PY2011 CM Application Form.doc - Impacting Alabama
SMALL CITY, LARGE CITY, AND COUNTY FUNDS APPLICATION
ALABAMA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM
PROGRAM YEAR 2023
FORWARD AN ORIGINAL AND TWO COPIES OF
THE FULL APPLICATION PACKAGE TO
CDBG Section
ALABAMA DEPARTMENT OF ECONOMIC AND COMMUNITY AFFAIRS
401 ADAMS AVENUE, SUITE 500
POST OFFICE BOX 5690
MONTGOMERY, ALABAMA 36103-5690
Attn: CDBG Application
ALABAMA CDBG APPLICATION SUMMARY FORM
Select One: Select One (if applicable):
_____________________________________________________________________________
|Community Name: | | |
|Chief Elected Official: | | |
|Mailing Address: |STREET | | |
| |CITY | |ST |AL |ZIP | | |
|Phone Number: | |E-mail Address: | |
|COUNTY: | |FEIN: | |
|UEI No.: | |UEI Expiration Date: | |
|Amount Requested: |$ | |2020 Census Population: | |
|Local Match: |$ | |Cash: |$ | |Source: | |
| | | |In-Kind: |$ | |Source: | |
|Non-Local Funds: |$ | |Source: | |
|Federal Congressional District: | |/ | |
|State District: |(Senate) | |/ | |/ |
|Prevention of Slum and Blight: | |Yes | |No |No. of Units Rehab/Demo: | |
|Contact Person/Grant Writer: | |
|Firm or Organization: | |
|Mailing Address: | |
|City, State & Zip |STREET | |ST | |ZIP | |
|Phone/E-mail Address: | |/ | |
|Select Activity(ies): |
|Activity 1: | |Activity 2: | |Activity 3: | |
|Other/Additional Activity(ies): | |
|For ADECA Use Only |
|Minority Yes No |Black Belt Yes No | Single/Primary (CM) Comprehensive (CP) |
| | |Residential Rehab (RR) Special Fund (SF) |
|Completed |______________ |AS 400 |______________ |IDIS |______________ |
|Date |______________ |Date |______________ |Date |______________ |
>> PLEASE SEE NEXT PAGE TO COMPLETE APPLICATION FORM ................
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