Standard Form 424 - Application For Federal Domestic Assistance - Short Organizational
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3OMB Number: 4040-0003
Expiration Date: 7/30/2011
APPLICATION FOR FEDERAL DOMESTIC ASSISTANCE - Short Organizational
* 1. NAME OF FEDERAL AGENCY:
2. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER:
CFDA TITLE:
* 3. DATE RECEIVED:
SYSTEM USE ONLY
* 4. FUNDING OPPORTUNITY NUMBER:
* TITLE:
5. APPLICANT INFORMATION
* a. Legal Name:
b. Address:
* Street1:
Street2:
* City:
County/Parish:
* State:
Province:
* Country:
* Zip/Postal Code:
USA: UNITED STATES
c. Web Address:
http://
* d. Type of Applicant: Select Applicant Type Code(s):
* e. Employer/Taxpayer Identification Number (EIN/TIN):
Type of Applicant:
* f. Organizational DUNS:
Type of Applicant:
* g. Congressional District of Applicant:
* Other (specify):
6. PROJECT INFORMATION
* a. Project Title:
* b. Project Description:
c. Proposed Project:
* Start Date:
* End Date:
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Parent category: Legal