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<br /> .,(p10, <br /> Federal Congressional District(s) (number): 14 <br /> <br /> Secondary Applicant (Partner) (Att£Zch additional sheets if more than one partner) <br /> Organization's Legal Name: See attached 1 i st. ( aocendix #= 1) <br /> <br /> Name of Organization's Oùef Executive: <br /> <br /> TItle: <br /> , <br /> Address: ¡ <br /> ¡ <br /> , <br /> City: State: Zip Code: <br /> <br /> Telephone: FAX: <br /> . . <br /> Has the law enforcement agency (primary applicant) received other COPS grants? <br /> ŒJ Yes 0 No <br /> If yes, under which program(s) has the law enforcement agency received Federal. <br /> funds? . <br /> ~ Phase I 0 Universal Hiring Program 0 COPS FAST <br /> 0 COPS MORE 0 Troops to Cops 0 Anti-Gang Initiative <br /> 0 Youth Firearms Initiative 0 COPS AHEAD <br /> 0 Commuri.ity Policing to Combat Domestic Violence <br /> Type of La,...' Enforcement Agency: <br /> z¡ Municipal Police 0 County Policé 0 State Police/Highway Patrol <br /> 0 Sheriff 0 Indian Tribal 0 Transit ' <br /> 0 School District 0 Public University or College <br /> 0 Public Housing 0 Private University or College <br /> 0 New/Start Up (Please specify type of new agency) <br /> 0 Consortium 0 Other (Please specify) <br /> <br /> Has your organization submitted a "Collaboration Agreement" signed by both pri- <br /> mary and secondary applicants, OR completed the partnership waiver request? (S€e <br /> p. 16-18 for more details) <br /> Œ Completed Collaboration Agreement <br /> 0 Completed Partnership Waiver Request <br /> 2 Application Form: Problem-Solving Partnerships (This page must ~ retumed to the COPS Office,) <br />