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Attachræ.nt M GENERAL IHSTRUCTIONS This is a multj.,purpose standard form. First, it will be used by applicants as a require-d facesheet for pre-app\ications. and app\ìcations submiUe-d in accordance with OM3 Circular A-102. Second, it will be used by Federal agencies to report to clearinghouses on major actions taken on applications reviewed by clearinghouses in accordance with OMB Circular A-95. Third. it will be used by Federal agencies to notify St~tes of grants-in-aId 8wardaò in accordance with Treasury areolar 1082. Fourth, it may be U5eò, on an optional basis. as a notification of intent from applicants to clearinghouses. as an early initial notice that Federal assistance is to be applied for (cleaiinghouse procedures will goYern). APPLICANT PROCEDURES FOR SECTION I ~""PI.c.ant will c:cmpIeltt aU !'lams in Secbon I. If an item ~ no' applicable, writtt "NA". II additional space is ~. '"~ an aslønsll -.- IitIð ~ the r~ ~ on the ba<;k 01 lhe form. An explanaÞQn follows fOl each item; fttM'1 /ttH7P ,. Ma'" apptopnaht bo)(. Pre-awlíCatjon and awI!Cðtion 10. Governmental unit whe<~ sognihcant and meanmglot 'm- gutdance 15 in 01.49 c.rcular A-102 and Fed;ofal agency pact could be obsefved. tlsi only !ar9i'st UnIt or unIts program irl'stl\JCbons. Noti/icatoon 01 intent guidance is in aHeèfed, such as State. county, 0' CIty. If enbfe unot Crculat A-95 and proce<1lJ1ttS from cleannghouse. AppIt- aHecled. list it ralh!w' than subunits. cant will not use> "Report 01 Federal Acbon" box. 11. Estimated numbet of personS dKectly beneflttng from 2a ,pplrcant s own conlrofnumbttf. i1 ~ed pr~. 2b. O$te Secbon 1 ì!! prepafed. 12. Use appropOat& code lener. Definitions are; 3a. NlJfTlbet assigned by Stat& clttaringhouse. or it óeleg.aled A.. New. A sobniIt"..a1 for the- first ti~ fOl a ~ project. by Stall'. b)' a'~ clearinghouse. All reqUótSts to B. Renewal. An extension for an 2Iddotìonal fundlngl Federal ag8f'lCies must contain thIs identifier i1 fn.g pro- ~t period IOf a prO~1 haYing no projected com- gram is covered by CrcularA-95 and required by applica. plation dale. but lor whIch Federal support rous& be bla Stat@/areaw.de cleaftnghoose procedures. It in re~ed each yeaf doubt, consult yOUt cleaftoghoose. C. Revision A modthcaloon to project nature Of' scope 3\). Da\8' appI<.aot nolif>8d 01 clearinghouse ~tiltef. which may result In funding chang-tt (,ocrease or de. 4&-4h. legal name of applrcant/recipoent. name of primaI)' orga- crease). fÚZabonai untl whICh will un<lðrt.aklt the assistance act,.,. O. Contin,;atlOn. An extension IOf an aðditional ft:ndingf íty. c:ompJoe\" r,ddrttSS of applicant. and name and budget period tOf a proïect the 8QenCy inibally agret>d lelepho- number of person who. can provide furtne, to fund 101 a ð9hnite number of years. jolormat>en abo\)t \his request. E. Augmenlaloon. ^ requl(ement tor additional lurm for a 5. Employer idenb/rcallor'l oombttr 01 applIcant as ass>gr>ed project prev;oosly aw""ded fund3 in ttItt same furtôngl by tnternal A~ Service. budget penod. Proïect nature and scope unchanged-. 6a. Use Catalog at federal Oomesbc AssIstanc& number 13. Amount reqUótSled Of to ~ contributed dunng the first aSSIgned to program under whIch assistance is request. 1und.ng/~t period by each contribtJlOf. VðIu& of io- ed. II mora than one progtam (e.g.. joint-funding) writtt kind oon!ributior1.s win ~ included. if the aCliort is It '.multipfe.' and explain in rerna"'!!. If unkl'lO'Wf'l; cite Pub!rc ch¡¡ong<t in do/la' atnO\Jnt of an exis:ing 9,ant (a rewisiorl-OI' Law 01' U.S. Cod@'. al'gmet1latoon). indicate only the amount of the- ch.ar>ge. 6b. Program tin. from Federal Catalog. AbbrtWiðte if ~ FOf decreaS8S enclose the amount in pat'8fl1he5es. II both ba!!C and ....pplemental amounts are ÍIIdud!!d. $ary. break out in reman.s For rnulltpte progtam funding. uw 7. Brief tilftr end. appropriate dtt5cription of project. For totals and show program btealoO\lts In remarlcs. It~ notiftC4~ ot lI'Itent. continú& in rem:ar1<s !IeCtion il neces. ~finibon$; 13<1, amount requested from F~at Gowllfflo sary to ~ propet ø-:npbOn. men'" 130, amount ßWl!Cðnt will contribute; 13<:.2II'IOI.Inf 8. Mostly seIf-expianalOty. ..City'. includes lawn, tOlm5hìp or from State. if applicant IS not a State; 13d. alTlOtJl'lt frorn olhef mun<:ipólltly. local ~rnent. if applICant is nol a local g<w1!m8f!en1; 9. Check the f)'PØ(~ ot ~ requested. The deftnj. 138, amount Irom 8"1 o~ $OtJrCt!5, explalO in ~ tioM of the t- -. ,.... Self expIðnatory. A. 8a.síc Granl Anorigil'\lll ~ for Federal fI.Jnm. "'!:t, The district{s) ~e most of actual ~ will b&1!JCCCITÞo This would not ~ .,." oonlribution prcMòed un- þ!ished. If city...,.,;œ 01' Stato-W>de. CO't"eriog swBfal dls- ~ a ~t.a\ gram. 1ric1s. write "city-wiðe'. or "StatflO-wiôe." B. ~1aI (;fIN'll A. request to inc:rðaStt . basic 1S. CompIettt or*f fOf ~s (item 12c). or augmenÞtllons grant ¡., C«tain ~ where the eIig<>Ið ~nt (Item 12e). Þnnot ~ \he required matching lIha,e of the 16. Approximatlt a..te projðct expected to ~n (U::JUalty a,. N!!C Fedefal program (e.g.. gants .ow:arðed by the 1Iwa\achia" Regoonat Corn~ to pro;hðe the aociat8CI witI1 ~bmated daltt of øvajlabihty of fundJr\¡) appI¡C81tl . matching sNorEr). 17. Eatim!tle<J ~ of monttu 10 ~te project af!« Fðd-Mal fur'>d$ NIt available. c. loan, ~ explanatory. 18. Estimated a..le pn.-appt.cationf eppI.catx:w"l will be ~. O. In:5UI'ance. Self explanatory. ted to F~al t>geOCy if trios proj€>ct t&qùltes cltoarmg. N>u$e re.n;:rw \I revieow r..:>1 rEoQ\»red, thl'" date WOtIId E. Ü1:t'>l!f. Ð<pIain on remarlcs page. ~Þr b& ~ as c1/Jte In Item 2b rrlV<O4J>O1'OMt 4:14 "J\OÆ J-. 4-111 Exhibit 1+-3. Afplication for Federal Assistance (Nonconstruction Programs) (Page 3 of 13) 13