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GENERAL INSTRUCtiONS FOR THE SF-424 This is a standard form used by applicants as a required facesheet for preapplications and applications submitted in accordance with OMS Circular A~1O2. It win be used by Federal agencies to obtain applicant certification that states which have established a review and comment procedure in response to Executive Order 12372 and have selected the program to be'included in their process have been given an opportunity to review the applicant's submission. APPLICANT PROCEDURES FOR SECTION I Applicant will complete all items in Section I with the exceptioo of Box 3, "State A~plication Identifier." If an item is not applicable, write "NA." If additional space is L ed, insert an asterisk ".," and use Section IV. An explanation follows for each item: Ite Item 1. \I1ark appropriate box. Preapplication and application are described in (a revision or augmentation under item 14), indicate only the amount of OMB Circular Þr-102 and Federal agency program instructions. Use of the change. For decreases, enclose the amount in parentheses. If both this form as a Notice of Intent is at State option. Federal agencies do basic and supplemental amounts are included, breakout in Section IV. not require Notices of Intent. For multiple program funding. use totals and show program breakouts 2a. Applicant's own control number, if desired. in Section IV. 12a-amount requested from Federal Government 12b--amount applicant will contribute. 12c-amount from State, if 2b. Date Section I is prepared (at applicant's option). applicant is not a State. 12d-amount from local government, if 3a. Number assigned by State. applicant is not a local government. 12e-amount from any other sources, explain in Section IV. 3b. Date assigned by State. 13b. The district(s) where most of action work wiD be accomplished. If city- 4a--4h. Legal name of applicant, name of primary organizational unit which will wide or State-wide, covering several districts, write "city-wide" or undertake the assistance activity, complete address of applicant, and "State-wide." name and telephone number of the person who can provide further 14. A. New. A submittal for project not previously funded. information about this request. 5. Employer Identification Number (EIN) of applicant as assigned by the B. Renewal. An extension for an additional funding/budget periOd for a Internal Revenue Service. project having no projected completion date, but for which Federal 6a. Use Catalog of Federal Domestic Assistance (CFDA) number assigned support must be renewed each year. to program under which assistance is requested. If more than one C. Revision. A modification to project nature or scope which may result program (e.g., joint funding), check "multiple" and explain in Section in funding change (increase or decrease). IV. If unknown, cite Public law or U.S. Code. D. Continuation. An extension for an additional funding/budget period 6b. Program title from CFDA. Abbreviate if necessary. for a project with a projected completion date. 7. Use Section IV to provide a summary description of the project. If E Augmentation. A requirement for additional funds for a project appropriate, i.e., if project affects particular sites as, for example, previously awarded funds in the same funding/budget period. construction or real property projects, attach a map showing the Project nature and scope unchanged. project location. 15. Approximate date project expected to begin (usually associated with 8. "City" includes town, township or other municipality. estimated date of availability of funding). 9. list only largest unit or units affected, such as State, county, or city. 16. Estimated number of months to complete project after Federal funds 10. Estimated number of persons directly qenefiting from project. are available. 11. Check the type(s) of assistance requested. 17. Complete only for revisions (item 14c), or augmentations (item 14e). A. Basic Grant-an original request for Federal funds. 18. Date preapplication/application must be submitted to Federal agency B. Supplemental Grant-a request to increase a basic grant in certain in order to be eligible for funding consideration. cpses where the eligible applicant cannot supply the required 19. Name and address of the Federal agency to which this request is matching share of the basic Federal program (e.g., grants awarded addressed. Indicate as clearly as possible the name of the office to by the Appalachian Regional Commission to provide the applicant which the application will be delivered. a matching share). 20. Existing Federal grant identification number if this is not a new request E. Other. Explain in Section IV. and directly relates to a previous Federal action. Otherwise, write 12. Amount requested or to be contributed during the first funding/budget "NA." period by each contributor. Value of in-kind contributions should be 21. Check appropriate box as to whether Section IV of form contains included. If the action is a change in dollar amount of an existing grant remarks and/or additional remarks are attached. APPLICANT PROCEDURES FOR SECTION II Applicants will always complete either item 22a or 22b and items 23a and 23b. 22a. Complete if application is subject to Executive Order 12372 (State 22b. Check if application is not subject to EO. 12372. review and comment). 23a. Name and title of authorized representative of legal applicant. FEDERAL AGENCY PROCEDURES FOR SECTION III Applicant completes only Sections I and II. Section 111 is completed by Federal agencies. 26. Use to identify award actions. will contribute. 28c-amount from State, if applicant is not a State. 27. Use Section IV to amplify where appropriate. 28d-amount from local government, if applicant is nol a local govern- 28. Amount to be contributed during the first funding/budg~t period by men!. 28e-amount from any other sources, explain in Section IV. each contributor. Value of in-kind contributions will be included. If the 29. Date action was taken on this request. aclion is a change in dollar amount of an existing grant (a revision or 30. Date funds will become available. 'iUgmentation under item 14), indicate only the amount of change. For 31. ~ame and telephone number of agency person who can provide more 'jecreases, enclose the amount in parentheses. If both basic and Information regarding this assistance. ;upplemental amounts are included, breakout in Section IV. For multiple 32. Date after which funds will no longer be available for obligation. Jrogram funding, use totals and show program breakouts in Section IV. 33. Check appropriate box as to whether Section IV of form contains 28a-amount awarded by Federal Government. 28b-amount applicant Federal remarks and/or attachment of additional remarks. CJD-3 * GPO : 19840- 421-526 (140)