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<br /> ~achrœnt M Item <br /> 19. Exi$ting Fedówll4 ide"ttif1catØt number if this is not a new 20. Indicata F~al agency to which this request is ad- <br /> request and dwe<:tly rlitlatasto a prtWiOu!> Federal action. dressed. Street address not required. but do US$ ZIP, <br /> ~ write "'NA" 21. Check app;'opnate bo. ås to whethar Section IV of 1000m <br /> contain!> ,ematks and/Of' addItional remarks ðll!l attached. <br /> APPLICANT PROCEDUHES FOR SECTION II <br /> Applicants will always complete items 233. 23b. and 23<:. If clearinghous.e r<Mew is required. item 220 must be fully completed. An <br /> explanatIOn follows fOl each item: <br /> Item Item <br /> 22b. Ust cleannghou~s to which submitted and show in 23b. Self explanatory <br /> appropriate block!> the Statl.lS of their responses. Fo, <br /> more than th,- deannghOOSó!S. continue in remarks Self explanatory. <br /> sectlOlt. All writt!!ft comments submitted by 01 through 23c. <br /> cleannghouses must bit attached. <br /> 23a. Naffi4t and btle 01 authorized repres.entahve 01 legal Notl!!: Applicant completes only Sections I and U. Seclion III is <br /> r:ppllCanl completed by Fedefal agencies. <br /> FEDERAL AGENCY PROCEDURES FOR SECTION III <br /> If appltcant,supphed information in Sections I and II needs no updating or adjustment to ftt the final Federal action. th& Federal agancy will <br /> complete SectIon III only. An explanatIOn fOf' each item follows: <br /> Item Item <br /> 24. Executive dep.artmertt 0' indePertdert1 agency haVIng pro- 35. Name and te4epttooe no. of ag!!ftcy pet'SOO who can <br /> gram adm,ntstrahon responsibtllty. provide more information regarding this aS$istance. <br /> 25 Sell explanatory. 36. Date after whICh lunds will no long&f be available. <br /> 26. Pnmary organIzatIOnal unit balo..... department le"el ha"ing 37. Check appropriate box as to whether Section IV 01 fo,m <br /> direct program management responsibility. contains Federal remarks and/or attachment of additIOn- <br /> 27 0n,ce dlfec.tly monttoring the program. al remarks. <br /> 28 Use to idt!'ntlty non-a.....ard actions where Federat 9,ant 38. For use with A-95 action notices only. Name and tele- <br /> identifIer ,n item 30 IS not applicable or will not suffice. phone 01 person who can assure that ftPPIopIíale A-95 <br /> BctlOn has been taken-II Sðme as person- Shown In item <br /> 29 C:>mplete add'~s ot administering offIce shown in item 35. wnte hSðmeh, If not applicable. write "NA", <br /> 26. <br /> 30 Use to IdentIty awatd actIOns where dltferant from Feder, Federal Agency Procedures-special considerations <br /> al applICatIOn tdertbher In Item 28. A Treasvry Orcula' 1082 compliance. Fe-::!eral agency will aSSOte <br /> 31. Sell explanatory. Use remarks sectIOn 10 ampltly wh!!fE~ proper completion 01 Sections I and III. If SectiOn I is betng <br /> appropriate compléied by Federal !.Igency. all applicable itemsrnust be filled <br /> 32. Amount to be contributed dl.lring the f1r5t funding/budget in. Addre5Ses of State InfOlmation Recepbon AgitnCies <br /> period by each contribolO1. Value of in-kind c:ontribtJtions (SCtA"'s) are provided by Treasury Department 10 each agitncy. <br /> will be included. " the action is ð change in dollar This form replaces SF 240. which will no Ior.g;.¡;> t:>e used. <br /> amount of an existing grant (it revision or augmentation). 8. OMS Orcula, A-95 compliance. Fedefal 89"I"CY will assure <br /> IndICate only the amount of change. FOI deaeases. proper completion of Sactions I. II, and 11/. This form i:; required. <br /> enclose the amount in parentheses. If both basic and for notifying all reviewing cJ.9aringhou~ 01 major actions on all <br /> supplerrn:tntal amount$ are included. break out in remarks. programs reviewed ~ A-95. Addresses of Sta:e and <br /> For multiple program fundIng. use totals and show pro- ~eawide cIa:lringhOt;ses are provided by OMS to (tach agency. <br /> gram breakouts in rttmarks. Item åðftnitions: 328. amount Substantive differences betwe-en applicant's rf>qUtlst and lor <br /> awarded by Feöe<-al Govemment; 32b. amount applicant dearinghous.e recommendations, end the project 8S finally <br /> will contribute; 32c. amount from State. if app;icanl is not awarded will be explained in A-95 notit>CÐlions to clearing- <br /> a State; 32d. amount from 10Cð1 goo.ernment if applicant is hous.es. <br /> not a local government; 32e. amount from any other C Special no18. In ~t. but not till Stales. the A-95 State clearing- <br /> I>OOtces. explain in remarks. Þouse find the (TC 1082) SCIRA Bte the Sðme oHlCe. 11'1 such <br /> 33. Dale action was< taken Oft this request. cases, th& A-95 ftward nooce to th& State cI<oaringhouse will <br /> MIdI the TC 1082 award t)l)tiœ requ;'€tffief11 to the Stale SCIRA. <br /> 34. Date lunds WIll become a...ajlable. DtJpI.cLIle noliflCDbon ~!d be 8"oi<}ed <br /> Exhibit M-3. Application for Federal Assistance <br /> (Nonconstruction Programs) <br /> (Page 4 of 13) <br /> ß ~ f()/T!oI Ø4 ~ M1oI! . {Rro 4 - 7 7 <br /> 14 <br />