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Ell <br />40 <br />C-1 <br />STATE OF FLORIDA <br />HAZARD MITIGATION GRANT PROGRAM (HMGP) <br />FLOOD MITIGATION ASSISTANCE (FMA) <br />Application <br />FOR STATE USE <br />FEMA- -DR-FL D Standard HMGP R 5% Initiative Application D Application Complete <br />0 Standard FMA Q Initial Submission or ❑ Rosubmisslon <br />Support Documents Eligible Applicant Project Type(s) <br />* Conforms with State 409 Plan 0 State or Local Government ❑ Wind <br />❑ In Declared Area D Privato Non -Profit (Tax ID Received) ❑ Flood <br />ci Statewide ORecognized Indian Tribe or Tribal Organization ❑ Other <br />Community NFIP Status: (checkolhalawy) <br />0 Participating Community lD 9: <br />• In Good Standing 0 Non -Participating <br />State Application ID <br />Slate Reviewer _ <br />Reviewer Phone �t <br />17 CRS Reviewer Fax fi <br />Revlewor 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) 922-5259. <br />Page 2 of 15 <br />