SF424 FOR ORGANIZATION.pdf
PDF 256 KB Posted
- Opportunity number
- PAS-JAKARTA-FY25-02
- Issued by
-
Department of State US Embassy Jakarta
About this file
This is Standard Form 424 (SF-424) Mandatory, which is the standard application form for federal assistance. The form shown is a blank template with highlighted fields requiring completion, including sections for type of submission (marked as "Application" and "Annual"), applicant information, contact details, and project details. The form includes fields for the applicant's legal name, EIN/TIN, UEI number, address (with country specified as Indonesia), organizational unit information, and authorized representative details. Additional sections cover the type of applicant, federal agency name, CFDA information, congressional districts, funding period dates, and estimated funding amounts (federal and matching funds). The form also includes certification requirements regarding federal debt delinquency and compliance with various federal regulations under U.S. Code Title 18, Section 1001.
This template is associated with the U.S. Ambassadors Fund for Cultural Preservation (AFCP) 2025 Grants Program (Solicitation PAS-JAKARTA-FY25-02) administered by the U.S. Embassy Jakarta. The program supports projects ranging from $25,000 to $500,000 for preserving historic buildings, archaeological sites, museum collections, and traditional cultural expressions. The form requires review under Executive Order 12372 and includes attachment capabilities for supporting documentation. The OMB control number is 4040-0020 with an expiration date of 02/28/2026.
SF424 FOR ORGANIZATION
View the file
Other files
| File | Type | Posted |
|---|---|---|
| SF424B.pdf | ||
| SF424A.pdf | ||
| AFCP-2025-Indonesia_ConceptNote.docx | DOCX document | |
| USAFCP2025-NOFO_Indonesia.pdf | ||
| USAFCP2025-NOFO_Indonesia_15JAN25.pdf |
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Text version
APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY
OMB Number: 4040-0020 Expiration Date: 02/28/2026
1.a. Type of Submission:
Other (specify):
1.b. Frequency:
Other (specify):
1.d. Version:
2. Date Received:
3. Applicant Identifier:
4a. Federal Entity Identifier:
4b. Federal Award Identifier:
5. Date Received by State:
6. State Application Identifier:
c. UEI:
Department Name: Division Name:
Street1: Street2:
City: County / Parish:
State: Province:
Zip / Postal Code:Country:
b. Employer/Taxpayer Identification Number (EIN/TIN):
Prefix: First Name: Middle Name:
Last Name: Suffix:
Title:
Organizational Affiliation:
Telephone Number: Fax Number:
Email:
STATE USE ONLY:
7. APPLICANT INFORMATION:
d. Address:
a. Legal Name:
e. Organizational Unit:
f. Name and contact information of person to be contacted on matters involving this submission:
Application
Plan
Funding Request
Other
Annual
Quarterly
Other
1.c. Consolidated Application/Plan/Funding Request?
Yes No
Initial Resubmission Revision Update
Explanation
IDN: INDONESIA
8a. TYPE OF APPLICANT:
Other (specify):
b. Additional Description:
9. Name of Federal Agency:
10. Catalog of Federal Domestic Assistance Number:
CFDA Title:
a. Applicant: b. Program/Project:
a. Start Date: b. End Date:
a. Federal ($): b. Match ($):
16. IS SUBMISSION SUBJECT TO REVIEW BY STATE UNDER EXECUTIVE ORDER 12372 PROCESS?
13. CONGRESSIONAL DISTRICTS OF:
14. FUNDING PERIOD:
15. ESTIMATED FUNDING:
APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY
Attach an additional list of Program/Project Congressional Districts if needed.
11. Descriptive Title of Applicant's Project:
12. Areas Affected by Funding:
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.
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17. Is The Applicant Delinquent On Any Federal Debt?
Prefix: First Name:
Middle Name:
Last Name:
Suffix: Title:
Organizational Affiliation:
Telephone Number:
Email:
Fax Number:
Signature of Authorized Representative:
Date Signed:
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 18, Section 1001)
Authorized Representative:
Attach supporting documents as specified in agency instructions.
APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY
** 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.
Yes No Explanation
** I Agree
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Consolidated Application/Plan/Funding Request Explanation:
Applicant Federal Debt Delinquency Explanation:
File details come from the government source that posted it. Updated .