424_Mandatory_SS_with_comments_FINAL

Supporting Statement

Data Collection Form for Application for Federal Assistance

SF-424 Mandatory Form

The SF-424 Mandatory form (Mandatory) is an OMB approved collection (4040-0002). We propose revising the form to add one additional data block that will collect the “Descriptive Title of Applicant’s Project.” The form instructions will also be revised.

Revision of this form to add an additional data block is necessary to comply with the requirements of the Federal Funding Accountability and Transparency Act (FFATA). FFATA was signed into law on September 26, 2006 (P.L. 109-282). The legislation requires the Office of Management and Budget (OMB) to establish a publicly available, online database containing information about entities that are awarded federal grants, loans, and contracts. The revised form will assist agencies in collecting the required data elements for the database through the SF-424 applications.

This form will be utilized by up to 26 Federal grant making agencies. The

4040-0002 collection expires on August 31, 2008 (July 1, 2005, Volume 70, Number 126, pages 38143-38145). We are requesting a 2-year clearance of this form.

The revisions for the new collection include the addition of one data collection block and revision of the instructions (Attachment A). The data filed labeled “County” will be revised to read “County/Parish.” The instructions are being revised to incorporate the new descriptive title block and also revises the instructions for areas affected by funding and the congressional district. These changes to the instructions will increase data quality and clarity for the collection. Comments were received from the public and have been incorporated into section 8.

A. Justification

1. Need and Legal Basis

On an annual basis, the Federal government commits nearly twenty percent of the Federal budget, or approximately $400 billion, to State and Local governments, Tribal organizations, education and research institutions, non-profit organizations, public housing authorities, commercial organizations, and individuals through the awarding of grants and cooperative agreements.  There are 26 Federal grant-making agencies and organizations sponsoring and administering over 900 programs.  More than half of these Federal agencies and grant-making organizations have discretionary programs authorized by legislation covering a broad range of subject matter.  To obtain Federal grant and cooperative agreement awards, applicant organizations must apply to the Federal agency or organization responsible for administering the program.

The Federal Grant and Cooperative Agreement Act of 1977 (31 USC 6301-6308) gives agencies the authority to select the appropriate award instrument within the limits of their program legislation to support or stimulate recipient activity. Public Law (P.L.)

106-107, the Federal Financial Assistance Management Improvement Act of 1999, was enacted to improve the effectiveness and performance of Federal financial assistance programs, simplify and streamline Federal financial assistance application process and reporting requirements, and improve the delivery of services to the public.  The issuance of the President’s Management Agenda in 2002 called for “agencies to allow applicants for Federal grants to apply for, and ultimately manage, grant funds online through a common web site, simplifying grants management and eliminating redundancies...”  

In its memorandum to agencies, (http://www.whitehouse.gov/omb/memoranda/fy04/m04-05.html); OMB established Grants.gov as the Federal government’s single, online portal for any person, business, or State, Local and Tribal government to find and apply for Federal grants, regardless of type.

The Federal Funding Accountability and transparency Act (FFATA) was signed into law on September 26, 2006 (P.L. 109-282). The legislation requires the Office of Management and Budget (OMB) to establish a publicly available, online database containing information about entities that are awarded federal grants, loans, and contracts. The changes in the SF-424 (Mandatory) form will assist agencies in collecting the FFATA required data elements for the database through the SF-424 applications. Required data elements include the descriptive title of the awardees project . Changes to the form instructions will increase data quality and clarity for the collection.

2. Information Users

The Mandatory form is the common form used by Federal grant-making agencies for grant applications under mandatory grant programs. It replaced numerous agency-specific forms. The form reduces the administrative burden to the Federal grants community, which includes applicants/grantees and Federal staff involved in grants-related activities. This information collection, the Mandatory cover page, requests objective information that is formatted in a consistent manner using common definitions. Agencies can use that data to populate their systems and databases. Federal agencies will not be required to collect all of the information included on the proposed form. The agency will identify the sections that must be completed by applicants through instructions that will accompany the forms. Agencies will implement processes for reviewing the applications and awarding grant funds. These processes are reflected in agencies’ policies and procedures documents. Agencies will also maintain and store application forms and data in accordance with their policies and practices.

Federal agencies will identify the form as a required form in their grant application instructions and will incorporate the revised form into their processes for reviewing the applications and awarding grant funds.  These processes are reflected in agencies’ policies and procedures documents.   Agencies will also maintain and store application forms and data in accordance with their policies and practices. The public that will use the form includes: Federal, State, local, or tribal governments, business or other for profit, and not for profit institutions.

3. Improved Information Technology

The Grants.gov Apply mechanism (http://www.grants.gov/Apply), which was deployed in October 2003, allows applicants to electronically find and apply for Federal grants. In its January 7, 2004 memorandum, OMB directed Federal grant-making agencies to use the Grants.gov Apply mechanism (http://www.whitehouse.gov/omb/memoranda/fy04/m04-05.html).  Information on the Mandatory form will be entered into fillable forms and submitted electronically through the Grants.gov portal.  Applicants can complete application forms that they download from Grants.gov and submit them in accordance with agency policies and instructions.  Agency policies and instructions include detailed submission guidance such as due dates, eligibility, information requirements, supporting documentation, etc.  Upon receipt of the application, Grants.gov will send an electronic acknowledgement to the applicant that the submission was received with the date and time of receipt.  In addition, Grants.gov will deliver the application to the agency.

4. Duplication of Similar Information

Development of the Mandatory form and data set reduces duplication of similar or identical forms and data sets across Federal agencies. This information collection also implements streamlining and simplification provisions of PL 106-107 and provides support for the President’s Management Agenda to allow applicants for Federal grants to apply for grant funds online. A cross-agency work group developed the proposed, revised Mandatory form and data set that will serve as a common application/plan cover page for mandatory grant programs.

SF-424 collections currently in use do not collect all of the FFATA required data elements from applicants. Revision of the Mandatory form reflects Grants.gov’s mission to reduce duplication of similar or identical forms and data sets, establish consistency in data collection processes across Federal agencies, and comply with the requirements of FFATA. This information collection also implements streamlining and simplification provisions of PL 106-107 and provides support for the President’s Management Agenda to allow applicants for Federal grants to apply for grant funds online.  A cross-agency work group developed the proposed revisions to the SF-424 (Mandatory) form and data set that will serve as a common form for various grant programs. 

5. Small Businesses

The Mandatory form is designed to collect the minimum amount of information necessary to comply with the FFATA requirements and is based on a previously OMB approved form. The only proposed revision to the data collection is the addition of a descriptive title and revision of instructions to provide further clarity to applicants.

6. Less Frequent Collection

The Mandatory form will provide information required by FFATA. Collection frequency will vary each period based on grant applications and proposals each institution submits. If the collection is not conducted or conducted less frequently, Federal grant-making agencies will not be able to collect all of the data elements required for FFATA compliance and make information about entities that receive Federal grants, loans, and contracts available through the publicly available, online database. Additionally, a significant PL 106-107 grants streamlining and simplification opportunity will be missed and progress towards fully achieving the President’s Management Agenda to allow applicants for Federal grants to apply for grant funds online would be impeded if the Mandatory form was not used.

 

7. Special Circumstances

The proposed collection of information will be conducted in a manner that complies with relevant legislation authorizing Federal grants programs, OMB policies related to the administration of Federal grants including OMB Circulars A-102, A-110 (relocated to Relocated to 2 CFR 215), A-21 (relocated to 2 CFR 220), A-87 (relocated to 2 CFR 225), and A-122 (relocated to 2 CFR 230), and guidelines of 5 CFR 1320.5(d)(2). 

8. Federal Register Notice/Outside Consultation

On February 28, 2005 the Grants.gov Program Management Office, one of the 26

E-Government initiatives, managed by HHS, published the proposed the SF-424 Mandatory collection for public comment in the Federal Register (February 28, 2005 Volume 70, Number 38, page 9656). Interested individuals were invited to send comments regarding any aspect of this collection of information. Public comments were incorporated.  Notice of adoption of Government-wide SF-424 Mandatory collection was published in the Federal Register on July 1, 2005 (Volume 70, No 126, pages 38143-38145)

Comments were received in response to the 60-day Federal Register Notice (January 7, 2008 Volume 73, Number 4, pp. 1224-1225). The comments and responses are as follows:

COMMENT: The SF424 is designed to capture applicant and 1st tier subrecipient data only. Guidance must be provided to pass-through entities at lower tiers on how to capture and report FFATA data elements. A modified version of an appropriately designed SF424 would

be ideal.

Response: This comment presumes that the mandatory grant from the federal agency is also mandatory to the sub-recipient at the next level. While some programs may mandate an automatic pass through of grant funds, these requirements should be handled under agency-specific guidance to the applicant in agency instructions.

Web based form: If the Web based form could be designed to automatically populate some fields, it would help applicants to more easily report accurate information, including Congressional District, resulting in faster and better reporting to USAspending.gov. We recommend the following:

1) For first time applicants (those who have not used the SF-424 before), entering their nine digit zip code should populate other geographic information cells (e.g. city, state, country, etc).

2) For applicants who have used the SF-424 before, entering their Dun and Bradstreet (DUNS) number should populate geographic and organizational information cells (e.g. organization name, applicant type, etc).

3) For all applicants, a cell for the zip code should be entered to the right of Section 16, Cell B (Program/Project Congressional District). When applicants enter the nine-digit zip code of the program/project, the congressional district should automatically populate. This is useful because most applicants are more familiar with the zip code of their project than the congressional district.

Response: Grants.gov is assessing the feasibility of pre-population for this form as well as across the various SF-424 families.

4) The field for entering the DUNS number should be moved up to the first page under Application filing name. This is useful because it will allow much of the organizational and geographic information to be populated automatically (per change #2), increasing the speed and ease of completing the form.

Response: The DUNS data field is already included in the section labeled “Applicant Information.” Grants.gov is assessing the feasibility of pre-population for this form as well as across the various SF-424 families.

State data - State Application Identifier (SAI): States may assign a state application identifier (SAI) number as a means of tracking the intergovernmental review of applications for which federal financial assistance is requested. If a state has determined that a particular application is subject to Executive Order 12372 and has assigned an SAI number to an applicant and that number is included on the SF 424 and/or correspondence from the state, the federal funding agency shall report the assigned SAI number as a FFATA data element.

Response: The State Application Identifier (SAI) is already included on the form in Block 6. The SAI is not a FFATA data element.

Subrecipient data:

Data fields need to be inserted as a subset of Item 13 to capture all FFATA required data elements related to pre-authorized subrecipients at the first tier level. Specific guidance needs to be provided as to how to report the congressional district (number or name?) an autofill based on zipcode would be ideal and reduce burden.

Response: The primary recipients may not know who the final sub-recipients will be at the time of initial award.  Hence, the collection of sub-recipient data should occur at the time of sub-award. The FFATA sub-award workgroup submitted an implementation plan addressing various deliverables required for the implementation of the FFATA sub-award reporting pilot and the actual sub-award reporting implementation. The group is awaiting implementation plan approval. Agencies may elect to issue agency-specific guidance to the applicant in agency instructions.

Grants.gov is assessing the feasibility of pre-population for this form as well as across the various SF-424 families.

RECOMMENDATION: To further reach the U.S. Government's goal of increased accountability, transparency, paperwork reduction and streamlining, we recommend the following enhancements to the proposed SF424 (Federal Financial Assistance Application Form) form:

1. provide an electronic version of the SF424 (as referenced above with auto-fill capabilities) accessible at the time of application on Grants.gov.

Response: The SF-424 Mandatory is fillable at the time of application when the application package is downloaded. Grants.gov is assessing the feasibility of pre-population for this form as well as across the various SF-424 families.

2. provide additional data elements on the SF424 to capture all FFATA required data elements related to pre-authorized subrecipients at the first tier level.

Response: The primary recipients may not know who the final sub-recipients will be at the time of initial award.  Hence, the collection of sub-recipient data should occur at the time of sub-award. The FFATA sub-award workgroup submitted an implementation plan addressing various deliverables required for the implementation of the FFATA

sub-award reporting pilot and the actual sub-award reporting implementation. The group is awaiting implementation plan approval. Agencies may elect to issue agency-specific guidance to the applicant in agency instructions.

3. provide OMB Circular references to all applicable instruction boxes.

Response: It is unclear what instruction boxes the comment refers to and what specific OMB Circular references would apply. Agencies retain discretion on which SF-424 is used for various grant programs.

9. Payment/Gift to Respondents

Not applicable since there is no payment to respondents, other than remuneration of grantees.

10. Confidentiality

The grant-making agencies will maintain the authoritative copy of all application materials and data.  Collection of information will be consistent with OMB policies related to the administration of Federal grants as well as agency policies and practices for access to electronic and paper records.  If application forms are submitted through the Grants.gov Apply mechanism, Grants.gov will maintain only transmission records pertaining to the files.  Grants.gov will not maintain application materials and data. 

11. Sensitive Questions

Not applicable since there are no sensitive questions.

12. Burden Estimate

Section A. Estimated Annualized Burden Hours to Respondents

By aggregating agency’s estimates documented in their Paperwork Reduction Act Change Worksheets (OMB 83-C), an estimate of the total burden of the information collection was developed.  All agencies with grant programs that award grants to organizations are eligible to use this form.  Information gathered from the Department of Agriculture, Department of Education, Department of Labor, Department of Transportation and the National Endowment for the Arts generated an estimate of the total burden. 

Collectively, these agencies receive 837 applications annually and estimate that it takes applicants 53 minutes on average to complete this form.  Cumulatively, these organizations report the total burden to applicants to be 807 hours. 

SF-424 (Mandatory) Form Estimated Annualized

Burden to Respondents

Agency	Number of Annual Respondents	Number of Responses per Respondent	Total Annual Responses	Average Burden on Respondent per Response in Hours	Total Burden Hours
DOL	110	2.6	286	60/60	286
DOT	50	1.1	55	60/60	55
DOEd	114	1	114	60/60	114
NEA	65	1	65	32/60	35
USDA	317	1	317	60/60	317
TOTAL	656		837		807

The assignment of 53 minutes of burden per response was calculated as follows:

807 total hrs. x 60 minutes = 48,420 total minutes.

48,420 / 908 total responses = 53.32 minutes per response. 53.32 minutes was rounded to 53 minutes for use in the table.

Section B. Burden Cost

SF-424 (Mandatory) Form Estimated Annualized

Cost to Respondents

Agency	Type of Respondent	Total Burden Hours	Hourly Wage Rate	Total Respondent Costs
DOL	Grant Writer	286	$30	$8,580
DOT	Grant Writer	55	$30	$1,650
DOEd	Grant Writer	114	$30	$3,420
NEA	Grant Writer	35	$30	$1,050
USDA	Grant Writer	317	$30	$9,510
TOTAL		807		$24,210

13. Capital Costs

The proposed collection is based on revisions to an SF-424 (Mandatory) form currently in use. There is no projected incremental increase in the cost burden to respondents and record keepers associated with the use of the revised Mandatory form.  The only revision to the Mandatory form will be the addition of the “Descriptive Title of Project” data field. It should be noted that many applicant organizations already have systems in place to respond to OMB’s guidance to Federal grant-making agencies to use Grants.gov’s Apply mechanism, which encourages the electronic submission of grants applications.     

14. Cost to the Federal Government

The proposed collection is based on revisions to the Mandatory form currently in use. There is no projected incremental increase in the cost burden to the Federal Government with the implementation of the revised Mandatory form.  The only addition to the Mandatory form currently in use is the Descriptive Title of Project. Each agency currently has existing personnel, systems and processes (or other resources) in place to receive and review their agency-specific grant applications.  Any additional cost for agency system development, maintenance and enhancements should not be attributed to use of the revised Mandatory form, and therefore its use is not expected to alter annualized Federal costs. 

Agency personnel time to review the form is estimated at 33.64 minutes per form. Based on 837 responses per year (837 x 33.64 minutes = 28,156 minutes; 28,156 minutes = 469 hours estimated personnel time.

Grants administrative personnel generally are in the GS-7 through GS-13 range. Based on a step one average of these grades, an average hourly salary is $27.36 per hour. (27.36/60 minutes = .456 per minute and .456 x 33.64 minutes = $15.34

per application.

Therefore, 837 annual applications x $15.34 = $12,839 of estimated annual cost to the federal government to review the form.  

15. Program or Burden Changes

The proposed collection is a revised collection. The burden hours on the proposed collection were based on agency estimates. 

16. Publication and Tabulation Dates

There are no publication plans for collected data including summarizing or tabulating by Grants.gov. The federal agencies that use the form may use the data collected to provide information as required to OMB in accordance with the Federal Funding Accountability and Transparency Act.

17. Expiration Date

Not applicable since the OMB number will be included on the data collection form.

18. Certification Statement

Not applicable since there are no exceptions to the certification.

B. Collections of Information Employing Statistical Methods

No statistical methods are employed in this information collection.

Attachment A (see next page)

ATTACHMENT A - APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY Version 01.1
1.a. Type of Submission: Application Plan Funding Request Other Other (specify)		* 1.b. Frequency: Annual Quarterly Other * Other (specify)				* 1.d. Version: Initial Resubmission		Revision Update
						* 2. Date Received:		STATE USE ONLY:
						3. Applicant Identifier:		5. Date Received by State:
								6. State Application Identifier:
						4a. Federal Entity Identifier:
						4b. Federal Award Identifier:
1.c. Consolidated Application/Plan/Funding		Request?
Yes No Explanation
7. APPLICANT INFORMATION:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN):						* c. Organizational DUNS:
d. Address:
* Street1:						Street2:
* City:						County / Parish:
* State:						Province:
* Country:						* Zip / Postal Code:
e. Organizational Unit:
Department Name:						Division Name:
f. Name and contact information of person to be contacted on matters involving this submission:
Prefix:	* First Name:					Middle Name:
* Last Name:						Suffix:
Title:
Organizational Affiliation:
* Telephone Number:						Fax Number:
* Email:

Authorized for Local Reproduction

Standard Form 424 Mandatory

APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY Version 01.1
* 8a. TYPE OF APPLICANT:
* Other (specify):
b. Additional Description:
* 9. Name of Federal Agency:
10. Catalog of Federal Domestic Assistance Number:
CFDA Title:
11. Descriptive Title of Applicant’s Project
12. Areas Affected by Funding:
13. CONGRESSIONAL DISTRICTS OF:
* a. Applicant: b. Program/Project:
Attach an additional list of Program/Project Congressional Districts if needed.
Add Attachment Delete Attachment View Attachment
14. FUNDING PERIOD:
a. Start Date: b. End Date:
15. ESTIMATED FUNDING:
* a. Federal ($): b. Match ($):
* 16. IS SUBMISSION SUBJECT TO REVIEW BY STATE UNDER EXECUTIVE ORDER 12372 PROCESS?
a. This submission was made available to the State under the Executive Order 12372 Process for review on: b. Program is subject to E.O. 12372 but has not been selected by State for review. c. Program is not covered by E.O. 12372.

Authorized for Local Reproduction

Standard Form 424 Mandatory

APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY Version 01.1
* 17. Is The Applicant Delinquent On Any Federal Debt?
Yes No Explanation
18. By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) ** I Agree ** This list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions.
Authorized Representative:
Prefix:	* First Name:
Middle Name:
* Last Name:
Suffix:	* Title:
Organizational Affiliation:
* Telephone Number:
* Fax Number:
* Email:
* Signature of Authorized Representative:
* Date Signed:
Attach supporting documents as specified in agency instructions.
Add Attachments Delete Attachments View Attachments

Authorized for Local Reproduction

Standard Form 424 Mandatory

OMB Number: 4040-0002
APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY Version 01.1
* Consolidated Application/Plan/Funding Request Explanation:
Authorized for Local Reproduction Standard Form 424 Mandatory

OMB Number: 4040-0002
APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY Version 01.1
* Applicant Federal Debt Delinquency Explanation:
Authorized for Local Reproduction Standard Form 424 Mandatory

ATTACHMENT A

INSTRUCTIONS FOR SF 424-M

Public reporting burden for this collection is estimated to average 1 hour per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget OMB), Paperwork Reduction Project (4040-0002), Washington, DC 20503. Please do not return your completed form to OMB.

This is a standard form (including the continuation sheet) required for use as a cover sheet for submission of applications, plans, and related

information under mandatory grant programs. Some of the items are required and some are optional at the discretion of the applicant or the

Federal agency (agency). Required items are identified with an asterisk on the form. In addition to the instructions provided below, applicants must consult agency instructions to determine agency-specific requirements.

Item:	Entry:		Item:	Entry:
1.	a. Select one Type of Submission in accordance with agency instructions. b. Select applicable frequency for the Type of Submission in 1.a. c. Indicate if the submission is a consolidated application/plan/funding request. d. Select the applicable version for the Type of Submission in 1.a.: Initial (first submission) Resubmission (repeating the submission without change due to problems with the initial submission) Revision (any change to a submission that has not yet been accepted or approved by the agency) Update (any change to an accepted or approved submission).		9.	Enter name of Federal agency from which assistance is being requested.
			10.	Enter the Catalog of Federal Domestic Assistance (CFDA) number and title of the program under which assistance is requested. Use the continuation sheet to enter multiple CFDA numbers and titles.
			11.	Enter a descriptive title of the project. For example, include in the description the primary purposes for which the funding shall be used; (e.g. community and economic development projects in the City of Chicago).
2.	Federal use only.		12.	List areas or entities affected using categories specified in agency instructions. This optional data element is intended for use only by programs for which the area(s) affected are likely to be different than the place(s) of performance reported on the Project/Performance Site Location form.
3.	Applicant use only.
4.	a. Enter Federal entity identifier, if any, as specified in agency instructions. b. Enter Federal award identifier assigned by agency (if applicable).
5.	State use only.		13.	a. Applicant – Enter the applicant’s congressional district. 13b. Program/Project – Enter all District(s) affected by the program or project. If all congressional districts are included for a State, use “all”, e.g., all congressional districts in Maryland would show as MD-all). This optional data element is intended for use only by programs for which the area(s) affected are likely to be different than the place(s) of performance reported on the Project/Performance Site Location attachment. Attach an additional list of Program /Project Congressional Districts, if necessary, in the block provided.
6.	State use only.
7.	Enter the following: a. Legal name of applicant, b. Employer/Taxpayer Identification Number (EIN/TIN) as assigned by the Internal Revenue Service. c. Organization’s DUNS number (received from Dun and Bradstreet) or the DUNS+4 number (if available), d. Complete address of the applicant. (A nine-digit zip code / postal code is required if the country is US.) e. Name of primary organizational unit (and department / division, if applicable), which will undertake the assistance activity, f. For the person to contact on matters related to this submission: name, organizational affiliation (if affiliated with an organization other than the applicant organization), e-mail address, phone number, and fax number.
			14.	a. Enter the start date of the funding period for this submission. b. Enter the end date of the funding period for this submission.
8.	a. Select the appropriate letter and enter in the space provided. Letters O, P, Q, R, S. T, U, V, and W are not applicable. A. State Government B. County Government C. City or Township Government D. Special District Government E. Regional Organization F. U.S. Territory or Possession G. Independent School District H. Public/State Controlled Institution of Higher Education I. Indian/Native American Tribal Government (Federally Recognized)	J. Indian/Native American Tribal Government (Other than Federally Recognized) K. Indian/Native American Tribally Designated Organization L. Public/Indian Housing Authority M. Nonprofit with 501C3 IRS Status (Other than Institution of Higher Education) N. Nonprofit without 501C3 IRS Status (Other than Institution of Higher Education) X. Other (specify in accordance with agency instructions) b. Enter secondary description of applicant type if required by the agency.	15.	a. Federal – Enter the amount requested from the Federal agency. If the agency has specified an amount, enter that amount. b. Match – Enter the amount of funds from all other sources.
			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. Check appropriate box. If “a.” is selected, insert date application was submitted to the State.
			17.	Select the appropriate box. 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. If yes, include an explanation.
			18.	To be signed by the authorized representative of the applicant organization. Enter the name, title, phone number, e-mail address, and fax number of authorized representative.