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2- APPLI• & NUMBER <br />FEDERAL ASSISTANCE CANTS <br />APPLI- None <br />1. TYPE . CATION <br />❑ NOTICE OF INTENT �R TI- b. DATE <br />SUBMISSION (OPTIONAL) <br />We.* ar ❑ PREAPPLICATION 19 91-0 <br />❑ APPLICATION ' <br />trele <br />Bin" <br />ATE <br />a. NUMBER <br />APPLI- <br />H-4alnmantty Aman At.-Ky <br />CATION <br />1-F tyw E.duaticuml Inuituteun <br />IDENTI- <br />J- Indian Tribe <br />FIER <br />6. GATE <br />Nom TD BE <br />ASSIGNED <br />ASSIGNED <br />Letter El <br />BY STATE <br />Enter onpropriare <br />4. LEGAL APPLICANT/RECIPIENT 1ge County a. Applicant Name ��++ <br />b. Organization Unit County Government <br />c. Street/P.O. Box P. o. Box 8181 <br />CL city : Eillsborough e. county Orange <br />f. State N. C. ZIP Code. 2727$ <br />h. Contact Perron INom• ; Terri. TySOn, RS4'P Direct-or <br />A 7arryhw. Nn, (919) 968 --6060 <br />7. TITLE OF APPLICANTS PROJECT (Use section IV of this form to provide a summary <br />a. description of the project.) <br />G 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 cam"ty as <br />a volunteer to the best of his/he-r ability. <br />Ci <br />9. AREA OF PROJECT IMPACT /Nam" a(nam rt„nrte xwra rtt, 10. ESTIMATED NO. OF <br />PERSONS BENEFITING <br />Orange County, North Carolina 480 <br />" 12. PROPOSED FUNDING 1 13. CONGRESSIONAL DISTRICT OF: <br />a. FEDERAL is DO a. APPLICANT <br />b• APPLICANT 36 59 400 Fourth <br />c. STATE I - •DO 15_ PROJECT START <br />d. LOCAL !3,177 -00 DAT E Y~ rh dar <br />e. OTHER ( _0_ 00 1991 -07 -01 <br />18. DATE DUE TO <br />F Total I3 79,264 .00 FEDERAL. AGENCY 1 <br />19. FLDERAL ACZNCY TO RECEI3%E REQUEST <br />a. ORGANIZATIONAL UNIT (IF APPROPRIATE) I b. <br />Reaian IV <br />b. PROJECT <br />Fourth <br />16. PROJECT <br />DURATION <br />12 -xa t9 <br />rew mmah day <br />19 <br />5. EMPLOYER IDENTIFICATION NUMBER (EIN) <br />56- 6000327 <br />6. a. NUMBER <br />PRO- <br />GRAM 2 - <br />IFrose CFOAr MULTIPLE ❑ <br />Sr. Volunteer Prg: <br />8. TYPE OF APPLICANT/RECIPIENT <br />A "rau <br />G -Spend Fhupaw Diauia <br />B-In S w <br />H-4alnmantty Aman At.-Ky <br />C usuwm <br />1-F tyw E.duaticuml Inuituteun <br />Organxmuan <br />J- Indian Tribe <br />D--county <br />K- OUWISP -type <br />E--Qey <br />TO THE 8Y E�F,CUTIVE ORDER 12372 PROCESS FOR REVIEW ON: <br />F-Zrhool Diatnct <br />Letter El <br />DATE. �� `�' 11 <br />Enter onpropriare <br />11. TYPE OF ASSISTANCE <br />A -Bate Grant D- Inrawsm <br />B- Suppl.menul Grant c- Other <br />C -Coen Ewer aap"wrratr temewsh <br />14. TYPE OF APPLICATION <br />A-.Vew C- tie+tart E- Augmenuuwt <br />B- tiene"I D-- Caewwroion r� <br />antrr appvyriarr 4•te.r ILtfrl <br />17. TYPE OF CHANGE. For New w Ne, <br />A- lnere.s Del an F-0Lher ISP nM <br />C- mere -o Durauan <br />0- 0earea+a Durnuan <br />FCC +nceilauon <br />:ntv I I LV I: _ <br />anam irtrr"st <br />20. EXISTING - ? ;Ut-rLAL <br />(IF :-4N0wN) GRANT IDENT. NO. <br />1440- 4768/09 <br />c. ADDRESS <br />21.- FLE-MARKS ADDED <br />101 Marietta Street, N ->�• <br />30 30 3 <br />[j Yea ';KLNo <br />Atlanta, Ga - <br />xx <br />22. <br />To dw bey c my knaww4 v.nd bdid dam <br />a. YES. THIS NOTICE OF =;NTIPREIPPLICATIONI APPLICATION WAS MADE AVAILABLE <br />THE <br />in this peaspp kzuwvsaglieauon am true <br />TO THE 8Y E�F,CUTIVE ORDER 12372 PROCESS FOR REVIEW ON: <br />APPLICANT <br />.nd mrrccs �`y damn m% ha been duty <br />DATE. �� `�' 11 <br />CERTffIES <br />auti 9^Rd by tas gtwe ng baby .r *. so. <br />: AMENDMENT <br />THAT <br />pliant and the epptiant tall eemcty .nth <br />&" "..- . t """'°`° if `be °""mn°e 1 <br />b. NO. PROGRAM IS NOT COVERED BY E-0. 12372 ❑ <br />b. APPLICANT] <br />p�°ed <br />OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW C3 <br />23. <br />TYPED NAME AND TITLE <br />b. G <br />CERTIFYING <br />REPRE• <br />Moses Carey, Chair <br />/1 <br />SENTATTVE <br />_,^ v J 55;1 Qnar <br />L <br />24. APPLICA- Year -"A day <br />125. FEDERAL APPLICATION IDENT. NO. <br />126. FEDERAL GRANT IDE CATION <br />1_ <br />27. ACTION TAKEN <br />28. FUNDING <br />Year month 'fay <br />30. 4 Year month da e <br />xx <br />i : s AWARDED <br />29. ACTION DATE. 19 <br />RATE G l9 <br />o2 <br />1; b. REJECTED <br />1 ! a. RETURNFO FOR <br />a. FEDERAL <br />S .0O <br />31. CONTACT FOR ADDITIONAL <br />32 r«v mw,A dear <br />�� <br />: AMENDMENT <br />INFORMATION rNamr and IN•v1• n.me.n <br />ENDING <br />r 14 RETURNED FOR <br />b. APPLICANT] <br />DO <br />DATE 19 <br />EP. 1== SUBMISSION <br />c STATE <br />00 <br />33. REMARKS ADDED <br />xx <br />BY ApnicANTTo <br />& LOCAL <br />.00 <br />C20 <br />STATE <br />A <br />e. OTHER <br />.00 <br />rl <br />c wTl WN <br />Yea Q No <br />f. Totai <br />S .00 <br />PAGE 1 <br />Provtbed by OATS C&srfur A•10 <br />1_ <br />