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C. Administrative Data <br /> 1 . Project Title: PREVENT <br /> 2. Identify the year of the project (1, 9, M. etc.) IV <br /> 3 Project penod Start October 1 , 2DD3 End: September 30, 2003 <br /> D. Fiscal Data <br /> Remit Warrant to: (This may only be either the individual fisted in B2 (Subgrantee CFO) or a designee in their <br /> office. If B2 is selected, do note fee the comae# . This is ordy nem for <br /> B2 X <br /> OR <br /> DESIGNEE <br /> Name: <br /> Title: <br /> Address: <br /> City, State, Zip <br /> Phone Number. <br /> 2. Is the subgranteelDwScipating; in the: State of Flodda Comet's Office electrcmic twmifer Droaram? <br /> (Reimbursement cannot be remitted to any entity other bm the subgrantee.) <br /> Yes X No <br /> 3. Frequency of Fiscal Reporting Monthly.. X Quarterly. <br /> 4. Subgrant Recipient FEID #. 5&6000674 <br /> 5. State Agency SAMAS #. <br /> 6. Project Generated Income (PGI): <br /> Will the project earn PGI? (See Semon G, Item 9.) Yes No X <br /> 7. Cash Advance: Will you request an advance? <br /> Yes Amount. No <br /> If yes, a letter of request must be mtmritted with the application or pnor to mon of the first claim for <br /> reimbursement. Amount requested must be justified and accepted by FDLE. <br /> Section - Page 3 of 16 <br />