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<br />~.i' <br />" J <br />'.'t <br />;:1 <br />(,' ',1 <br />\ 1 <br />:}tj <br />Jl. <br />f~ <br />;l,",.f:t, " <br />i,} <br />~ ..1 <br />};t(l,'. <br />"H <br />l' ' <br />'4..'~,' <br />,~ <br />~Jf,~ ,t <br />,\'1\' <br />r-.~l <br />;,'l~':) <br />::~~ { <br />J,:~,' <br />i.Jf <br />.f-'i:: <br />'; j,t <br />'.i/.'" <br /> <br />l\t <br />'~J' <br />. ~'. <br />! f <br />, ' <br />., <br />:,n:f <br />~.,rjj <br />, '(" <br />~) ~: <br />.. :\' <br />I ," <br />",,", <br />.H,~ <br />q! <br />Lo,I <br />.. ,~ <br />;' ~l<; <br />Z ,) <br />,"! t <br />;.:, <br />.'ii'l <br />. , <br /> <br />PART III <br />(continued) <br /> <br />Section C. Sourc:e of Non.Federal ,... :!Sources <br /> <br />Line 8.11 - Enter amounts of non-Federal resout..:es that <br />will be used On the grant. If in-kind contributions are in. <br />cluded, provide a brief explanation c, a separate sheet. (See <br />Attachment F. Office of Management and Budget Circular <br />No. A.I 02.) <br />Column (al - Enter the program titles identical to Col. <br />umn (a). Section A. A breakdown by function or activity is <br />not neces~i:ry. <br /> <br />Column (bl - Enter the amour.[ of cash and in.kind con- <br />tributions to be I"""dde by the applicant as shown in Seclion <br />A. (See also Att....."Olent F, Office af Manag...ment and Bud- <br />get Circular No. A-102.) <br /> <br />Column lei - Enter the State contributivn if the appli- <br />cant is not a State or State agency. Applicants which are a <br />State or State agencies should leave this column blank. <br /> <br />Column (d) - Enter the amount of cash and in-kind con- <br />tributions to be made from all other sources. <br /> <br />Column (el - Enter totals of Columns (b), {cl, and (d). <br /> <br />Line 12 - Enter the to',l for ei\ch of Columns (b)-(e). The <br />amount in Column (e) should be equal to the amount on <br />line 5, Column (fI, Section A. <br /> <br />Section D. Forecasted Cash Needs <br /> <br />Line 13 - Enter the amount of cash needed by quarter <br />from the grantor agency during me first year. <br /> <br />line 14 - Enter the amount of cash from all other sources <br />nceded by quarter during the first year. <br /> <br />Line 15 - Enter the totals of amounts on Lines 13 and 14. <br /> <br />Section E. Budget Estimates of Federal Funds Needed for <br />Balance of the Project <br /> <br />lines 16.19 - Enter in Column (OIl the same grant program <br />titles shown in Column (a), Section A. A breakdown by <br />function or activity is not necessary. For new applications <br />and continuing grant applications, enter in the proper col- <br />umns amounts of Federal funds which will be needed to <br />complete the program or project over the succeeding fund- <br />ing periods (usually in years). This Section need not be <br />completed for amendments, changes, or supplements to <br />funds for the current year of existing grants. <br /> <br />If more than fOur lines are needed to list the program titles <br />submit additional schedules as necessary. <br /> <br />line 20 - Enter the total for each of the Columns (b)-(e). <br />When additional schedules are prepared for this Section, <br />annotate accordingly and show the overall totals on this <br />line. <br /> <br />- -'1 <br /> <br />..~-- -'-. <br /> <br />..~~:- . <br /> <br />.~:r <br /> <br />Section F - Other Budget InformatiO:1. <br /> <br />Line 21 - Use this space to .. :Jlain al'T'l')unts for individual <br />direct object cost categories t:);.)t may appear to be out of <br />the ordinary or to explain the details as required by the <br />Federal grantor agency. <br /> <br />Line 22 - Enter the type of indirect rate (provisional, pre. <br />determined, final or fixed) that will be in effect during the <br />funding period, the estimated amount of the base to which <br />the rate is applied, and the total indirect expense. <br /> <br />Line 2) - Provide any other explanations required herein <br />or any other comments deemed necessary. <br /> <br />PI\RTIV <br />PROGRAM NARRATIVE <br /> <br />Prepare the program narrative statement in accordance with <br />the following instructions for all new grant programs. Re- <br />quests for continuation or refunding and changes on an <br />approved project should respond to item 5b only Requests <br />for supplemental assistance should respond to question 5c <br />only. <br /> <br />1. OBJECTIVES ANO NEEO FOR THIS ASSISTANCE. <br /> <br />Pinpoint any relevant physical, economic, social, financial, <br />institutional, or other problems requiring a solution. Dem- <br />onstrate the need for assistance and state the principal and <br />subordinate objectives of the project. Supporting documen- <br />tation. or other testimonies from concerned interests other <br />than the applicant may rn; used. Any relevant data based on <br />planning studies should be included or footnoted. ' <br /> <br />2. RESULTS OR BENEFITS EXPECTED. <br />Identity results and benefits to be derived. For example, <br />when applying for a grant to establish a neighborhood <br />health center provide a description of who will occupy the <br />facility, how the facility will be used. and how the facility <br />will benefit the general public. <br /> <br />3. APPROACH. <br /> <br />a. Outline a plan of action pertaining to the scope and <br />detail of how the proposed work will be accom- <br />plished for each grant program, function or activity, <br />provided in the budget. Cite factors which might ac. <br />celerate or d~celerate the work and your reason for <br />taking this approach as opposed to others. Describe <br />any unusual features of the project such as design or <br />technological innovations, - reductions in cost or time, <br />or extraordinary social and community involvement. <br /> <br />b. Provide for each grant program, function or activity, <br />quantitative monthly or quarterly projections of the <br /> <br />"OJ' ~1< <br /> <br />~ /;, <br /> <br />- <br />1 <br /> <br />accomplishments to be achieved in such terms as the <br />number of jobs credted; the number of people ser",.v; <br />and the number of patients treated. When accc"n: <br />pfishments cannot be quantified by activity or fl''l(,- <br />tion, Pst them in chronological order to show the <br />schedul~ of acc.::mplishments and their target dates <br /> <br />c. Identify the kinds of data to be collected and main.' <br />tained and discuss the criteria to h~ used to evaluate <br />the results and successes of the project. Explain the <br />methodology that will be used to determine if the <br />needs identified and discussed are being met and it" <br />the results and benefits identified in item 2 are being <br />achieved. <br /> <br />d. List organizations, cooperators, consultants, or other <br />key individuals who will work on the proje~t alano <br />with a short description of the nature of their effort <br />or contribution. <br /> <br />4, GEOGRAPHIC LOCATION. <br />Give a precise location of the project or area to be served <br />by the proposed project. Maps or other graphic aids may be <br />attached. <br />5, IF APPLICABLE, PROVIDE THE FOLLOWING IN. <br />FORMATION, <br /> <br />a. For research or demonstration assistance requests. <br />present a biographical sketch of the plogram director <br />with the following information; name, address, phone <br />number, background, and other quality ing experience <br />for the project. Also, list the name, training and back- <br />ground for other key personnel engaged in the <br />project. <br /> <br />b. Discuss accomplishments to date and list in chrono- <br />logical order a schedule of accomplishments, progress <br />or milestones anticipated with the new funding reo <br />quest. If there have been significant changes in thl-l <br />project objectives, location approach, or time delays, <br />explain and justify. For other requests for changes or <br />amendments, explain the reason for the changelsl. If <br />the scope or objectives have changed or an extension <br />of time is necessary, explain the circumstances and <br />justify. If the total budget has been ~xceeded. or if <br />individ~al budget items have changed more than t' e <br />prescribed limits contained in Attachrnent K to 0' <br />fice of Management and Budget Circular No. A'102, <br />explain and justify the change and its effect on the <br />project. <br /> <br />c. For supplemental assistance request~, explain the rea- <br />son for the request and justify th" need for additional <br />funding. <br /> <br />.~:Y;)'" .. <br /> <br />1-:>'.- <br />\'"" . <br />