2023 Subgrantee Application

2023 Subgrantee Application

REMEMBER...

DO NOT attempt to complete this application prior to reviewing the 2023 CDBG Guidebook, which you can find at the top of this web page. Complete and prepare all documents from Section 1 prior to completing and submitting this form.

Applicant Organization*

Activity Name*

Address*

City*

State*

Zip Code*

Phone Number*

Phone

Email Address*

Contact Person*

Title*

Applicant Type*

City Department

Non-Profit Organization

Other Public Agency

Agency*

Enter name of agency.

Federal ID #*

DUNS #*

National Objective*

Benefit persons of low-moderate income

Address slum/blight conditions

Urgent Need

Low-Mod Income Benefits*

Select

Requested CDBG Entitlement Funding*

Funding leveraged from other sources*

20% of total project costs strongly recommended, but not required. If zero, please indicate.

Total activity cost*

Proposal Summary*

Describe your proposal in a few words.

Persons served*

How many low-moderate income persons will be served through this activity?

Previous CDBG awards*

Yes

Award Completion*

Yes

This activity is...*

new

continuing from previous years

expanded from previous years

Approval/ Permit?*

Identify whether the activity requires additional local, state or federal approval (license, permit, design/historic/environmental review, etc.). Check all that apply.

REQUIRED: Upload Site Control Documentation

For construction/site development/land acquisition projects, use DOCUMENT UPLOAD at the end of this form to provide applicable documents such as deed, MOU, purchase contract.

Please upload the following documents, as applicable:

Grant Application Supplement Organization Documents Site Control Documentation Budget Form 1 and/or Budget Form 2 OMB Circular A-133 Audit Report Environmental Impact Location Map

Document Upload

Drag and drop files here or

By checking the "I Agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

I Agree*

Send me a copy of my responses

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