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40 <br />40 <br />4D <br />STA TE OF FLCIRIUA <br />HAZARD MITIGATION GRANT PROGRAM (IIMGP) <br />FLOOD MITIGATION ASSISTANCE (FMA) <br />Application <br />FOR STATE USE ONLY <br />FEMA- -DR-FL Q Standard HMGP G 5% Initiative Application Q Application Comptete <br />0 Standard FMA ❑ Initial Submission or 0 Resubmission <br />Support Documents Eligible Applicant Project Types) <br />❑ Conforms with State 409 Plan 0 Slate or Local Govern mant 0 Wind <br />* In Declared Area o Privale Mon -Profit (Tax 1D Received) ❑ Flood <br />* Statewide i3Recognized Indian Tripe or Tribal Organization ❑ Other <br />Community NFIP Status: (Check an Mal BOY) <br />* Participating Community ID #: <br />* In Good Standing o Nan -Participating Q CRS <br />State Application 10 <br />State Reviewer <br />Reviewer Phone 0 <br />Reviewer Fax # <br />Reviewer Email: <br />Date Application Received <br />Date: <br />This application is for all 'Federal Emergency Management Agency (FEMA Region IV) Hazard Mitigation Grant Program (HMGP) <br />and Flood Mitigation Assistance (FMA) 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) 922-5269. <br />Page 2 of 15 <br />