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C, <br />• <br />3. STATE <br />FEDERAL ASSISTANCE <br />CANT S <br />NUMBER <br />CATION <br />C- Suaututs <br />APPLI- <br />None <br />1.00FFTYPE <br />b. DATE <br />NOT& TO ee <br />ASSIGNED <br />AMONE a <br />a�cNS <br />13 NOTICE OF INTENT <br />ICDENTI- <br />b. DATE <br />b. APPLIC <br />SUBMISSION (OPTIONAL) <br />FIER <br />E.D. 1=2 SU13MMWN <br />BY APMWANT'TO <br />aatrarr ar ❑ PREAPPLICATION <br />C STATE <br />rew <br />91 <br />094 <br />e ❑ APPLICATION <br />19 <br />tear <br />arms <br />e. OTHER <br />.00 <br />3. STATE <br />a. NUMBER <br />APPLI- <br />H- AWArauto <br />CATION <br />C- Suaututs <br />IDENTI• <br />Organization <br />FIER <br />b. DATE <br />NOT& TO ee <br />ASSIGNED <br />AMONE a <br />a�cNS <br />F,Schaoi Diana <br />13Y 9TA1'E <br />INFORMATION imteer and eer e,n <br />ephenr nhvt <br />4. LEGAL APPLICANT/RECSPMNT <br />a. Applicant Name "range County <br />b. Organisation Unit County Government <br />c. Street/P.O. Box P. 0. BOX 8181 <br />a. City . Hillsborough e. county Orange <br />f. State N. C • ZIP Code. 27278 <br />t h. Contact Person rrvamr Terri Tyson, A0 Director <br />° rt rerephoar avna (919) 968 -6060 <br />La 7. TITLE OF APPLICANTS PROJECT (Use section N of this form to provide a summary <br />description of the project) <br />Orange County - Chapel Hill Retired Senior Volunteer <br />Program. The project provides the means by which an <br />,.individual aged 60 or older may serve the colmnulity as <br />4 a volunteer to the best of his/her ability. <br />e <br />9. AREA OF PROJECT IMPACT womr. of mie.. ronnttft Aran-% raen 10. ESTIMATED NO. OF <br />0. Orange County, North Carolina PERSONS BENEFITING � 480 <br />" 12. PROPOSED FUNDING 13. CONGRESSIONAL DISTRICT OF: <br />a. FEDERAL S 28,312 •oo a. APPLICANT b. PROJECT <br />b. APPLICANT 37,775 Fourth Fourth <br />c. STATE - - .00 15. PROJECT START 16. PROJECT <br />d. LOCAL 13,17-7 .00 <br />DATE Ytar math do. DURATION <br />e. OTHER _0_ .00 1991- -07 -01 12 .lraaraa <br />Total 5 <br />f. 18. DATE DUE TO a <br />79 264 00 FEDERAL AGENCY r 19 Y�ar y,�arlt„(a. <br />19. FEDERAL AGENCY TO RECEIVE REQUEST V V l <br />a. ORGANIZATIONAL UNIT (IF APPROPRIATE) b. ADMINISTRATIVE CONTA <br />Region IV <br />c. ADDRESS <br />101 Marietta Street, N.W. <br />Atlanta, Ga. 30303 <br />Year a 14 dry <br />19 <br />5. EMPLOYER IDENTIFICATION NUMBER (EIN) <br />56- 6000327 <br />6. <br />PRO - a. NUMBER <br />GRAM h I2 I. to l o l ?1 <br />(Fran CFDAr MULTIPLE Q <br />Sr. Volunteer Pr-- <br />8. TYPE OF APPLICANT/RECIPIENT <br />A-Stata <br />G- Sotvai Purpow Disvict <br />H- AWArauto <br />H- Community Action Atrenry <br />C- Suaututs <br />1- I•Hgiyr Eduaauonai Inaut4uun <br />Organization <br />J-- •Induut Tribe <br />0-- county <br />K -Other aSp C*).- <br />E -City <br />31. CONTACT FOR ADDITIONAL <br />F,Schaoi Diana <br />r 1 d. RETURNED <br />Enter appropriate letter El <br />11. TYPE OF ASSISTANCE <br />A -$rate Grant D-4nauruiv <br />B- +Suppiemenui Grant 9- -0ther <br />C -Lora 6nan am n tiriarr 4ruwau <br />14. TYPE OF APPLICATION - <br />A-New C -Rnmmn E- Auymentauon <br />S- Ranawal D- conunuisim" <br />Sacra apprvpnatr irnrr <br />17. TYPE OF CHANGE (For 14r or 14er <br />A- lncreew Dollars F -Other eSpnim <br />B- Deusaar unllars <br />C- lnerea -e Duration <br />D- Occreaar Duration <br />E- Cancellation <br />Eanr aopr. L <br />rnaw liter -r <br />20. aXLSTLNG FEDERAL <br />(IF KNOWN) GRANT MENT. Y0. <br />1440-4763/09 <br />21. REMARKS ADDED <br />QYes - No <br />F <br />22. To thr beat d r <br />THE my is --i and wir data a. YES, THUS NOTICE OF UMNT/PREAPPLICATION /APPLICATION WAS MADE AVAILABLE <br />in this prea*kaamramieauaa Ara erw TO THE E CUTTVE ORDER 12372 PROCESS FOR REVIEW ON: <br />APPLICANT and - ur6 docueura has bten duty DATE <br />CERTIFIES auLh- -d by thr greenanR body of the ap. <br />ti THAT piicenc and the applfeua . 11 a�tply with <br />dw act' "" `be °tea"° i' b. NO, PROGRAM IS NOT COVERED BY E.Q. 12372 El ` aav�.ed OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REV IEN ❑ <br />CERTIFYING TYPED NAME AND TITLE b. SIGNATURE <br />SREEA. Moses Carey, Chair <br />24. AI?PLTCA- car nreraA day 25- FEDERAL APPLICATION IDENT. NO. <br />26. FEDERAL GRANT IDENTIFICATION <br />� <br />SSTARTING Yee( aronah dap. <br />DATE 19 <br />32 Yew arwen dear <br />-ATE G 19 <br />33. REMARKS ADDED <br />Yes 0 No <br />PAGE 1 <br />FreeaAtd es oaN9 crr�ere. A -acs <br />1. <br />27. ACTION TAKEN <br />28. FUNDING <br />year aranth dos <br />2a <br />1 : a. AWARDED <br />l ; b. RF-nD= <br />29. ACTION DATE( 19 <br />r <br />` RL'T RNrsa FOR <br />AMENDMENT <br />s. FEDERAL <br />S .00 <br />31. CONTACT FOR ADDITIONAL <br />w s <br />r 1 d. RETURNED <br />INFORMATION imteer and eer e,n <br />ephenr nhvt <br />b. APPLIC <br />.00 <br />_} <br />rx <br />E.D. 1=2 SU13MMWN <br />BY APMWANT'TO <br />C STATE <br />00 <br />094 <br />STATE <br />a. DEFERRED <br />d. LOCAL <br />.00 <br />e. OTHER <br />.00 <br />ta <br />r. WrMDRAWN I <br />f. Taal <br />; .00 <br />� <br />SSTARTING Yee( aronah dap. <br />DATE 19 <br />32 Yew arwen dear <br />-ATE G 19 <br />33. REMARKS ADDED <br />Yes 0 No <br />PAGE 1 <br />FreeaAtd es oaN9 crr�ere. A -acs <br />1. <br />