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FEDERAL ASSISTANCE <br />1. TYPE <br />❑ NOTICE OF INTENT <br />SUBMISSION <br />(OPTIONAL) <br />fMerh am <br />l3 PREAPPLICATION <br />m <br />b <br />LL- APPLICATION <br />2. APPLI- a. NUMBER 3. STATE a. NUMBER <br />CANT'S APPLI- <br />APPLI- NONE CATION <br />CATION IDENTI- <br />FIER I b. DATE rear mae,A der Norm TO BE b. A DATE <br />ASSIGNED SSIGNED <br />1990 -05 -01 BY STATE <br />Leave <br />Blaah <br />19 <br />rear maeeh dnr <br />4. LEGAL APPLICANT/RECIPIENT 5. EMPLOYER IDENTIFICATION NLlmkiz x114) <br />a. Applicant Name ORANGE COUNTY <br />b. Organization Unit :County Government 6. a. NUMBER <br />c. Street/P.O. Box : P O. BOx 8181 PRO- 7 Z 0 <br />GRAM <br />d. City Hillsboroughcounty Orange <br />f State N.C. g. ZIP Code. 27278 f'`""" cam' MULTIPLE ❑ <br />ah. ContactPerson(No . Terri Tyson, RSVP Director b. TITLE Retired Senior <br />&Trieph;M.N.., Volunteer Program <br />7. TITLE OF APPLICANT'S PROJECT (Use section IV. <br />a IV . of this form to provide a summary 8. TYPE OF APPLICANTIRECIPIENT <br />description of the project.A -Ste G-Special Purpuae District <br />-Retired B_,,�r� V r a n g e County-Chapel <br />H- Zommunity Anion Agency <br />W C�Swtitunt I- higher Eduertw.ul Inrtitutiao <br />m Senior Volunteer Program.The project provides <br />anitatlar d.Indisn Tribe <br />13pen/pt s <br />the means by which an individual aged 60 or 0-r-ty K• -0ther E-citr <br />3 or older may serve the community as a v o I u n t e e -SehoolDidLneL 1-'1 <br />aa. Enter appropriate letter l� <br />e <br />! 9. AREA OF PROJECT IMPACT IN- of riam tw.neit•�t .m s v% eft, 10. ESTIMATED NO. OF 11. TYPE OF ASSISTANCE <br />Z PERSONS BENEFITING A -ac Gmt D- Inaum"M <br />°. Oran a County, North Carolina r o l lu n a 4 8 0 B- 5uppleswental Grant E -other <br />g y C -Loan Eefer app Wnate lWh„d EM <br />12. PROPOSED FUNDING i 13. CONGRESSIONAL DISTRICT OF: <br />a. FEDERAL <br />$ 10,081 .00 <br />a. APPLICANT <br />Fourth <br />15. PROJECT START <br />DATE Year month day <br />1 19 90 -07 -C <br />b. APPLICANT <br />c. STATE <br />.00 <br />00 <br />d. LOCAL <br />00 <br />e. OTHER <br />•00 <br />18. DATE DUE TO <br />_ FEDERAL AGENCY • <br />f Total <br />Is 10,081 .00 <br />19. FEDERAL AGENCY TO RECEIVE REQUEST <br />a. ORGANIZATIONAL UNIT (IF APPROPRIATE) b. t <br />b. PROJECT <br />Fourth <br />16. PROJECT <br />DURATION <br />L 12 Mae,ha <br />Year maalh day <br />14. TYPE OF APPLICATION <br />A -New <br />C- Revision E- Augtmentatim <br />a- Renewal <br />D- Canunwtion <br />Enter apprupraak Wrrr EJ <br />17. TYPE OF CHANGE fFw Nr or lief <br />A -Immam Dallas <br />F -Usher fSpenfy) <br />B- Decr+rae Dallan <br />d. LOCAL <br />C- Inaeaaa Duration <br />.00 <br />0-- Decroaae Duration, <br />E.- Canrellrtion <br />f. Total' <br />$ <br />Eater <br />[Merl <br />prior Irlfe.ea, <br />20. EXISTING FEDERAL <br />GRANT IDENT. NO. <br />r (IF KNOWN) <br />440- 4768/08 <br />c. ADDRES 21. REMARKS ADDED <br />101 Marietta Street, N.W. Yes EkNo <br />Atlanta Ga. 30303 <br />p 22. To the hea of my knowledge and belieG dau• a. YES, THIS NOTICE OF INTENT /PREAPPLICATION /APPLICATION WAS MADE AVAILABLE <br />F THE in this pterppikutsoulappluatue are true TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON: <br />v APPLICANT and __,I_ Out document has been duly DATE <br />I` CERTIFIES +uthanud by the governing{ body of the sp. <br />THAT F pliant and tha applicant will comply with <br />Lim <br />pproved, "'""""' d the °"""`i1Ot " b. NO. PROGRAM IS NOT COVERED BY E.O. 12372 0 <br />approved OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW 0 <br />23. TYPED NAME AND TITLE I b. SIGNATURE <br />REPRE- <br />SENTATIVE <br />24. APPLICA <br />Moses Carey, Chair <br />Year nun <br />27. ACTION TAKEN <br />Its AWARDFD <br />Z I 1 b RFJWMD <br />C c RETURNED FOR <br />AMKNDMRNT <br />e I t d. UNTURNE0 MR <br />r ED. 1=72 SUUMMSION <br />', BY APPLICANT TO <br />Z STATE <br />t3 i! i .. DEFERRED <br />C i f. WITHDRAWN <br />Mr 125. <br />28. FUNDING <br />a.FEDERAL $ <br />'AT PIU74 <br />b. APPLICAN <br />.00 <br />c. STATE <br />.00 <br />d. LOCAL <br />.00 <br />e. OTHER <br />.00 <br />f. Total' <br />$ <br />.00 <br />.A N IDENT. NO. 26. FEDERAL GRANT IDENTIFICATION <br />rear matth dRv ST ar ARTING Ye month dare <br />29. ACTION DATEip 19 DATE 19 <br />31, CONTACT FOR ADDITIONAL 32. rear e.-Wh dohs <br />INFORMATION ,Nerve o n l kkp%- auabtr, ENDING <br />DATE 19 <br />33. REMARKS ADDED <br />Yea 0 No <br />PAGE 1 <br />p veerbed by OMB Oreular A-102 <br />