SF424_4_0-V4.0.pdf
PDF 144 KB Posted
- Attached to
- FY 2023 Recompete Pilot Program - Phase 1 Federal grant opportunity
- Opportunity number
- EDA-RECOMPETEPHASE1-2023
About this file
This document contains details of a federal grant opportunity from the Department of Commerce Economic Development Administration. The solicitation number is EDA-RECOMPETEPHASE1-2023 and is titled the FY 2023 Recompete Pilot Program - Phase 1. This grant opportunity falls under the federal grant program numbered 11.040, titled Distressed Area Recompete Pilot Program. Applicants should reference solicitation EDA-RECOMPETEPHASE1-2023 and federal grant program 11.040 for any submissions or inquiries regarding this funding opportunity from the Economic Development Administration.
Application for Federal Assistance
View the file
Other files for this federal grant opportunity
| File | Type | Posted |
|---|---|---|
| Recompete Pilot Program Phase 1 NOFO.pdf | ||
| SFLLL_2_0-V2.0.pdf | ||
| CD511-V1.1.pdf | ||
| SF424A-V1.0.pdf |
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Application for Federal Assistance (SF-424) win2k D:20061002180508- 04'00' D:20061002180508- 04'00' OMB Number: 4040-0004 Expiration Date: 11/30/2025
* 1. Type of Submission:
* 2. Type of Application:
* 3. Date Received:
4. Applicant Identifier:
5a. Federal Entity Identifier:
5b. Federal Award Identifier:
6. Date Received by State:
7. State Application Identifier:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN):
* c. UEI:
* Street1:
Street2:
* City:
County/Parish:
* State:
Province:
* Country:
* Zip / Postal Code:
Department Name:
Division Name:
Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
Title:
Organizational Affiliation:
* Telephone Number:
Fax Number:
* Email:
* If Revision, select appropriate letter(s):
* Other (Specify):
State Use Only:
8. APPLICANT INFORMATION:
d. Address:
e. Organizational Unit:
f. Name and contact information of person to be contacted on matters involving this application:
Application for Federal Assistance SF-424 Type of Submission is required. Select one type of submission in accordance with agency instructions.
Type of Submission: Select one type of submission in accordance with agency instructions. One selection is required.
Type of Application: Select one type of application in accordance with agency instructions. One selection is required.
Type of Application is required. Select one type of application in accordance with agency instructions.
* 9. Type of Applicant 1: Select Applicant Type:
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
* Other (specify):
* 10. Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
CFDA Title:
* 12. Funding Opportunity Number:
* Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
* 15. Descriptive Title of Applicant's Project:
Attach supporting documents as specified in agency instructions.
Application for Federal Assistance SF-424 Form Attachments:
* a. Federal
* b. Applicant
* c. State
* d. Local
* e. Other
* f. Program Income
* g. TOTAL Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
* Title:
* Telephone Number:
* Email:
Fax Number:
* Signature of Authorized Representative:
* Date Signed:
18. Estimated Funding ($):
21. *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 18, Section 1001) ** The 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:
Application for Federal Assistance SF-424
* a. Applicant Attach an additional list of Program/Project Congressional Districts if needed.
* b. Program/Project
* a. Start Date:
* b. End Date:
16. Congressional Districts Of:
17. Proposed Project:
E.O. 12372 Review selection is required: Select status of Review.
Application Subject to Review: One selection is required.
Applicant Delinquent on Federal Debt: A selection is required.
Applicant Delinquent on Federal Debt is required: Select an option.
* 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)
* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
If "Yes", provide explanation and attach
| XDPFirstField: |
| Mandatory: |
| Type of Submission is required. Select one type of submission in accordance with agency instructions. : |
| Type of Application is required. Select one type of application in accordance with agency instructions.: |
| DateEntered1: |
| DateEntered2: |
| Submission Type - Preapplication: Select one type of submission in accordance with agency instructions. One selection is required. |
Select if the type of submission is a Preapplication.:
Submission Type - Application: Select one type of submission in accordance with agency instructions. One selection is required.
Select if the type of submission is an Application.:
Submission Type - Changed Application: Select one type of submission in accordance with agency instructions. One selection is required.
Select this submission if requested by the agency to change or correct a previously submitted application. Unless requested by the agency, applicants may not use this to submit changes after the closing date.:
Application Type - New: Select one type of application in accordance with agency instructions. One selection is required..
Select New if the application is being submitted to an agency for the first time.:
Application Type - Continuation: Select one type of application in accordance with agency instructions. One selection is required.
Select Continuation if the submission is an extension for an additional funding/budget period for a project with a projected completion date. This can include renewals.:
Application Type - Revision: Select one type of application in accordance with agency instructions. One selection is required.
Select Revision if the submission is a change in the Federal Government’s financial obligation or contingent liability from an existing obligation. :
| Revision Type: Select a revision type from the list provided. A selection is required if Type of Application is Revision.: |
| Other (specify): Please specify the type of revision. This field is required if E. Other is checked.: |
| Date Received: Enter the date received, if applicable. Enter in the format mm/dd/yyyy. This field is required.: |
| Applicant Identifier: Enter the applicant's control number, if applicable.: |
| Federal Entity Identifier: Enter the number assigned to your organization by the Federal agency.: |
| Federal Award Identifier: For new applications leave blank. For a continuation or revision to an existing award, enter the previously assigned Federal award identifier number. If a changed/corrected application, enter the Federal Identifier in accordance with agency instructions.: |
| Date Received by State: Enter the date received by the State, if applicable. Enter in the format mm/dd/yyyy.: |
| State Application Identifier: Enter the identifier assigned by the State, if applicable.: |
| Organization Name: Enter the legal name of the applicant that will undertake the assistance activity. This field is required.: |
| EIN/TIN: Enter either TIN or EIN as assigned by the Internal Revenue Service. If your organization is not in the US, enter 44-4444444. This field is required.: |
| UEI: Enter the UEI of the applicant organization. This field is required.: |
| Street1: Enter the first line of the Street Address. This field is required.: |
| Street2: Enter the second line of the Street Address.: |
| City: Enter the City. This field is required.: |
| County/Parish: Enter the County/Parish.: |
| State: Select the state, US possession or military code from the provided list. This field is required if Country is the United States.: |
| Province: Enter the Province.: |
| Country: Select the Country from the provided list. This field is required.: USA: UNITED STATES |
| ZIP/ Postal Code: Enter the nine-digit Postal Code (e.g., ZIP code). This field is required if the country is the United States.: |
| Department Name: Enter the name of primary organizational department, service, laboratory, or equivalent level within the organization which will undertake the assistance activity.: |
| Division Name: Enter the name of primary organizational division, office, or major subdivision which will undertake the assistance activity.: |
| AOR Prefix: Select the Prefix from the provided list or enter a new Prefix not provided on the list.: |
| AOR First Name: Enter the First Name. This field is required.: |
| AOR Middle Name: Enter the Middle Name.: |
| AOR Last Name: Enter the Last Name. This field is required.: |
| AOR Suffix: Select the Suffix from the provided list or enter a new Suffix not provided on the list.: |
| Title: Enter the position title.: |
| Organizational Affiliation: Enter the organization if different from the applicant organization.: |
| Telephone Number: Enter the daytime Telephone Number. This field is required.: |
| Fax Number: Enter the Fax Number.: |
| Email: Enter a valid Email Address. This field is required.: |
| TextField1: |
| ViewBurdenStatement: |
| Type of Applicant 1: Select the appropriate applicant type. A selection is required.: |
| Type of Applicant 2: Select the appropriate applicant type.: |
| Type of Applicant 3: Select the appropriate applicant type.: |
| Type of Applicant Other: Enter the applicant type here if you selected "Other (specify)" for Type of Applicant.: |
| Agency Name: Pre-populated from the Application cover sheet.: |
| CFDA Number: Pre-populated from the Application cover sheet.: |
| CFDA/Program Title: Pre-populated from the Application cover sheet.: |
| Opportuntity Number: Pre-populated from the Application cover sheet. This field is required.: |
| Opportunity Title: Pre-populated from the Application cover sheet. This field is required.: |
| Competition Number: Pre-populated from the Application cover sheet.: |
| Competition Title: Pre-populated from the Application cover sheet.: |
| spacer: |
| Project Title: Enter a brief, descriptive title of the project. This field is required.: |
| FileName: |
| MimeType: |
| href: |
| hashAlgorithm: |
| HashValue_data: |
| ObjList: |
| FNList: |
| AttCount: |
| Add: |
| Delete: |
| View: |
| Done: |
| Attachment Check Box: Indicates whether an Attachment is attached: |
| Additional Project Title - View Attachment Button: Select to view attachment(s).: |
| Additional Project Title - Delete Attachment Button: Select to delete attachment(s).: |
| Additional Project Title - Add Attachment Button: Select to add attachment(s).: |
| Debt Explanation - View Attachment Button: Click here to view the attachment.: |
| Debt Explanation - Delete Attachment Button: Click here to delete the attachment.: |
| Debt Explanation - Add Attachment Button: Click here to add the attachment.: |
| Debt Explanation is required.: |
| Applicant District: Enter the Congressional District in the format: 2 character State Abbreviation - 3 character District Number. Examples: CA-005 for California's 5th district, CA-012 for California's 12th district. |
If outside the US, enter 00-000.
This field is required.:
Program District: Enter the Congressional District in the format: 2 character State Abbreviation - 3 character District Number. Examples: CA-005 for California's 5th district, CA-012 for California's 12th district.
If all districts in a state are affected, enter "all" for the district number. Example: MD-all for all congressional districts in Maryland.
If nationwide (all districts in all states), enter US-all.
If the program/project is outside the US, enter 00-000.
This field is required.:
| Additional Congressional Districts: |
| Additional Congressional Districts - Add Attachment Button: Click here to add the attachment.: |
| Additional Congressional Districts - Delete Attachment Button: Click here to delete the attachment.: |
| Additional Congressional Districts - View Attachment Button: Click here to view the attachment.: |
| Project Start Date: Enter the date in the format MM/DD/YYYY. This field is required.: |
| Project End Date: Enter the date in the format MM/DD/YYYY. This field is required.: |
| Federal Estimated Funding: Enter the dollar amount. This field is required.: |
| Applicant Estimated Funding: Enter the dollar amount. This field is required.: |
| State Estimated Funding: Enter the dollar amount. This field is required.: |
| Local Estimated Funding: Enter the dollar amount. This field is required.: |
| Other Estimated Funding: Enter the dollar amount. This field is required.: |
| Program Income Estimated Funding: Enter the dollar amount. This field is required.: |
| Total Estimated Funding: Enter the total dollar amount. This field is required.: |
| E.O. 12372 Review selection is required: Select status of Review.: |
| State Review Available: Click to select option.: |
| State Review Not Selected: Click to select option.: |
| State Review Not Covered: Click to select option.: |
| State Review Date: Enter the date in the format MM/DD/YYYY.: |
| Applicant Delinquent on Federal Debt is required: Select an option.: |
| Delinquent on Debt: Click to select option.: |
| Not Delinquent on Debt: Click to select option.: |
| I Agree checkbox is required: Check I Agree checkbox to provide the required Certifications and Assurances.: |
| Certification Agree: Check to select. This field is required.: N: No |
| AOR Title: Enter the position title. This field is required.: |
| AOR Telephone Number: Enter the daytime Telephone Number. This field is required.: |
| AOR Fax Number: Enter the Fax Number.: |
| AOR Email: Enter a valid Email Address. This field is required.: |
| AORSignature: |
| DateEntered19: |
| DateEntered20: |
| DateSigned: |
| LastField: |
File details come from the government source that posted it. Updated .