95-15468. Availability of Discretionary Grants to Promote Community Development in Sites With Significant Refugee Populations in Order to Increase Economic Independence Among Refugees and Their Families  

  • [Federal Register Volume 60, Number 121 (Friday, June 23, 1995)]
    [Notices]
    [Pages 32686-32700]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 95-15468]
    
    
    
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    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    Office of Refugee Resettlement
    
    
    Availability of Discretionary Grants to Promote Community 
    Development in Sites With Significant Refugee Populations in Order to 
    Increase Economic Independence Among Refugees and Their Families
    
    AGENCY: Office of Refugee Resettlement (ORR), HHS.
    
    SUMMARY: This program announcement governs the availability of funds 
    and award procedures for approximately $1,000,000 in FY 1995 
    discretionary grants for technical assistance and operating costs to 
    promote community development in sites with significant refugee 1 
    populations in order to increase economic independence among refugees 
    and their families. This announcement is soliciting applications for 
    cooperative agreement project periods up to three years. Awards, on a 
    competitive basis, will be for a one-year budget period, although 
    project periods may be for three years. Applications for continuation 
    grants funded under these awards beyond the one-year budget period, but 
    within the three-year project period will be entertained in subsequent 
    years on a noncompetitive basis, subject to availability of funds, 
    satisfactory progress by the grantee, and a determination that 
    continued funding would be in the best interest of the Government.
    
        \1\ In addition to persons who meet all requirements of 45 CFR, 
    400.43, eligibility for refugee social services also includes: (1) 
    Cuban and Haitian entrants, under section 501 of the Refugee 
    Education Assistance Act of 1980 (Pub. L. 96-422); (2) certain 
    Amerasians from Vietnam who are admitted to the U.S. as immigrants 
    under section 584 of the Foreign Operations, Export Financing, and 
    Related Programs Appropriations Act, 1988, as included in the FY 
    1988 Continuing Resolution (Pub. L. 100-202); and (3) certain 
    Amerasians from Vietnam, including U.S. citizens, under title II of 
    the Foreign Operations, Export Financing, and Related Programs 
    Appropriations Act, 1989 (Pub. L. 100-461), 1990 (Pub. L. 101-167), 
    and 1991 (Pub. L. 101-513). For convenience, the term ``refugee'' is 
    used in this notice to encompass all such eligible persons unless 
    the specific context indicates otherwise.
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    Available Funds
    
        In FY 1995, ORR expects to make available approximately $1,000,000 
    for one award in this program area. The amount in subsequent years will 
    depend upon the availability of funding, need, and the best interests 
    of the Government.
        The Director reserves the right to award more or less than the 
    funds described above depending upon the quality of the applications or 
    such other circumstances as may be deemed to be in the best interest of 
    the Government.
    
    Authorization
    
        Authority for this activity is contained in Section 412(c)(1)(A) of 
    the Immigration and Nationality Act, which authorizes the Director ``to 
    make grants to, and enter into contracts with, public or private 
    nonprofit agencies for projects specifically designed-- * * * (iii) to 
    provide where specific needs have been shown and recognized by the 
    Director, health (including mental health) services, social services, 
    educational, and other services.''
    
    Application Submission
    
        Forms and instructions for submitting an application are included 
    with this announcement which may be reproduced. Additional copies also 
    may be obtained by contacting the Office of Refugee Resettlement at the 
    address below. An original and two copies of all applications should be 
    submitted to: Department of Health and Human Services, Administration 
    for Children and Families, Division of Discretionary Grants, 370 
    L'Enfant Promenade SW, Sixth Floor, Washington, DC 20447 Or hand 
    delivered to: Division of Discretionary Grants, 901 D St. SW, 6th Fl. 
    ACF Guard Station, Washington, DC 20447.
    
    FOR FURTHER INFORMATION CONTACT: Ms. Anna Mary Portz, Office of Refugee 
    Resettlement, 370 L'Enfant Promenade SW., Washington, D.C. 20447, 
    Telephone (202) 401-1196, email: aportz@acf.dhhs.gov.
    
    Purpose and Scope
    
        The Refugee Act of 1980 mandates two broad goals: (1) To assist 
    refugees in achieving self-sufficiency as early as possible after 
    arrival, and (2) to provide long-term effective resettlement. Since 
    1975, almost two million refugees have been resettled in communities 
    throughout the United States. While many refugees have achieved 
    economic and social self-sufficiency, some continue to face poverty, 
    joblessness, under-employment and lack of access to opportunities. ORR 
    recognizes that in [[Page 32687]] order for refugees to be effectively 
    resettled, refugees need to have continuing access to mainstream 
    services and resources beyond ORR funds; and refugee communities must 
    be strengthened so that they can provide their own members with a long-
    term economic and social safety net.
        The purpose of this announcement is to solicit applications for a 
    project to strengthen refugee community-based organizations (CBOs) 
    which are already engaged in community development in sites where 
    significant refugee populations currently reside. A strong CBO is able 
    to tap into a community's desire for self-help, improve services, 
    nurture leaders, raise money from a variety of sources within and 
    outside the community, expand housing and economic opportunities and, 
    at the same time, remain accountable to the community. Most 
    importantly, these organizations give refugees a sense of hope about 
    their community's future.
        Strong refugee CBOs are critical building blocks for effective 
    resettlement. Such organizations can foster long-term community 
    development--the process by which refugee communities identify their 
    own needs and wants, mobilize resources, and develop and carry out 
    their own strategies--in order to improve their own communities.
        The successful applicant to this notice will be expected to do 
    three things:
        (1) Design and implement a comprehensive strategy which will 
    increase the organizational capacity of a certain number of refugee 
    CBOs so that these organizations can promote effective, long-term 
    development of their communities
        (2) Provide limited core funding to this group of CBOs so that they 
    can devote specific staff resources to a sustained implementation of 
    their respective organizational and community development plans; and,
        (3) Conduct a select number of activities, such as workshops or 
    peer-to-peer assistance, for the purpose of providing broad technical 
    assistance in community and organizational development to additional 
    refugee CBOs which are not selected for participation in items 1 and 2 
    described above.
        ORR will enter into a cooperative agreement with the successful 
    applicant(s) in order to jointly develop the technical assistance 
    procedures and project schedules. ORR will also provide guidance on 
    selection of participating refugee CBOs and service and monitoring 
    protocols.
    
    Eligible Applicants
    
        Eligible applicants are public or private nonprofit organizations. 
    If an applicant represents a consortium (that is, the applicant 
    includes other types of agencies among its membership), the single 
    organization identified to be the grant recipient with primary 
    administrative and fiscal responsibilities must be a nonprofit 
    organization.
    
    Application Content
    
        All applications must be submitted on Standard Form (SF) 424 Parts 
    I through III. A narrative project description constitutes Part IV and 
    must not exceed 30 pages (typewritten, double spaced on standard, 
    letter-size paper) plus a maximum of 20 pages of appended material. In 
    the event that the project description and/or supplementary material 
    exceed the page limitations, only the first 30 pages of the project 
    description (if single-spaced, only the first 15 pages), and the first 
    20 pages of the supplementary material, will be considered in the 
    review process. The limitation should be considered as a maximum, and 
    not necessarily a goal to be achieved.
        Part IV should contain the following sections:
        A. A discussion of the specific criteria to be used in participant 
    selection, and the community development needs to be addressed by this 
    project. ORR recognizes that concentrated planning has to occur at all 
    stages in the design and implementation of such a project. Part of this 
    planning should involve detailed consideration of the priority criteria 
    for determination of which ethnic CBOs will be invited to participate 
    with the applicant technical assistance provider in proposed activities 
    1 and 2 referenced in the section titled Purpose and Scope.
        ORR suggests the following criteria for refugee ethnic CBO 
    participants to be served by the grantee. Agencies served should be 
    viable nonprofit organizations with IRS 501(c)(3) status. 
    Organizational missions should provide a commitment to community 
    accountability and grassroots democracy.
        These CBOs should have staff and an actively involved broad-based 
    board. Such organizations should reflect the community-responsiveness, 
    decision-making, and oversight role of the Board.
        Applicants should discuss how they would identify organizations 
    with these respective characteristics, and suggest other criteria they 
    consider appropriate to qualify for receipt of services funded under 
    this grant. Applications should include examples of appropriate CBOs 
    for participation. (Final selection of participating CBOs will require 
    ORR concurrence under the terms of the Cooperative Agreement.)
        B. A description of the applicant's approach to community 
    development and how the applicant determines the type of technical 
    assistance that is required. A discussion of the perceived strengths 
    and obstacles in promoting effective refugee community development and 
    how the applicant can incorporate the strengths in its approach. An 
    analysis of how the strategies proposed would enhance community 
    development for refugees, indicating specifically how these services 
    can be applied and how the refugee communities selected can develop 
    constituency support. If the proposal was developed by a consortium or 
    other combination of entities, the role of each must be detailed.
        C. A description of the anticipated one-, two-, and three-year 
    outcomes. ORR expects at a minimum that during the project period a 
    certain number of refugee community-based organizations will exhibit 
    (1) significant progress toward a stabilized, multiple-source income 
    base appropriately related to the economic forces in the local 
    community; (2) outreach and accountability to multiple strata of the 
    local refugee community demonstrated inter alia by constituency-
    contributed financial support; (3) a track record of advocacy 
    activities and relevant organizational collaboration; and if 
    appropriate, (4) a demonstrated resettlement-related service provision 
    or refugee representation capacity.
        D. A description of the applicant's qualifications to carry out the 
    proposed activities, particularly descriptions of relevant previous 
    experience emphasizing experience with differing cultural groups. 
    Applications should include names and addresses of at least three 
    organizations for whom the applicant has previously provided similar 
    services, as well as a brief outline of the measurable outcomes 
    achieved for each. The applicant should also include resumes of key 
    staff proposed to work for the applicant in the implementation of this 
    grant, if awarded. (Applicants which cannot document experience in 
    technical assistance similar to that required herein will not be 
    considered.)
        E. A description of the proposed activities based on an analysis of 
    refugee ethnic community-based organizational needs and available 
    resources, as necessary to address the development of the refugee 
    community. Applicants should provide a detailed workplan of 
    [[Page 32688]] the steps and activities proposed to carry out the 
    objectives of the project, if funded, including a timetable for 
    implementation. ORR anticipates that such activities may include, but 
    are not limited to:
         Intensive, individually tailored technical assistance to a 
    certain number of refugee ethnic community-based organizations in a 
    limited number of sites;
         General community development assistance (i.e. grassroots 
    democracy and organizing, leadership training, coalition building, 
    resource development) for a broad audience of refugee community-based 
    organizations;
         Facilitation of peer to peer consultation among community-
    based organizations; and
         Development and applied testing of a refugee appropriate 
    model design or curricula for these activities.
        F. A line-item budget with narrative justification for each line 
    which correlates with and/or refers to the workplan.
    
    Application Review Criteria
    
        Applications will be reviewed, scored, and ranked in accordance 
    with the following criteria:
        1. Understanding of community development demonstrated by the 
    quality of the discussion of the criteria that would be used and how 
    they would be applied in selecting implementation sites and 
    participating refugee CBOs, including appropriate examples of each. (10 
    Points)
        2. Adequacy of the applicant's community development strategy, 
    including leveraging of other resources and recruiting mainstream 
    service providers, and the appropriateness of this approach for refugee 
    community organizations. (25 Points)
        3. Appropriateness of the anticipated outcomes. (15 Points)
        4. Qualifications of the applicant agency, including the staffing 
    plan and qualifications of key personnel to carry out the proposed 
    activities. (25 Points)
        5. Adequacy and reasonableness of implementation plan. (15 points)
        6. Appropriateness, cost-effectiveness, and reasonableness of the 
    budget. (10 Points)
    
    Administrative Requirement
    
    A. Availability of Application Forms
    
        All forms necessary for submission of an application, as described 
    herein are attached to this announcement and may be reproduced.
    
    B. Assurances and Procedures
    
        Applicants requesting financial assistance for a non-construction 
    project must file the Standard Form 424B, ``Assurances: Non-
    Construction Programs.'' Applicants must sign and return the Standard 
    Form 424B with their applications.
        The following certifications are attached: Drug-Free Workplace, 
    Debarment, Environmental Tobacco Smoke, and Anti-Lobbying. In signing 
    and submitting an application, the applicant should be aware that it is 
    certifying that it will comply with the Federal requirement concerning 
    the above-cited certifications for a drug-free workplace, debarment, 
    and environmental tobacco smoke. By signing and submitting the 
    applications, applicants are providing these certifications and need 
    not mail back the certification with the applications. However, the 
    applicant must submit a signed certification regarding Lobbying with 
    the application.
        Copies of the certifications and assurance are located at the end 
    of this announcement.
        Any non-profit organization submitting an application must submit 
    proof of its non-profit status in its application at the time of 
    submission. The non-profit agency can accomplish this by providing a 
    copy of the applicant's listing in the Internal Revenue Service's (IRS) 
    most recent list of tax-exempt organizations described in Section 
    501(c)(3) of the IRS code or by providing a copy of the currently valid 
    IRS tax exemption certificate, and by providing a copy of the articles 
    of incorporation bearing the seal of the State in which the corporation 
    or association is domiciled.
    
    C. Closing Date
    
        1. Applications will be considered to have met the announced 
    deadline if they are received at the address specified in this 
    announcement by 6:30 p.m. on July 24, 1995. Applicants are responsible 
    for mailing applications well in advance, when using all mail services, 
    to ensure that the applications are received on or before the deadline 
    date. (Applicants are cautioned that postmarks will not be considered 
    as a methodology for meeting the deadline.)
        2. Applications which do not meet the criteria in paragraph 1 of 
    this section are considered late applications. The ACF shall notify 
    each late applicant that its application will not be considered in the 
    current competition.
        3. The ACF may extend the deadline for all applicants because of 
    acts of God such as floods, hurricanes, etc., or when there is a 
    widespread disruption of the mails. However, if the ACF does not extend 
    the deadline for all applicants, it may not waive or extend the 
    deadline for any applicant.
        4. Once an application has been submitted, it is considered as 
    final and no additional materials will be accepted by ORR. An 
    application with an original signature and two copies is required. 
    Applications, if mailed, should be addressed to: Department of Health 
    and Human Services, Administration for Children and Families, Division 
    of Discretionary Grants, 370 L'Enfant Promenade SW., Washington, DC 
    20447.
        No application will be accepted by telefax. Hand delivered 
    applications are accepted during the normal working hours of 8 a.m. to 
    6:30 p.m. (Eastern Daylight Time), Monday through Friday, on or prior 
    to the established closing date at: Administration for Children and 
    Families, Division of Discretionary Grants, 6th Floor, ACF Guard 
    Station, 901 D Street, SW., Washington, DC 20447.
        The application should reference this program announcement.
    Intergovernmental Review
    
        This program is covered by Executive Order 12372, 
    ``Intergovernmental Review of Federal Programs,'' and 45 CFR part 100, 
    ``Intergovernmental Review of Department of Health and Human Services 
    Programs and Activities.'' Under the Order, States may design their own 
    processes for reviewing and commenting on proposed Federal assistance 
    under covered programs.
        All States and Territories except Alabama, Alaska, Colorado, 
    Connecticut, Hawaii, Idaho, Kansas, Louisiana, Massachusetts, 
    Minnesota, Montana, Nebraska, Oklahoma, Oregon, Pennsylvania, South 
    Dakota, Tennessee, Virginia, Washington, American Samoa and Palau have 
    elected to participate in the Executive Order process and have 
    established Single Points of Contact (SPOCs). Applicants from these 
    nineteen jurisdictions need take no action regarding Executive Order 
    12372. Applicants for projects to be administered by Federally-
    recognized Indian Tribes are also exempt from the requirements of E.O. 
    12372. Otherwise, applicants should contact their SPOCs as soon as 
    possible to alert them of the prospective applications and receive any 
    necessary instructions. Applicants must submit any required material to 
    the SPOCs as soon as possible so that the program office can obtain and 
    review SPOC comments as part of the award process. It is imperative 
    that the applicant submit all required materials, if any, to the SPOC 
    and indicate the date of this submittal (or the date of contact 
    [[Page 32689]] if no submittal is required) on the Standard Form 424, 
    item 16a.
        Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application 
    deadline date to comment on proposed new or competing continuation 
    awards.
        SPOCs are encouraged to eliminate the submission of routine 
    endorsements as official recommendations. Additionally, SPOCs are 
    requested to clearly differentiate between mere advisory comments and 
    those official State process recommendations which they intend to 
    trigger the ``accommodate or explain'' rule.
        When comments are submitted directly to ACF, they should be 
    addressed to: Department of Health and Human Services, Administration 
    for Children and Families, Division of Discretionary Grants, 6th Floor, 
    OFM/DDG, 370 L'Enfant Promenade SW., Washington, DC 20447.
        A list of Single Points of Contact for each State and Territory is 
    included as Appendix A of this announcement.
    
    Applicable Regulations
    
        Applicable HHS regulations will be provided to grantees upon award.
    
    Post-Award Requirements--Records and Reports
    
        Grantees are required to file Financial Status (SF-269) on a semi-
    annual basis and Program Progress Reports on a quarterly basis. Funds 
    shall be accounted for and reported upon separately from all other 
    grant activities. Successful applicants will be given specific 
    instructions by ACF, following the award of the grant, for reporting 
    grant performance.
        The official recipient point for all reports and business 
    management correspondence is the Division of Discretionary Grants. The 
    original and two copies of each report and business management 
    correspondence shall be submitted to the Department of Health and Human 
    Services, Administration for Children and Families, Division of 
    Discretionary Grants, 370 L'Enfant Promenade SW., Washington, DC 20447.
        The final Financial and Program Progress Reports shall be due 90 
    days after the project expiration date or termination of grant support.
        ORR expects grantees to maintain adequate records to track and 
    report on project outcomes and expenditures by budget line item.
        The Catalog of Federal Domestic Assistance (CFDA) number assigned 
    to this announcement is 93.576.
    
        Dated: June 19, 1995.
    Regina Lee,
    Deputy Director, Office of Refugee Resettlement.
    Appendix A--Executive Order 12372--State Single Points of Contact
    
    ARIZONA
        Mrs. Janice Dunn, Attn: Arizona State Clearinghouse, 3800 N. 
    Central Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 
    280-1315
    ARKANSAS
        Tracie L. Copeland, Manager, State Clearinghouse, Office of 
    Intergovernmental Services, Department of Finance and 
    Administration, PO Box 3278, Little Rock, Arkansas 72203, Telephone 
    (501) 682-1074
    CALIFORNIA
        Glen Stober, Grants Coordinator, Office of Planning and 
    Research, 1400 Tenth Street, Sacramento, California 95814, Telephone 
    (916) 323-7480
    DELAWARE
        Ms. Francine Booth, State Single Point of Contact, Executive 
    Department, Thomas Collins Building, Dover, Delaware 19903, 
    Telephone (302) 736-3326
    DISTRICT OF COLUMBIA
        Rodney T. Hallman, State Single Point of Contact, Office of 
    Grants Management and Development, 717 14th Street, NW, Suite 500, 
    Washington, DC 20005, Telephone (202) 727-6551
    FLORIDA
        Florida State Clearinghouse, Intergovernmental Affairs Policy 
    Unit, Executive Office of the Governor, Office of Planning and 
    Budgeting, The Capitol, Tallahassee, Florida 32399-0001, Telephone 
    (904) 488-8441
    GEORGIA
        Mr. Charles H. Badger, Administrator, Georgia State 
    Clearinghouse, 254 Washington Street, SW, Atlanta, Georgia 30334, 
    Telephone (404) 656-3855
    ILLINOIS
        Steve Klokkenga, State Single Point of Contact, Office of the 
    Governor, 107 Stratton Building, Springfield, Illinois 62706, 
    Telephone (217) 782-1671
    INDIANA
        Jean S. Blackwell, Budget Director, State Budget Agency, 212 
    State House, Indianapolis, Indiana 46204, Telephone (317) 232-5610
    IOWA
        Mr. Steven R. McCann, Division of Community Progress, Iowa 
    Department of Economic Development, 200 East Grand Avenue, Des 
    Moines, Iowa 50309, Telephone (515) 281-3725
    KENTUCKY
        Ronald W. Cook, Office of the Governor, Department of Local 
    Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601, 
    Telephone (502) 564-2382
    MAINE
        Ms. Joyce Benson, State Planning Office, State House Station 
    #38, Augusta, Maine 04333, Telephone (207) 289-3261
    MARYLAND
        Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department 
    of State Planning, 301 West Preston Street, Baltimore, Maryland 
    21201-2365, Telephone (301) 225-4490
    MASSACHUSETTS
        Karen Arone, State Clearinghouse, Executive Office of 
    Communities and Development, 100 Cambridge Street, Room 1803, 
    Boston, Massachusetts 02202, Telephone (617) 727-7001
    MICHIGAN
        Richard S. Pastula, Director, Michigan Department of Commerce, 
    Lansing, Michigan 48909, Telephone (517) 373-7356
    MISSISSIPPI
        Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal 
    Grant Management and Reporting, 301 West Pearl Street, Jackson, 
    Mississippi 39203, Telephone (601) 960-2174
    MISSOURI
        Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of 
    Administration, P.O. Box 809, Room 430, Truman Building, Jefferson 
    City, Missouri 65102, Telephone (314) 751-4834
    NEVADA
        Department of Administration, State Clearinghouse, Capitol 
    Complex, Carson City, Nevada 89710, Telephone (702) 687-4065, 
    Attention: Ron Sparks, Clearinghouse Coordinator
    NEW HAMPSHIRE
        Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State 
    Planning, Attn: Intergovernmental Review, Process/James E. Bieber, 
    2\1/2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 
    271-2155
    NEW JERSEY
        Gregory W. Adkins, Acting Director, Division of Community 
    Resources, N.J. Department of Community Affairs, Trenton, New Jersey 
    08625-0803, Telephone (609) 292-6613
        Please direct correspondence and questions to: Andrew J. 
    Jaskolka, State Review Process, Division of Community Resources, CN 
    814, Room 609, Trenton, New Jersey 08625-0803, Telephone (609) 292-
    9025
    NEW MEXICO
        George Elliott, Deputy Director, State Budget Division, Room 
    190, Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone 
    (505) 827-3640, FAX (505) 827-3006
    NEW YORK
        New York State Clearinghouse, Division of the Budget, State 
    Capitol, Albany, New York 12224, Telephone (518) 474-1605
    NORTH CAROLINA
        Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., 
    N.C. State Clearinghouse, 116 W. Jones Street, Raleigh, North 
    Carolina 27603-8003, Telepone (919) 733-7232
    NORTH DAKOTA
        N.D. Single Point of Contact, Office of Intergovernmental 
    Assistance, Office of Management and Budget, 600 East Boulevard 
    Avenue, Bismarck, North Dakota 58505-0170, Telephone (701) 224-2094
    OHIO
        Larry Weaver, State Single Point of Contact, State/Federal Funds 
    [[Page 32690]] Coordinator, State Clearinghouse, Office of Budget 
    and Management, 30 East Broad Street, 34th Floor, Columbus, Ohio 
    43266-0411, Telephone (614) 466-0698
    RHODE ISLAND
        Mr. Daniel W. Varin, Associate Director, Statewide Planning 
    Program, Department of Administration, Division of Planning, 265 
    Melrose Street, Providence, Rhode Island 02907, Telephone (401) 277-
    2656
        Please direct correspondence and questions to: Review 
    Coordinator, Office of Strategic Planning
    SOUTH CAROLINA
        Omeagie Burgess, State Single Point of Contact, Grant Services, 
    Office of the Governor, 1205 Pendleton Street, Room 477, Columbia, 
    South Carolina 29201, Telephone (803) 734-0494
    TENNESSEE
        Mr. Charles Brown, State Single Point of Contact, State Planning 
    Office, 500 Charlotta Avenue, 309 John Sevier Building, Nashville, 
    Tennessee 37219, Telephone (615) 741-1676
    TEXAS
        Mr. Thomas Adams, Governor's Office of Budget and Planning, PO 
    Box 12428, Austin, Texas 78711, Telephone (512) 463-1778
    UTAH
        Utah State Clearinghouse, Office of Planning and Budget, Attn: 
    Carolyn Wright, Room 116 State Capitol, Salt Lake City, Utah 84114, 
    Telephone (801) 538-1535
    VERMONT
        Mr. Bernard D. Johnson, Assistant Director, Office of Policy 
    Research & Coordination, Pavilion Office Building, 109 State Street, 
    Montpelier, Vermont 05602, Telephone (802) 828-3326
    WEST VIRGINIA
        Mr. Fred Cutlip, Director, Community Development Division, West 
    Virginia Development Office, Building #6, Room 553, Charleston, West 
    Virginia 25305, Telephone (304) 348-4010
    WISCONSIN
        Mr. William C. Carey, Federal/State Relations, Wisconsin 
    Department of Administration, 101 South Webster Street, PO Box 7864, 
    Madison, Wisconsin 53707, Telephone (608) 266-0267
    WYOMING
        Sheryl Jeffries, State Single Point of Contact, Herschler 
    Building, 4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone 
    (307) 777-7574
    GUAM
        Mr. Michael J. Reidy, Director, Bureau of Budget and Management 
    Research, Office of the Governor, PO Box 2950, Agana, Guam 96910, 
    Telephone (671) 472-2285
    NORTHERN MARIANA ISLANDS
        State Single Point of Contact, Planning and Budget Office, 
    Office of the Governor, Saipan, CM, Northern Mariana Islands 96950
    PUERTO RICO
        Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico 
    Planning Board, Minillas Government Center, PO Box 41119, San Juan, 
    Puerto Rico 00940-9985, Telephone (809) 727-4444
    VIRGIN ISLANDS
        Jose L. George, Director, Office of Management and Budget, #41 
    Norregade Emancipation Garden Station, Second Floor, Saint Thomas, 
    Virgin Islands 00802
        Please direct correspondence to: Linda Clarke, Telephone (809) 
    774-0750
    
    BILLING CODE 4184-01-P
    
    [[Page 32691]]
    
    [GRAPHIC][TIFF OMITTED]TN23JN95.016
    
    
    
    BILLING CODE 4184-01-C
    [[Page 32692]] INSTRUCTIONS FOR THE SF 424
    
        This is a standard form used by applicants as a required 
    facesheet for preapplications and applications submitted for Federal 
    assistance. It will be used by Federal agencies to obtain applicant 
    certification that States which have established a review and 
    comment procedure in response to Executive Order 12372 and have 
    selected the program to be included in their process, have been 
    given an opportunity to review the applicant's submission.
    
    Item and Entry
    
        1. Self-explanatory.
        2. Date application submitted to Federal agency (or State if 
    applicable) & applicant's control number (if applicable).
        3. State use only (if applicable).
        4. If this application is to continue or revise an existing 
    award, enter present Federal identifier number. If for a new 
    project, leave blank.
        5. Legal name of applicant, name of primary organizational unit 
    which will undertake the assistance activity, complete address of 
    the applicant, and name and telephone number of the person to 
    contact on matters related to this application.
        6. Enter Employer Identification Number (EIN) as assigned by the 
    Internal Revenue Service.
        7. Ester the appropriate letter in the space provided.
        8. Check appropriate box and enter appropriate letter(s) in the 
    space(s) provided:
    
    --``New'' means a new assistance award.
    --``Continuation'' means an extension for an additional funding/
    budget period for a project with a projected completion date.
    --``Revision'' means any change in the Federal Government's 
    financial obligation or contingent liability from an existing 
    obligation.
    
        9. Name of Federal agency from which assistance is being 
    requested with this application.
        10. Use the Catalog of Federal Domestic Assistance number and 
    title of the program under which assistance is requested.
        11. Enter a brief descriptive title of the project. If more than 
    one program is involved, you should append an explanation on a 
    separate sheet. If appropriate (e.g., construction or real property 
    projects), attach a map showing project location. For 
    preapplications, use a separate sheet to provide a summary 
    description of this project.
        12. List only the largest political entities affected (e.g., 
    State, counties, cities).
        13. Self-explanatory.
        14. List the applicant's Congressional District and any 
    District(s) affected by the program or project.
        15. Amount requested or to be contributed during the first 
    funding/budget period by each contributor. Value of in-kind 
    contributions should be included on appropriate lines as applicable. 
    If the action will result in a dollar change to an existing award, 
    indicate only the amount of the change. For decreases, enclose the 
    amounts in parentheses. If both basic and supplemental amounts are 
    included, show breakdown on an attached sheet. For multiple program 
    funding, use totals and show breakdown using same categories as item 
    15.
        16. Applicants should contact the State Single Point of Contact 
    (SPOC) for Federal Executive Order 12372 to determine whether the 
    application is subject to the State intergovernmental review 
    process.
        17. This question applies to the applicant organization, not the 
    person who signs as the authorized representative. Categories of 
    debt include delinquent audit disallowances, loans and taxes.
        18. To be signed by the authorized representative of the 
    applicant. A copy of the governing body's authorization for you to 
    sign this application as official representative must be on file in 
    the applicant's office. (Certain Federal agencies may require that 
    this authorization be submitted as part of the application.)
    
    BILLING CODE 4184-01-P
    
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    BILLING CODE 4184-01-C
    [[Page 32695]] INSTRUCTIONS FOR THE SF-424A
    
    General Instructions
    
        This form is designed so that application can be made for funds 
    from one or more grant programs. In preparing the budget, adhere to 
    any existing Federal grantor agency guidelines which prescribe how 
    and whether budgeted amounts should be separately shown for 
    different functions or activities within the program. For some 
    programs, grantor agencies may require budgets to be separately 
    shown by function or activity. For other programs, grantor agencies 
    may require a breakdown by function or activity. Sections A, B, C, 
    and D should include budget estimates for the whole project except 
    when applying for assistance which requires Federal authorization in 
    annual or other funding period increments. In the latter case, 
    Sections A, B, C, and D should provide the budget for the first 
    budget period (usually a year) and Section E should present the need 
    for Federal assistance in the subsequent budget periods. All 
    applications should contain a breakdown by the object class 
    categories shown in Lines a-k of Section B.
    
    Section A. Budget Summary
    
        Lines 1-4, Columns (a) and (b).
        For applications pertaining to a single Federal grant program 
    (Federal Domestic Assistance Catalog number) and not requiring a 
    functional or activity breakdown, enter on Line 1 under Column (a) 
    the catalog program title and the catalog number in Column (b).
        For applications pertaining to a single program requiring budget 
    amounts by multiple functions or activities, enter the name of each 
    activity or function on each line in Column (a), and enter the 
    catalog number in Column (b). For applications pertaining to 
    multiple programs where none of the programs require a breakdown by 
    function or activity, enter the catalog program title on each line 
    in Column (a) and the respective catalog number on each line in 
    column (b).
        For applications pertaining to multiple programs where one or 
    more programs require a breakdown by function or activity, prepare a 
    separate sheet for each program requiring the breakdown. Additional 
    sheets should be used when one form does not provide adequate space 
    for all breakdown of data required. However, when more than one 
    sheet is used, the first page should provide the summary totals by 
    programs.
        Lines 1-4, Columns (c) through (g.)
        For new applications, leave Columns (c) and (d) blank. For each 
    line entry in Columns (a) and (b), enter in Columns (e), (f), and 
    (g) the appropriate amounts of funds needed to support the project 
    for the first funding period (usually a year).
        For continuing grant program applications, submit these forms 
    before the end of each funding period as required by the grantor 
    agency. Enter in Columns (c) and (d) the estimated amounts of funds 
    which will remain unobligated at the end of the grant funding period 
    only if the Federal grantor agency instructions provide for this. 
    Otherwise, leave these columns blank. Enter in Columns (e) and (f) 
    the amounts of funds needed for the upcoming period. The amount(s) 
    in Column (g) should be the sum of amounts in Columns (e) and (f).
        For supplemental grants and changes to existing grants, do not 
    use Columns (c) and (d). Enter in Column (e) the amount of the 
    increase or decrease of Federal funds and enter in Column (f) the 
    amount of the increase or decrease of non-Federal funds. In Column 
    (g) enter the new total budgeted amount (Federal and non-Federal) 
    which includes the total previous authorized budgeted amounts plus 
    or minus, as appropriate, the amounts shown in Columns (e) and (f). 
    The amount(s) in Column (g) should not equal the sum of amounts in 
    Columns (e) and (f).
        Line 5--Show the totals for all columns used.
    
    Section B Budget Categories
    
        In the column headings (1) through (4), enter the titles of the 
    same programs, functions, and activities shown on Lines 1-4, Column 
    (a), Section A. When additional sheets are prepared for Section A, 
    provide similar column headings on each sheet. For each program, 
    function or activity, fill in the total requirements for funds (both 
    Federal and non-Federal) by object class categories.
        Lines 6a-i--Show the totals of Lines 6a to 6h in each column.
        Line 6j--Show the amount of indirect cost.
        Line 6k--Enter the total of amounts on Lines 6i and 6j. For all 
    applications for new grants and continuation grants the total amount 
    in column (5), Line 6k, should be the same as the total amount shown 
    in Section A, Column (g), Line 5. For supplemental grants and 
    changes to grants, the total amount of the increase or decrease as 
    shown in Columns (1)-(4), Line 6k should be the same as the sum of 
    the amounts in Section A, Columns (e) and (f) on Line 5.
        Line 7--Enter the estimated amount of income, if any, expected 
    to be generated from this project. Do not add or subtract this 
    amount from the total project amount. Show under the program 
    narrative statement the nature and source of income. The estimated 
    amount of program income may be considered by the federal grantor 
    agency in determining the total amount of the grant.
    
    Section C. Non-Federal-Resources
    
        Lines 8-11--Enter amounts of non-Federal resources that will be 
    used on the grant. If in-kind contributions are included, provide a 
    brief explanation on a separate sheet.
        Column (a)--Enter the program titles identical to Column (a), 
    Section A. A breakdown by function or activity is not necessary.
        Column (b)--Enter the contribution to be made by the applicant.
        Column (c)--Enter the amount of the State's cash and in-kind 
    contribution if the applicant is not a State or State agency. 
    Applicants which are a State or State agencies should leave this 
    column blank.
        Column (d)--Enter the amount of cash and in-kind contributions 
    to be made from all other sources.
        Column (e)--Enter totals of Columns (b), (c), and (d).
        Line 12--Enter the total for each of Columns (b)-(e). The amount 
    in Column (e) should be equal to the amount on Line 5, Column (f), 
    Section A.
    
    Section D. Forecasted Cash Needs
    
        Line 13--Enter the amount of cash needed by quarter from the 
    grantor agency during the first year.
        Line 14--Enter the amount of cash from all other sources needed 
    by quarter during the first year.
        Line 15--Enter the totals of amounts on Lines 13 and 14.
    
    Section E. Budget Estimates of Federal Funds Needed for Balance of 
    the Project
    
        Lines 16-19--Enter in Column (a) the same grant program titles 
    shown in Column (a), Section A. A breakdown by function or activity 
    is not necessary. For new applications and continuation grant 
    applications, enter in the proper columns amounts of Federal funds 
    which will be needed to complete the program or project over the 
    succeeding funding periods (usually in years). This section need not 
    be completed for revisions (amendments, changes, or supplements) to 
    funds for the current year of existing grants.
        If more than four lines are needed to list the program titles, 
    submit additional schedules as necessary.
        Line 20--Enter the total for each of the Columns (b)-(e). When 
    additional schedules are prepared for this Section, annotate 
    accordingly and show the overall totals on this line.
    
    Section F. Other Budget Information
    
        Line 21--Use this space to explain amounts for individual direct 
    object-class cost categories that may appear to be out of the 
    ordinary or to explain the details as required by the Federal 
    grantor agency.
        Line 22--Enter the type of indirect rate (provisional, 
    predetermined, final or fixed) that will be in effect during the 
    funding period, the estimated amount of the base to which the rate 
    is applied, and the total indirect expense.
        Line 23--Provide any other explanations or comments deemed 
    necessary.
    
    ASSURANCES--NON-CONSTRUCTION PROGRAMS
    
        Note: Certain of these assurances may not be applicable to your 
    project or program. If you have questions, please contact the 
    awarding agency. Further, certain Federal awarding agencies may 
    require applicants to certify to additional assurances. If such is 
    the case, you will be notified.
        As the duly authorized representative of the applicant I certify 
    that the applicant:
        1. Has the legal authority to apply for Federal assistance, and 
    the institutional, managerial and financial capability (including 
    funds sufficient to pay the non-Federal share of project costs) to 
    ensure proper planning, management and completion of the project 
    described in this application.
        2. Will give the awarding agency, the Comptroller General of the 
    United States, and if appropriate, the State, through any authorized 
    representative, access to and the right to examine all records, 
    books, papers, or documents related to the award; and will 
    [[Page 32696]] establish a proper accounting system in accordance 
    with generally accepted accounting standards or agency directives.
        3. Will establish safeguards to prohibit employees from using 
    their positions for a purpose that constitutes or presents the 
    appearance of personal or organizational conflict of interest, or 
    personal gain.
        4. Will initiate and complete the work within the applicable 
    time frame after receipt of approval of the awarding agency.
        5. Will comply with the Intergovernmental Personnel Act of 1970 
    (42 U.S.C. 4728-4763) relating to prescribed standards for merit 
    systems for programs funded under one of the nineteen statutes or 
    regulations specified in Appendix A of OPM's Standards for a Merit 
    System of Personnel Administration (5 CFR 900, Subpart F).
        6. Will comply with all Federal statutes relating to 
    nondiscrimination. These include but are not limited to: (a) Title 
    VI of the Civil Rights Act of 1964 (Pub. L. 88-352) which prohibits 
    discrimination on the basis of race, color or national origin; (b) 
    Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 
    1681-1583, and 1685-1686), which prohibits discrimination on the 
    basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as 
    amended (29 U.S.C. 794), which prohibits discrimination on the basis 
    of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 
    U.S.C. 6101-6107), which prohibits discrimination on the basis of 
    age; (e) the Drug Abuse Office and Treatment Act of 1972 (Pub. L. 
    92-255), as amended, relating to nondiscrimination on the basis of 
    drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism 
    Prevention, Treatment and Rehabilitation Act of 1970 (Pub. L. 91-
    616), as amended, relating to nondiscrimination on the basis of 
    alcohol abuse or alcoholism; (g) sections 523 and 527 of the Public 
    Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as 
    amended, relating to the confidentiality of alcohol and drug abuse 
    patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 
    U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in 
    the sale, rental or financing of housing; (i) any other 
    nondiscrimination provisions in the specific statute(s) under which 
    application for Federal assistance is being made; and (j) the 
    requirements of any other nondiscrimination statute(s) which may 
    apply to the application.
        7. Will comply, or has already complied, with the requirements 
    of Titles II and III of the Uniform Relocation Assistance and Real 
    Property Acquisition Policies Act of 1970 (Pub. L. 91-646) which 
    provide for fair and equitable treatment of persons displaced or 
    whose property is acquired as a result of Federal or federally 
    assisted programs. These requirements apply to all interests in real 
    property acquired for project purposes regardless of Federal 
    participation in purchases.
        8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
    1501-1508 and 7324-7328) which limit the political activities of 
    employees whose principal employment activities are funded in whole 
    or in part with Federal funds.
        9. Will comply, as applicable, with the provisions of the Davis-
    Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 
    276c and 18 U.S.C. 874), and the Contract Work Hours and Safety 
    Standards Act (40 U.S.C. 327-333), regarding labor standards for 
    federally assisted construction subagreements.
        10. Will comply, if applicable, with flood insurance purchase 
    requirements of Section 102(a) of the Flood Disaster Protection Act 
    of 1973 (Pub. L. 93-234) which requires recipients in a special 
    flood hazard area to participate in the program and to purchase 
    flood insurance if the total cost of insurable construction and 
    acquisition is $10,000 or more.
        11. Will comply with environmental standards which may be 
    prescribed pursuant to the following: (a) Institution of 
    environmental quality control measures under the National 
    Environmental Policy Act of 1969 (Pub. L. 91-190) and Executive 
    Order (EO) 11514; (b) notification of violating facilities pursuant 
    to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) 
    evaluation of flood hazards in floodplains in accordance with EO 
    11988; (e) assurance of project consistency with the approved State 
    management program developed under the Coastal Zone Management Act 
    of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of Federal actions 
    to State (Clear Air) Implementation Plans under Section 176(c) of 
    the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) 
    protection of underground sources of drinking water under the Safe 
    Drinking Water Act of 1974, as amended, (Pub. L. 93-523); and (h) 
    protection of endangered species under the Endangered Species Act of 
    1973, as amended, (Pub. L. 93-205).
        12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
    U.S.C. 1271 et seq.) related to protecting components or potential 
    components of the national wild and scenic rivers system.
        13. Will assist the awarding agency in assuring compliance with 
    Section 106 of the National Historic Preservation Act of 1966, as 
    amended (16 U.S.C. 470), EO 11593 (identification and protection of 
    historic properties), and the Archaeological and Historic 
    Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
        14. Will comply with Pub. L. 93-348 regarding the protection of 
    human subjects involved in research, development, and related 
    activities supported by this award of assistance.
        15. Will comply with the Laboratory Animal Welfare Act of 1966 
    (Pub. L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to 
    the care, handling, and treatment of warm blooded animals held for 
    research, teaching, or other activities supported by this award of 
    assistance.
        16. Will comply with the Lead-Based Paint Poisoning Prevention 
    Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead based 
    paint in construction or rehabilitation of residence structures.
        17. Will cause to be performed the required financial and 
    compliance audits in accordance with the Single Audit Act of 1984.
        18. Will comply with all applicable requirements of all other 
    Federal laws, executive orders, regulations and policies governing 
    this program.
    
    SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL----------------------------
    TITLE------------------------------------------------------------------
    APPLICANT ORGANIZATION-------------------------------------------------
    DATE SUBMITTED---------------------------------------------------------
    
    BILLING CODE 4184-01-P
    
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    BILLING CODE 4184-01-C
    [[Page 32699]] Certification Regarding Debarment, Suspension, and 
    Other Responsibility Matters--Primary Covered Transactions
    
        By signing and submitting this proposal, the applicant, defined 
    as the primary participant in accordance with 45 CFR Part 76, 
    certifies to the best of its knowledge and believe that it and its 
    principals:
        (a) Are not presently debarred, suspended, proposed for 
    debarment, declared ineligible, or voluntarily excluded from covered 
    transactions by any Federal Department or agency;
        (b) Have not within a 3-year period preceding this proposal been 
    convicted of or had a civil judgment rendered against them for 
    commission of fraud or a criminal offense in connection with 
    obtaining, attempting to obtain, or performing a public (Federal, 
    State, or local) transaction or contract under a public transaction; 
    violation of Federal or State antitrust statutes or commission of 
    embezzlement, theft, forgery, bribery, falsification or destruction 
    of records, making false statements, or receiving stolen property;
        (c) Are not presently indicted or otherwise criminally or 
    civilly charged by a governmental entity (Federal, State, or local) 
    with commission of any of the offenses enumerated in paragraph 
    (1)(b) of this certification; and
        (d) Have not within a 3-year period preceding this application/
    proposal had one or more public transactions (Federal, State, or 
    local) terminated for cause or default.
        The inability of a person to provide the certification required 
    above will not necessarily result in denial of participation in this 
    covered transaction. If necessary, the prospective participant shall 
    submit an explanation of why it cannot provide the certification. 
    The certification or explanation will be considered in connection 
    with the Department of Health and Human Services (HHS) determination 
    whether to enter into this transaction. However, failure of the 
    prospective primary participant to furnish a certification or an 
    explanation shall disqualify such person from participation in this 
    transaction.
        The prospective primary participant agrees that by submitting 
    this proposal, it will include the clause entitled ``Certification 
    Regarding Debarment, Suspension, Ineligibility, and Voluntary 
    Exclusion--Lower Tier Covered Transaction.'' provided below without 
    modification in all lower tier covered transactions and in all 
    solicitations for lower tier covered transactions.
    Certification Regarding Debarment, Suspension, Ineligibility and 
    Voluntary Exclusion--Lower Tier Covered Transactions
    
    (To Be Supplied to Lower Tier Participants)
    
        By signing and submitting this lower tier proposal, the 
    prospective lower tier participant, as defined in 45 CFR Part 76, 
    certifies to the best of its knowledge and belief that it and its 
    principals:
        (a) Are not presently debarred, suspended, proposed for 
    debarment, declared ineligible, or voluntarily excluded from 
    participation in this transaction by any federal department or 
    agency.
        (b) Where the prospective lower tier participant is unable to 
    certify to any of the above, such prospective participant shall 
    attach an explanation to this proposal.
        The prospective lower tier participant further agrees by 
    submitting this proposal that it will include this clause entitled 
    ``Certification Regarding Debarment, Suspension, Ineligibility, and 
    Voluntary Exclusion--Lower Tier Covered Transactions,'' without 
    modification in all lower tier covered transactions and in all 
    solicitations for lower tier covered transactions.
    
    Appendix E
    
    Certification Regarding Environmental Tobacco Smoke
    
        Public Law 103-227, Part C--Environmental Tobacco Smoke, also 
    known as the Pro-Children Act of 1994 (Act), requires that smoking 
    not be permitted in any portion of any indoor facility owned or 
    leased or contracted for by an entity and used routinely or 
    regularly for the provision of health, day care, education, or 
    library services to children under the age of 18, if the services 
    are funded by Federal programs either directly, or through State or 
    local governments, by Federal grant, contract, loan, or loan 
    guarantee. The law does not apply to children's services provided in 
    private residences, facilities funded solely by Medicare or Medicaid 
    funds, and portions of facilities used for inpatient drug or alcohol 
    treatment. Failure to comply with the provisions of the law may 
    result in the imposition of a civil monetary penalty of up to $1000 
    per day and/or the imposition of an administrative compliance order 
    on the responsible entity.
        By signing and submitting this application the applicant/grantee 
    certifies that it will comply with the requirements of the Act. The 
    applicant/grantee further agrees that it will require the language 
    of this certification be included in any subawards which contain 
    provisions for children's services and that all subgrantees shall 
    certify accordingly.
    
    Appendix F--Certification Regarding Lobbying
    
    Certification for Contracts, Grants, Loans, and Cooperative 
    Agreements
    
        The undersigned certifies, to the best of his or her knowledge 
    and belief, that:
        (1) No Federal appropriated funds have been paid or will be 
    paid, by or on behalf of the undersigned, to any person for 
    influencing or attempting to influence an officer or employee of any 
    agency, a Member of Congress, an officer or employee of Congress, or 
    an employee of a Member of Congress in connection with the awarding 
    of any Federal contract, the making of any Federal grant, the making 
    of any Federal loan, the entering into of any cooperative agreement, 
    and the extension, continuation, renewal, amendment, or modification 
    of any Federal contract, grant, loan, or cooperative agreement.
        (2) If any funds other than Federal appropriated funds have been 
    paid or will be paid to any person for influencing or attempting to 
    influence an officer or employee of any agency, a Member of 
    Congress, an officer or employee of Congress, or an employee of a 
    Member of Congress in connection with this Federal contract, grant, 
    loan or cooperative agreement, the undersigned shall complete and 
    submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in 
    accordance with its instructions.
        (3) The undersigned shall require that the language of this 
    certification be included in the award documents for all subawards 
    at all tiers (including subcontracts, subgrants, and contracts under 
    grants, loans, and cooperative agreements) and that all 
    subrecipients shall certify and disclose accordingly.
        This certification is a material representation of fact upon 
    which reliance was placed when this transaction was made or entered 
    into. Submission of this certification is a prerequisite for making 
    or entering into this transaction imposed by section 1352, title 31, 
    U.S. Code. Any person who fails to file the required certification 
    shall be subject to a civil penalty of not less than $10,000 and not 
    more than $100,000 for each such failure.
    
    State for Loan Guarantee and Loan Insurance
    
        The undersigned states, to the best of his or her knowledge and 
    belief, that:
        If any funds have been paid or will be paid to any person for 
    influencing or attempting to influence an officer or employee of any 
    agency, a Member of Congress, an officer or employee of Congress, or 
    an employee of a Member of Congress in connection with this 
    commitment providing for the United States to insure or guarantee a 
    loan, the undersigned shall complete and submit Standard Form-LLL 
    ``Disclosure Form to Report Lobbying,'' in accordance with its 
    instructions.
        Submission of this statement is a prerequisite for making or 
    entering into this transaction imposed by section 1352, title 31, 
    U.S. Code. Any person who fails to file the required statement shall 
    be subject to a civil penalty of not less than $10,000 and not more 
    than $100,000 for each such failure.
    ----------------------------------------------------------------------
    Signature
    
    ----------------------------------------------------------------------
    Title
    
    ----------------------------------------------------------------------
    Organization
    
    ----------------------------------------------------------------------
    Date
    
    BILLING CODE 4184-01-P
    
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    [FR Doc. 95-15468 Filed 6-22-95; 8:45am]
    BILLING CODE 4184-01-C
    
    

Document Information

Published:
06/23/1995
Department:
Refugee Resettlement Office
Entry Type:
Notice
Document Number:
95-15468
Pages:
32686-32700 (15 pages)
PDF File:
95-15468.pdf