br />NIA <br />Note: If the subgrantee is participating in the State of Florida Comptroller's Office electronic transfer <br />orwram, reimbursement cannot be remitted to any other entity. <br />2. Method of Payment: X Monthly D Quarterly <br />(It is mandatory that the method selected be consistent throughout the entire grant period.) <br />3. Vendor # (Enter Federal Employer Identification Number of Subgrantea)° <br />4. SAMAS # (Enter if you area state <br />5. Will the Project earn Project Generated Income (PGI)? M Yes X No <br />(See Section H., Paragraph 13, for a definition of PGI.) <br />6. Will the applicant be requesting an advance or tederal runds? O Yes X No <br />(If Yes, a letter of request must he attached.) <br />Subgrent Appkaffw SacUon 11 - Pop 2 N 16 <br />