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Application for Funding Assistance <br /> Florida Department of Law Enforcement <br /> Edward Byrne Memorial State and Local Law Enforcement Assistance Formula Grant Program <br /> C. Administrative Data <br /> 1 . Project Title: Substance Abuse Administration <br /> 2 Identify the year of the project (1, it, III, etc.) <br /> 3. Project period Start: October 1 , 2003 End September 30, 2004 <br /> D. Fiscal Data <br /> Remit Warrant to: (This may only be ether the individual listed in B2 (Subgrantee CFO) or a designee in their <br /> office. 9 132 is selected do not reenter the contact information. This is only needed for designee. <br /> B2 X <br /> OR <br /> DESIGNEE <br /> Name: <br /> Title: <br /> Address: <br /> City, State, Zip <br /> Phone Number. <br /> 2. Is the subgrantee participating in the State of Florida Comptroller's Office electronic transfer Program? <br /> (Reimbursement cannot be remitted to any entity other than the subgrantee.) <br /> Yes X No <br /> 3. Frequency of Fiscal Reporting Monthly. X Quarterly. <br /> 4. Subgrant Recipient FEID # 59-6000674 <br /> 5. State Agency SAMAS It <br /> 6. Project Generated Income (PGI): <br /> Will the project earn PGI? (See Section G, Item 9.) Yes No X <br /> 7. Cash Advance: Will you request an advance? <br /> Yes Amount No X <br /> If yes, a letter of request must be submitted with the application or prior to submission of the first claim for <br /> reimbursement. Amount requested must be justified and accepted by FDLF. <br /> FDLE Byrne Formula Grant Applicabon Package Grant Application <br /> Section 1/ - Page 3 <br /> n. a_ rnnnc nn i+ MC i__. . nA � A1^n % <br />