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Application for 2004 -2005 13 <br />Town of Chapel Hill Community Development Block Grant (CDBG) <br />Program <br />and / or <br />Orange County HOME Program <br />NAME OF APPLICANT: <br />CONTACT PERSON: <br />Address (no P.O. boxes): _ <br />Mailing Address (if different): <br />City: <br />Zip:_ <br />County: <br />E -mail address: <br />Phone: ( <br />PART I STANDARD APPLICATION <br />1. APPLICANT INFORMATION <br />State: <br />Federal I.D # <br />Fax:( ) <br />Type of Applicant <br />(Check all that apply) <br />• Applicant is an existing entity <br />• Corporation ❑ General Partnership ❑ Limited Partnership <br />• Limited Liability Company <br />Suite #: <br />• Joint Venture ❑ For - Profit ❑ Non -Profit ❑ Local Housing Authority <br />• Municipality ❑ Individual(s) ❑ CHDO ❑ Current Owner <br />❑ Proposed Owner ❑ Developer ❑ Contractor ❑ Other: (specify) _ <br />If a non profit organization please submit a copy of your 501 (c)(3) documents and a <br />current list of all Board members. <br />CDBG / HOME Program Application 4 <br />.January 2004 <br />