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C_3 <br />40 <br />STATE OF FLORIDA <br />HAZARD MITIGA'T'ION GRANT PROGRAM (HMGP) <br />FLOOD MITIGATION ASSISTANCE+" (FMA) <br />Application <br />ONE' <br />F[kIA- -DR-FL 0 Standard HMGP ❑ 5% Initiative Application ❑ Application Complete <br />0 Standard FMA O Initial Submission or ❑ Resubmission <br />Support Documents Eligible Applicant Project Typo(s) <br />O Conforms with State 409 Plan O State or Local Government O Wind <br />d In declared Area O Private Nan-Protil {Tax ID Received) O Flood <br />❑ Statewide ORecognized Indian Tribe or Tribal organization O Other <br />Community NFIP Status: (cn— alftxaowrr <br />O Participating Community ID M. Reviewer Phone # <br />O In Good Standing 0 Non -Participating O CRS Reviewer Fax # <br />State Application ID Reviewer Email: <br />State Reviewer Date Application Received <br />Date: _ . <br />This application is for all Federal Emergency Management Agency (FEMA Region Iv) Flazard Mitigation Grant Program (HMGP) <br />and Flood Mitigation Assistance (F -MA) proposals. Please complete ALL sections and provide the documents requested. If you <br />require technical assistance with this application. please contact your State Emergency Management Division at (850) 922-5289. <br />Page 2 of 15 <br />