Fillable FORM CGFA-192: - NOTICE OF APPLICATION FOR F (Legislative Information System)

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FORM CGFA-192: - NOTICE OF APPLICATION FOR F (Legislative Information System)

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CGFA – Commission on Government Forecasting & Accountability – 802 Stratton Building, Springfield, IL 62706 217/782-5320 2/2019
FORM CGFA-192
NOTICE OF APPLICATION FOR F
EDERAL ASSISTANCE
1. TYPE OF YEARLY APPLICATION
New = A. (SAI #) Request & Award (90) lines (10 & 13a & 14)
B. or Request funds only (NOI) line (10)
Award = (NOA) lines (13a & 14)
Award Amendment = (+/-) (NOAA)
lines (13c & 14)
Request Amendment = (+/-) (NO
IA) line (10)
Revision = Date Changes (
REV) lines (9 & 13e)
2. STATE APPLICATION IDENTIFIER
(SAI #)
CGFA gives the SAI # out on
the
first activity of the application.
(CGFA INTERAL USE ONLY)
3. APPLICANT INFORMATION
AGENCY NAME
AGENCY DIVISION AND NUMBER
4. ADDRESS (City, State, & Zip Code)
5. NAME AND TELEPHONE NUMBER FOR CONTACT PERSON INVOLVED IN
PROCESSING THIS APPLICATION
Is this the Single Point of Contact for your agency
Yes
No
6. FEDERAL GRANTING AGENCY
7. CATALOG OF FEDERAL DOMESTIC ASSISTANCE
NUMBER (CFDA #)
TITLE:
8. PROGRAM TITLE AND FISCAL YEAR
FY ____________________
9. DATE PROPOSED PROJECT
START DATE (Month/Date/Year)
END DATE (Month/Date/Year)
10. FUNDING (REQUESTED)
A. Federal
$
11. TYPED NAME OF AUTHORIZED REPRESENTATIVE
A. Signature of Authorized Representative
B. State
$
C. Local
$
D. Other
$
E. TOTAL
$
12. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS PREAPPLICATION/APPLICATION ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY
AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
13. ACTION TAKEN (IF APPLICABLE)
A. Awarded
B. Rejected
C. Returned for Award Amended (+/-)
D. Withdrawn
E. Revision (Date Changes)
14. FUNDING (AWARDED)
A. Federal (+/-)
$
B. State
$
C. Local
$
D. Other
$
E. TOTAL (+/-)
$
-
- -
- -
.
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FORM CGFA-192: - NOTICE OF APPLICATION FOR F (Legislative Information System)

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Completed 13 August 2020

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