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City of Charlottesville CDBG & HOME Funding Application

Please correct the field(s) marked in red below:

1
Agency/Organization
Agency/Organization
2
My organization is applying for:
My organization is applying for:
3
I have received CDBG and/or HOME funds in the past:
I have received CDBG and/or HOME funds in the past:
4
Is the organization a non-profit, tax-exempt as defined by the Internal Revenue Service under U.S.C. 501(c) (3)?
Is the organization a non-profit, tax-exempt as defined by the Internal Revenue Service under U.S.C. 501(c) (3)?
5
What are the organization’s Tax Identification Number and DUNS number?
What are the organization’s Tax Identification Number and DUNS number?
6
Has the organization received $500,000 or more in federal funds for the current year?
Has the organization received $500,000 or more in federal funds for the current year?
7
Does the organization have written fiscal policies and procedures?
Does the organization have written fiscal policies and procedures?
8
Does the organization have a process or procedure to assure no conflict of interest, real or apparent?
Does the organization have a process or procedure to assure no conflict of interest, real or apparent?
9
Name of Program/Project:
10

COUNCIL PRIORITIES

Indicate which Council Priority the program addresses:

COUNCIL PRIORITIES Indicate which Council Priority the program addresses: