Agenda - 04-04-1994 - VIII-D - Laserfiche WebLink

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6. OMB A=rovat No.C'.,SZ-^o43 APPLICATION FOR 2-DATE SUBMITTED Applicant identifier FEDERAL ASSISTANCE 0?-23-q4 NONE 1.TYPE OF SUBMISSION: 0 3.DATE RECEIVED BY STATE State Applicztfon identifier ADplimoon PreaD0fica0on 9300000720 ❑Cons",cuon ❑ Construction ❑Non-ConstrucDan ❑ Nor-Construction 4.DATE RECEIVED BY FEDERAL AGENCY Federal Identifier S.APPLICANT INFORMATION Legal Name: +organizational Unit ORANGE COUNTY I COTM GOVE Address(give dry,counry,state,and zip coca): Name and telephone number of the person to be contacted on matters involving this application (give area code): ORANGE COUNTY Katherine P. Mangum (Kathy) , RSVP Director P.O. BOX 8181 (919) 968-2054 HILLSBOROUGH, NC 27278 • EMPLOYER IDENTIFICATION NUMBER(IIM 7. TYPE OF APPLICANT:(ante!applOpnate IaRer in box) A. State H. Inoependent School Cistrict B. County I. State Controlled Institution of Higher Learning C. Municipal J. Private University • TYPEOFAPPUCATION: D. Township K. Indian Tribe ❑ New ES Continuation ❑ Revision E- Interstate L. Individual F. Intermunicipal M. Profit Organization If Revision,enter appropriate letter(s)in box(es): [3 [] G. Special District N. Other(Specify): A. Increase Award B. Decrease Award C. Increase Duration 9• NAME OF FEDERAL AGENCY: D. Decrease Duration Other(specify): ACTION 10. CATALOG OF FEDERAL DOMESTIC a 11. DESCRIPTIVE TITLE OF APPLICANTS PROJECT: The FW>ruri bS ASSISTANCE NUMBER: 7 2 O O 2 i�`-'�'�-�-� for arrty1CtL7 is 55 & U)E?r tYe CPP= Mty tD sett e TILE: Retired Senior Volunteer Program d-e OCTmm2_t•1eS rrn-profit agmcies tluuxjh mgan:n tfilL and reAmding Wlmteer placarsits. P1acmmts are 12, AREAS AFFECTED BY PROJECT(cities,counties,States,etc.): based Cn ttn volunteer's ski ls, expertise, 1nterFSts & the rx'edS Of t x? agffines. Aga)mjes c-me re4l1red Hillsborough, Chapel Hill, Carrbor ,to subrat cbtiailed job descri.ptias of each Orange County, North Carolina assigiTtaitt. 73. PROPOSED PROJECT: 14. CONGRESSIONAL DISTRICTS OF: Ppqi nn TV - Start Date Ending Date a. Applicant b. Project Fourth Fourth 07-01-94 06-30-97 15. ESTIMATED FUNDING: IL 1S APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? a. Federal $ 112,545 •00 a. YES. THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON: b. Applicant $ 133,107 0D DATE c. State $ b. NO. ❑ PROGRAM IS NOT COVERED BY E.O.12372 d. Local $ 38,331 - ❑ OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW e. Other $ •00 f. Program Income $ aa 17. 13 THE APPLICANT DEUNOUENT ON ANY FEDERAL DFBT7 ❑ Yes If'Yes,'attach an explanation. No g. TOTAL $283,983 .co te. TO THE BEST OF MY KNOWLEDGE AND BELIEF,ALL DATA IN THIS APPUCATIOWPREAPPUCA110N ARE TRUE AND CORRECT,THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPUCANTAND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED a Typed Name of Authorized Representative b. Title c. Telephone Number Moses Carey Chair Oran e Co. Corrmissione 91vt, ?1 181 d. Signature of Authorized Representative a. Date Signed Previous EaLoas Not Usaele uthoru:ea of ocsl eproaucvon Page 1 Stunaara Form 424(Rev.4.aa) rescnoea oy OMd ,rcwar A-IC2