[Federal Register Volume 59, Number 83 (Monday, May 2, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-10209]


[[Page Unknown]]

[Federal Register: May 2, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

Availability of Financial Assistance for Projects Funded Under 
the Adoption, Opportunities Program

AGENCY: Administration on Children, Youth and Families (ACYF), 
Administration for Children and Families (ACF), Department of Health 
and Human Services (DHHS).

ACTION: Announcement of the Availability of Financial Assistance and 
Request for Applications to Carry Out Demonstration Projects Funded 
Under the Adoption Opportunities Branch in the Children's Bureau, 
Administration on Children, Youth and Families.

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SUMMARY: The Children's Bureau of the Administration on Children, Youth 
and Families announces the availability of fiscal year 1994 funds for 
grants to public or private nonprofit child welfare and adoption 
agencies, organizations and adoptive parent groups to assist in 
supporting programs directed to: (A) Increasing the placements in 
adoptive families of minority children who are in foster care and have 
the goal of adoption, with a special emphasis on the recruitment of 
minority families; (B) providing post-legal adoption services for 
families who have adopted special needs children; and, (C) increasing 
the rate of placement of children in foster care who are legally free 
for adoption.
    Funding for these grants is authorized under Title II of the Child 
Abuse Prevention and Treatment and Adoption Reform Act of 1978 (Pub. L. 
95-266, as amended).
    This announcement contains all necessary application materials.

DATES: The deadline for submission of applications is July 1, 1994.

ADDRESSES: Applications may be mailed to the Department of Health and 
Human Services, Administration for Children and Families, Division of 
Discretionary Grants, 370 L'Enfant Promenade SW., 6th Floor East, OFM/
DDG, Washington, DC 20447.
    Hand delivered applications are accepted during normal working 
hours of 8:00 a.m. to 4:30 p.m., Monday through Friday, on or prior to 
the established closing date at: Administration for Children and 
Families, Division of Discretionary Grants, 6th Floor OFM/DDG, 901 D 
Street SW., Washington, DC 20447.

FOR FURTHER INFORMATION CONTACT: ACYF Operations Program, Telephone: 1 
(800) 351-2293.

SUPPLEMENTARY INFORMATION: The Administration on Children, Youth and 
Families (ACYF) administers national programs for children and youth, 
works with States and local communities to develop services which 
support and strengthen family life, seeks out joint ventures with the 
private sector to enhance the lives of children and their families, and 
provides information and other assistance to parents.
    The concerns of ACYF extend to all children from birth through 
adolescence, with particular emphasis on children who have special 
needs. Many of the programs administered by the agency focus on 
children from low-income families; children and youth in need of foster 
care, adoption or other child welfare services; preschool children, 
including children with disabilities; abused and neglected children; 
runaway and homeless youth; and children from Native American families.
    The priority areas identified in this announcement are derived from 
legislative mandates as well as Departmental goals and initiatives. The 
priorities reflect the state of current knowledge as well as emerging 
issues which come to ACYF's attention by several means including 
consultation with advocates, policymakers, and practitioners in the 
field.
    The priorities seek to focus attention on and to encourage 
demonstration efforts to obtain new knowledge and improvements in 
service delivery for the solution of particular problems and to promote 
the dissemination and utilization of the knowledge and model practices 
developed under these priorities.
    This program announcement consists of three parts. Part I provides 
information on the goals of the Children's Bureau (CB), the ACYF office 
which is requesting applications, and the statutory authorities for 
awarding grants.
    Part II describes the review process and the programmatic 
priorities under which applications are being solicited.
    Part III provides information and instructions for the development 
and submission of applications.

Part I--Introduction

A. Goals of the Children's Bureau

    Within ACYF, Children's Bureau's Division of Child Welfare plans, 
manages, coordinates and supports child welfare services programs. It 
administers the Foster Care and Adoption Assistance Program, the Child 
Welfare Services Program, the Child Welfare Research, Demonstration and 
Training Program, the Adoption Opportunities Program, the Temporary 
Child Care and Crisis Nurseries Program, Independent Living Program and 
the Abandoned Infants Assistance Program.
    The Bureau's programs are designed to promote the welfare of all 
children, including disabled, homeless, dependent or neglected children 
and their families. The programs aid in preventing and remedying the 
neglect, abuse and exploitation of children and the unnecessary 
separation of children from families.

B. The Statutory Authority Covering this Announcement

    The Adoption Opportunities Program provides financial support for 
demonstration projects to: Improve adoption practices; eliminate 
barriers to adoption; and find permanent homes for children, 
particularly children with special needs. Authorization: Child Abuse 
Prevention and Treatment and Adoption Reform Act of 1978, Title II, 
Section 203, as amended, Public Law 95-266; Public Law 98-457, the 
Child Abuse Prevention, Adoption and Family Services Act of 1988, as 
amended, Title II, Section 201, Public Law 100-294; Public Law 102-295; 
42 U.S.C. 5111 et seq.

Part II--Review Process and Priority Areas

A. Eligible Applicants

    Each priority area description contains information about the types 
of agencies and organizations which are eligible to apply under that 
priority area. Because eligibility varies depending on statutory 
provisions, it is critical that the ``Eligible Applicants'' section of 
each priority area be reviewed carefully.
    Before review, each application will be screened for applicant 
organization eligibility as specified under the selected priority area. 
Applications from ineligible organizations will not be considered or 
reviewed in the competition, and the applicant will be so informed.
    Only agencies and organizations, not individuals, are eligible to 
apply under this Announcement. All applications developed jointly by 
more than one agency or organization, must identify only one lead 
organization and official applicant. Participating agencies and 
organizations can be included as co-participants, subgrantees or 
subcontractors. For-profit organizations are eligible to participate as 
subgrantees or subcontractors with eligible non-profit organizations 
under all priority areas.
    Any non-profit agency which has not previously received Federal 
support must submit proof of non-profit status either by making 
reference to its listing in the Internal Revenue Service's (IRS) most 
recent list of tax-exempt organizations or by submitting a copy of its 
letter from the IRS under IRS Code Section 501(c)(3). The ACYF cannot 
fund a non-profit applicant without acceptable proof of its non-profit 
status.

B. Review Process and Funding Decisions

    Timely applications postmarked by the deadline date which are from 
eligible applicants will be reviewed and scored competitively. Experts 
in the field, generally persons outside the Federal government, will 
use the appropriate evaluation criteria listed later in this section to 
review and score the applications. The results of this review are a 
primary factor in making funding decisions.
    The ACYF reserves the option of discussing applications with, or 
referring them to, other Federal or non-Federal funding sources when 
this is in the best interest of the Federal government or the 
applicants. ACYF may also solicit comments from ACF Regional Office 
staff, other Federal agencies, interested foundations, national 
organizations, specialists, experts, States and the general public. 
These comments, along with those of the expert reviewers, will be 
considered by ACYF in making funding decisions.
    In making decisions on awards, ACYF may give preference to 
applications which focus on or feature: minority populations; a 
substantially innovative strategy with the potential to improve theory 
or practice in the field of human services; a model practice or set of 
procedures that holds the potential for replication by organizations 
that administer or deliver human services; substantial involvement of 
volunteers; substantial involvement (either financial or programmatic) 
of the private sector; a favorable balance between Federal and non-
Federal funds available for the proposed project; the potential for 
high benefit for low Federal investment; a programmatic focus on those 
most in need; and/or substantial involvement in the proposed project by 
national or community foundations.
    To the greatest extent possible, efforts will be made to ensure 
that funding decisions reflect an equitable distribution of assistance 
among the States and geographical regions of the country, rural and 
urban areas, and ethnic populations. In making these decisions, ACYF 
may also take into account the need to avoid unnecessary duplication of 
effort.

C. Evaluation Criteria

    A panel of at least three reviewers (primarily experts from outside 
the Federal government) will review the applications. To facilitate 
this review, applicants should ensure that they address each minimum 
requirement in the priority area description under the appropriate 
section of the Program Narrative Statement.
    The reviewers will determine the strengths and weaknesses of each 
proposal using the evaluation criteria listed below, provide comments 
and assign numerical scores. The point value following each criterion 
heading indicates the maximum numerical weight.
    All applications will be evaluated against the following criteria.
    A. Objective and Need for Assistance (20 points). The extent to 
which the application pinpoints any relevant physical, economic, 
social, financial, institutional or other problems requiring a 
solution; demonstrates the need for the assistance; states the 
principal and subordinate objectives of the project; provides 
supporting documentation or other testimonies from concerned interests 
other than the applicant; and includes and/or footnotes relevant data 
based on the results of planning studies. The application must identify 
the precise location of the project and area to be served by the 
proposed project. Maps and other graphic aids may be attached.
    B. Approach (35 points). The extent to which the application 
outlines a sound and workable plan of action pertaining to the scope of 
the project, and details how the proposed work will be accomplished; 
cites factors which might accelerate or decelerate the work, giving 
acceptable reasons for taking this approach as opposed to others; 
describes and supports any unusual features of the project, such as 
design or technological innovations, reductions in cost or time, or 
extraordinary social and community involvements; and provides for 
projections of the accomplishments to be achieved. It lists the 
activities to be carried out in chronological order, showing a 
reasonable schedule of accomplishments and target dates.
    The extent to which, when appropriate, the application identifies 
the kinds of data to be collected and maintained, and discusses the 
criteria to be used to evaluate the results and successes of the 
project. The extent to which the application describes the evaluation 
methodology that will be used to determine if the needs identified and 
discussed are being met and if the results and benefits identified are 
being achieved. The application also lists each organization, agency, 
consultant, or other key individuals or groups who will work on the 
project, along with a description of the activities and nature of their 
effort or contribution.
    C. Results or Benefits Expected (20 points). The extent to which 
the application identifies the results and benefits to be derived, the 
extent to which they are consistent with the objectives of the 
proposal, and the extent to which the application indicates the 
anticipated contributions to policy, practice, theory and/or research. 
The extent to which the proposed project costs are reasonable in view 
of the expected results.
    D. Staff Background and Organization's Experience (25 points). The 
application identifies the background of the project director/principal 
investigator and key project staff (including name, address, training, 
educational background and other qualifying experience) and the 
experience of the organization to demonstrate the applicant's ability 
to effectively and efficiently administer the project. The application 
describes the relationship between the proposed project and other work 
planned, anticipated or underway by the applicant with Federal 
assistance.
    E. Structure of Priority Area Descriptions. Each priority area 
description is composed of the following sections:
    Eligible Applicants: This section specifies the type of 
organization eligible to apply under the particular priority area. 
Specific restrictions are also noted, where applicable.
    Purpose: This section presents the basic focus and/or broad goal(s) 
of the priority area.
    Background Information: This section briefly discusses the 
legislative background as well as the current state-of-the-art and/or 
current state-of-practice that supports the need for the particular 
priority area activity. Relevant information on projects previously 
funded by ACYF and/or others, and State models are noted, where 
applicable.
    Minimum Requirements for Project Design: This section presents the 
basic set of issues that must be addressed in the application. 
Typically, they relate to project design, evaluation, and community 
involvement. This section also asks for specific information on the 
proposed project. Inclusion and discussion of these items is important 
since they will be used by the reviewers in evaluating the applications 
against the evaluation criteria. Project products, continuation of the 
project effort after the Federal support ceases, and dissemination/
utilization activities, if appropriate, are also addressed.
    Project Duration: This section specifies the maximum allowable 
length of time for the project period; it refers to the amount of time 
for which Federal funding is available.
    Federal Share of Project Cost: This section specifies the maximum 
amount of Federal support for the project.
    Matching Requirement: This section specifies the minimum non-
Federal contribution, either through cash or in-kind match, required in 
relation to the maximum Federal funds requested for the project.
    Anticipated Number of Projects To Be Funded: This section specifies 
the number of projects that ACYF anticipates it will fund under the 
priority area.
    CFDA: This section identifies the Catalog of Federal Domestic 
Assistance (CFDA) number and title of the program under which 
applications in this priority area will be funded. This information is 
needed to complete item 10 on the (SF 424) grant application form.
    Please note that applications that do not comply with the specific 
priority area requirements in the section on Eligible Applicants will 
not be reviewed. Applicants should also note that non-responsiveness to 
the section Minimum Requirements for Project Design will result in a 
low evaluation score by the reviewers. Applicants must clearly identify 
the specific priority area under which they wish to have their 
applications considered, and tailor their applications accordingly. 
Previous experience has shown that an application which is broader and 
more general in concept than outlined in the priority area description 
scores lower than one more clearly focused on, and directly responsive 
to, that specific priority area.

E. Available Funds

    The ACYF intends to award new grants resulting from this 
announcement during the fourth quarter of fiscal year 1994, subject to 
the availability of funds. The size of the actual awards will vary.
    Each priority area description includes information on the maximum 
Federal share of the project costs and the anticipated number of 
projects to be funded.
    The term budget period refers to the interval of time (usually 12 
months) into which a multi-year period of assistance (project period) 
is divided for budgetary and funding purposes. The term project period 
refers to the total time a project is approved for support, including 
any extensions.
    Where appropriate, applicants may propose project periods which are 
shorter than the maximums specified in the various priority areas. Non-
Federal share contributions may exceed the minimums specified in the 
various priority areas when the applicant is able to do so. However, 
applicants should propose only that non-Federal share they can 
realistically provide since any unmatched Federal funds will be 
disallowed by ACF.
    For multi-year projects, continued Federal funding beyond the first 
budget period is dependent upon satisfactory performance by the 
grantee, availability of funds from future appropriations and a 
determination that continued funding is in the best interest of the 
Government.

F. Grantee Share of Project Costs

    Grantees must provide at least 25 percent of the total cost of the 
project. The total approved cost of the project is the sum of the ACYF 
share and the non-Federal share. The non-Federal share may be met by 
cash or in-kind contributions, although applicants are encouraged to 
meet their match requirements through cash contributions. Therefore, a 
project requesting $200,000 in Federal funds (based on an award of 
$100,000 per budget period), must include a match of at least $33,333 
(25% total project cost).

G. Index of Priority Areas

    To assist potential applicants in using this announcement, a 
priority area index in numerical order, is presented below.

1.01  Adoptive Parent Groups as Partners in the Adoption of Children 
with Special Needs
1.02  Increase Adoptive Placements of Minority Children
1.03  Adoptive Placement of Foster Care Children
1.04  Post-Legal Adoption Services
1.05  Respite Care as a Service for Families who Adopt Children with 
Special Needs
1.06  Synthesis of Results of Post-Legal Adoption Projects
1.07  Regional Conferences on the Adoption of Minority Children
1.08  Developing Collaborative Efforts between Foster Care and Adoption 
Staff to Improve Child Welfare Services From Intake to Permanency
1.09  Field Initiated Projects

H. Priority Areas

1.01  Adoptive Parent Groups as Partners in the Adoption of Special 
Needs Children
    Eligible Applicants: Voluntary or public social service agencies, 
adoption exchanges or other national, regional or statewide adoption-
related organizations.
    Purpose: To develop new adoptive parent groups or expand or 
strengthen existing adoptive parent groups to assist and support 
families adopting children, especially minority parent groups.
    Background: Through the years adoptive parents have aggressively 
promoted the adoption of children with special needs. As consumers of 
adoption services, these parents bring to the adoption field a special 
perspective both on the children to be served and the agencies that 
serve them. They have advocated effectively for children and challenged 
the term ``unadoptable'' by demonstrating that children with special 
needs can be placed with families of their own. Often the members of 
parent groups have come together out of a common need to help each 
other to more effectively access the child welfare system for the 
purpose of adoption. Having experienced common problems, the members of 
parent groups may share information and insights and provide empathy 
and support for one another through regularly scheduled social and 
educational activities.
    In past years, parent groups have used Federal funds to: Establish 
warm-lines as resources for adoptive parents; sponsor adoption fairs 
with the participation and cooperation of adoption agencies and other 
groups involved in adoption; establish resource libraries; form new 
support groups; conduct support group conferences; publish and 
distribute newsletters; and provide adoptive parents stipends to attend 
conferences.
    Currently, there are more than 452,000 children in foster care in 
the United States and the numbers are growing. Fifty thousand of these 
children have special needs and are waiting to be adopted. Over half of 
these waiting children are of minority heritage. Strong parent groups 
can play an important role in promoting the adoption of these children 
by sponsoring such activities as information and referral services; 
recruitment and orientation for prospective adoptive parents; and 
respite care and work with social service agencies to support families 
following placement and legalization. The ACYF recognizes the need to 
support the development of strong, effective parent groups working in 
partnership with child welfare/adoption agencies to advocate for needed 
services and support; to promote the adoption of children with special 
needs; and to support the establishment of new adoptive parent groups 
and strengthen existing groups.
    Minimum Requirements: In order to compete successfully under this 
priority area, the applicant should:

     Document its capability to assist local or State adoptive 
parent groups to work with child welfare agencies.
     Describe the process to be used in developing new adoptive 
parent groups, especially minority groups, and specify the number of 
new groups to be developed.
     Describe a plan for awarding sub-grants, not to exceed 
$5,000, to incorporated non-profit local or State adoptive parent 
groups to work with child welfare agencies and adoptive families, 
including pre- and post-adoption services.
     Describe the methods to be used to request proposals from 
parent groups which focus on special needs adoption problems or issues.
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
D.C. (The Conference provides the opportunity for Adoption 
Opportunities and other Children's Bureau grantees to exchange 
information and address current child welfare trends and issues.)
     Provide assurances that the project will be fully staffed 
and implemented within 90 days of the notification of the grant award.
    Project Duration: The length of the project must not exceed 17 
months.
    Federal Share of Project Costs: The maximum Federal share of the 
project is not to exceed $85,000 for the 17-month project period.
    Matching Requirements: Grantees must provide at least 25 percent of 
the total cost of the project.
    Anticipated Number of Projects to be Funded: It is anticipated that 
a minimum of three projects will be funded.
1.02  Increase Adoptive Placements of Minority Children
    Eligible Applicants: States, local government entities, public or 
private non-profit licensed child welfare or adoption agencies, and 
adoption exchanges and community-based organizations with experience in 
working with minority populations. Given limited funds, and in order to 
generate and financially support the widest possible variety of issues 
and approaches, priority will be given to applicants which have not 
been funded under this priority area in previous fiscal years. However, 
previously funded applicants under this priority area will not be 
precluded from receiving grants.
    Purpose: To implement programs designed to increase the adoptive 
placement of minority children who are in foster care and have the goal 
of adoption, with a special emphasis on the recruitment, retention and 
utilization of minority families; adoptive placements for minority 
children over the age of ten; and adoptive placement of sibling groups.
    Background Information: The Adoption Opportunities legislation, 
emphasizes the recruitment of minority families and authorizes funds 
for demonstration projects for the recruitment of families to adopt 
waiting minority children. It is estimated that approximately half of 
the 50,000 children currently free for adoption and awaiting placement 
are minority children. Many of them are older, some are in siblings 
groups, some have disabilities and they may wait long periods of time 
before they are placed with adoptive families.
    The Packard Foundation reports that the current situation for 
children of color is alarming. The proportion of these children in 
foster care is three times greater than their proportion in the 
population of the United States. The ACYF is aware that there must be a 
continuous focus on the adoption of minority children and has funded a 
number of programs designed specifically to recruit minority families 
and to place minority children.
    Minimum Requirements for Project Design: In order to successfully 
compete under this priority area, the applicant should:

     Identify and describe existing barriers to minority 
adoption in the locale where the project would be implemented; the 
number of families that would be recruited; and the number of children 
that would be placed.
     Describe the innovative methods that would be employed to 
recruit and prepare minority families (including single applicants) in 
a timely manner in order to retain recruited families.
     Provide assurances that the program would not require 
payment of fees by adoptive families.
     Describe how training in cultural competence would be 
provided to all relevant staff to increase their effectiveness in 
serving minority children and families.
     Provide for an assessment of the project's effectiveness 
in achieving the desired objectives and its ability to provide services 
to prospective adoptive families through the completion of the 
adoption.
     Document how the program would be continued beyond Federal 
funding as part of the agency's ongoing program and describe the 
specific steps which would be taken to accomplish this.
     Private adoption agencies must provide evidence of 
licensure (a copy of the license must be included with the 
application).
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
DC (The Conference is held for Adoption Opportunities and other 
Children's Bureau grantees to exchange information and address current 
child welfare trends and issues.)
     Provide assurances and document that the project would be 
staffed and implemented within 90 days of the notification of the grant 
award.
    Project Duration: The length of the project must not exceed 24 
months.
    Federal Share of Project Costs: The maximum Federal share is not to 
exceed $100,000 per 12-month budget period.
    Matching or Cost Sharing Requirement: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects to be Funded: It is anticipated that 
15 projects will be funded.

1.03 Adoptive Placement of Foster Care Children
    Eligible Applicants: Eligibility is limited to State social service 
agencies. Given limited funds, and in order to generate and financially 
support the widest possible variety of issues and approaches, priority 
will be given to applicants which have not been funded under this 
priority area in previous fiscal years. However, previously funded 
applicants under this priority area will not be precluded from the 
receiving grants.
    Purpose: To develop programs which will assist States in their 
efforts to increase the placement of foster care children legally free 
for adoption according to a pre-established plan and goals for 
improvement.
    Background Information: The Adoption Opportunities legislation, as 
amended by Public Law 100-294, authorizes the funding of grants to 
States to improve adoption services for the placement of special needs 
children who are legally free for adoption. Children in foster care who 
are free for adoption, particularly children with special needs, do not 
always move smoothly through the child welfare system into placement 
with a permanent family. States have received Federal grants to make 
systemic changes in their adoption programs; to provide computer 
hardware, software and fees for membership in the National Adoption 
Exchange's Network; and to develop a consortium of nine States with 
large numbers of children in care in order to share knowledge to 
improve and enhance their special needs adoption programs; and to form 
a national post-legal adoption consortium of seven States to focus on 
models of post legal adoption services. More than half of the States 
have received grants to improve adoption services.
    Increasingly, children entering foster care have more complex 
problems which require more intensive services. Permanent families must 
be continuously recruited and prepared to parent the growing population 
of children who cannot return to their birth families. Supportive 
services must be added or improved so that the children in foster care 
who are legally free for adoption can move into adoptive placements in 
a timely manner. This will require collaborative efforts with the court 
system to terminate parental rights. Further, agencies must commit 
resources for the ongoing support of adoptive families not only at 
placement, but also after legalization of the adoption. Past projects 
have demonstrated that greater improvements in placing these children 
are achieved when permanent plans are made and carried out very early 
in the placement; when there are sufficient numbers of trained and 
experienced staff; and when there are available resources and 
administrative commitments to adoption and to coordinated community-
based efforts.
    Minimum Requirements for Project Design: In order to successfully 
compete under this priority area, the applicant should: 
     Identify and verify the number of foster care children in 
the area to be served who are legally free and waiting for adoptive 
placements.
     Provide and verify the rate of placement of foster care 
children placed in adoption in the year preceding the application. (The 
rate of placement is the number of children placed divided by the 
number of children waiting for adoption.)
     Describe the methods to be employed to increase the rate 
of placement of foster care children into adoption and the goals for 
improvement to be achieved during the period of the grant.
     Propose and describe an evaluation component which would 
focus on the innovations used to improve the placement of children who 
are legally free for adoption and which would address the successes and 
failures of the initiative.
    The evaluation should include the collection and analysis of data 
to determine placement rates and the types of clients served (e.g., 
waiting children, prospective adoptive families). Data should be 
collected to determine the availability of adoptive families during the 
program period. The evaluation should also include descriptive 
information on the processes and procedures used in implementing the 
project. This information should be used to assess placement rates and 
the success or failure of the innovative program methodologies used.

     Document how the program would be continued beyond Federal 
funding or part of the agency's ongoing program, if successful, and 
describe the specific steps which would be taken to accomplish this.
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
DC (The Conference is held for Adoption Opportunities and other 
Children's Bureau grantees to exchange information and address current 
child welfare trends and issues.).
     Describe the report and/or other products that would be 
developed under the project, including the types of information that 
would be presented, and the steps that would be undertaken to 
disseminate and promote the utilization of project products and 
findings.
    Project Duration: The length of the project must not exceed 12 
months.
    Federal Share of Project Costs: The maximum Federal share is not to 
exceed $100,000.
    Matching or Cost Sharing Requirement: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects to be Funded: It is anticipated that 
two projects will be funded.
1.04  Post-Legal Adoption Services
    Eligible Applicants: States, local government entities, and public 
or private nonprofit licensed child welfare or adoption agencies. Given 
limited funds, and in order to generate and financially support the 
widest possible variety of issues and approaches, priority will be 
given to applicants which have not been funded under this priority area 
in previous fiscal years. However, applicants previously funded under 
this priority area will not be precluded from receiving grants.
    Purpose: To develop or replicate post-legal adoption projects which 
will provide services to strengthen and preserve families who have 
adopted children with special needs. The services provided shall 
supplement, not supplant, services supported by any other funds 
available to the applicant for the same general services.
    Background Information: The Adoption Opportunities legislation 
authorizes funds for increased post-legal adoption services. 
Recognition of special issues in adoption in the past decade has led 
adoption professionals to reconsider the concept that agency services 
to adoptive families end with the legal consummation of the adoption. 
Historically, once the adoption was legally consummated, the newly-
formed family was to be considered the same as any other family. 
However, adoption is a life-long process, and service providers need to 
understand the unique interpersonal dynamics of adoption in order to 
provide effective post-legal adoption services (those provided after 
the legalization of the adoption) to families who seek assistance.
    Over the years, ACYF has funded more than 70 programs across the 
country to provide post-legal adoption services for families who have 
adopted children with special needs. Information on these projects can 
be obtained from the National Adoption Information Clearinghouse, 11426 
Rockville Pike, suite 410, Rockville, Maryland 20852; telephone: (301) 
231-6512.
    Funds awarded under this priority area in FY 1994 will support both 
the institutionalization of post-legal adoption services in communities 
where such services already exist and the development of such services 
in communities where they do not yet exist. Support will also be 
provided for the development of additional models of service delivery. 
Services funded under this priority area shall be provided to families 
who have adopted children with special needs.
    Minimum Requirements for Project Design: In order to successfully 
compete under this priority area, the applicant should:

     Propose to provide services such as individual, group and/
or family counseling; case management; training of mental health 
professionals and staff of public agencies and of private, nonprofit 
child welfare and adoption agencies licensed by the State to provide 
adoption services; and provide assistance to adoptive parents, adopted 
children and siblings of adopted children.
     Describe the models that would be developed or replicated 
and the services that would be provided.
     Describe the existing post-legal adoption services, if 
any; the need for new services; and plans for the development, 
implementation, and institutionalization of such services.
     Describe how the proposed project would build upon the 
existing literature and knowledge base related to post-legal adoption 
services.
     Provide specific written commitments from collaborating or 
cooperating agencies, if any.
     Document how the program would be continued beyond Federal 
funding as part of the agency's ongoing program and describe the 
specific steps which would be taken to accomplish this.
     Provide assurances that the project would be staffed and 
implemented within 90 days of the notification of the grant award.
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
DC. (The Conference is held for Adoption Opportunities and other 
Children's Bureau grantees to exchange information and address current 
child welfare trends and issues.)

    Project Duration: The length of the project must not exceed 24 
months.
    Federal Share of Project Costs: The maximum Federal share is not to 
exceed $100,000 per 12-month budget period.
    Matching or Cost Sharing Requirements: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects To Be Funded: It is anticipated that 
15 projects will be funded.
1.05  Respite Care as a Service for Families Who Adopt Children With 
Special Needs
    Eligible Applicants: States, local government entities, public or 
private nonprofit licensed child welfare or adoption agencies, 
University Affiliated Programs, licensed child care or respite care 
providers, and incorporated adoptive parent groups with experience in 
working with adoptive populations.
    Purpose: To develop or replicate a variety of affordable respite 
care models for the adoptive parents of children with special needs, 
especially for the adoptive parents of medically fragile or severely 
physically or emotionally handicapped children.
    Background Information: The ACYF recognizes the need for respite 
services for adoptive families in order to maintain and support the 
family unit. Respite may be needed early in the adoptive placement or 
later in the child's development. Research indicates that the majority 
of care is requested to relieve the primary caregiver for vacations, 
emergencies or planned circumstances.
    There are few specialized respite care programs for adoptive 
families that provide temporary relief or rest from parental 
responsibilities, despite the increasing availability of post-legal 
adoption services. Such programs can be especially helpful to families 
who adopt children with special needs by providing support during 
emergencies or respite from the daily demands of a special needs child. 
Generally, such respite care is provided by skilled caregivers or 
companions; however, with proper preparation, it can also be provided 
by friends and relatives.
    In some respite care programs, training and reimbursement are 
offered to whomever the family designates as provider, a mutually 
satisfying arrangement that allows the family to control the quality of 
care. Also, this approach may offer families living in rural areas the 
flexibility of locating their own providers since distance frequently 
limits respite resources.
    Since 1990, ACYF has awarded grants to expand and develop respite 
care services for adoptive parents of children with special needs. 
These projects have developed services such as: payment to families to 
obtain their own respite services to be provided in their own homes for 
short periods of time and on weekends; recruitment and training of 
individuals to provide short breaks for adoptive parents as well as 
supportive services to parents such as tutorial and recreational 
activities outside the home; sponsorship of camp programs and other 
specialized events for the children and their families. Programs funded 
in 1990 which will end in 1994 include the University of Kansas, Bureau 
of Child Research; La Hacienda Foster Care, Tucson, Arizona; the 
University of Alabama at Birmingham; the Mercy Respite Care 
Corporation, Grand Rapids, Michigan; and the Northwest Adoption 
Exchange, Seattle, Washington. Information about these programs can be 
secured from the National Adoption Information Clearinghouse, 11426 
Rockville Pike, suite 410, Rockville, Maryland 20852; telephone: (301) 
231-6512.
    Minimum Requirements for Project Design: In order to successfully 
compete under this priority area, the applicant should:
     Describe plans to develop or replicate respite care models 
for the adoptive parents of special needs children that include, but 
are not limited to:

--Facility-based models such as those located in churches, day care 
centers, community-based group homes, rehabilitation centers, as well 
as mother's day out programs, weekend respite, evening respite, and 
overnight respite programs;
--In-home respite care services offered in the family's home and,
--Respite-host family services offered in the provider's home.

     Describe the respite care services that would be provided 
for the parents of children who are medically fragile or who have 
severe physical or emotional problems.
     Describe the preparation, referral, follow-up, and 
counseling services that would be provided to respite service users.
     Describe the collaboration that would be established with 
groups such as community recreational services, churches, day care 
centers, group homes, residential treatment centers, adoptive parent 
groups, and University Affiliated Programs in providing respite 
services.
     Describe the training that would be provided to service 
providers.
     Estimate the number of special needs children and families 
that would be served and document that a sufficient volume of special 
needs adoptive families exists to support a program of the size 
proposed.
     Provide for an evaluation of the project and include a 
discussion of the proposed evaluation design.
     Provide assurances that the project would be staffed and 
implemented within 90 days of the notification of the grant award.
     Document how the program would be continued beyond Federal 
funding as part of the agency's ongoing program and describe the 
specific steps which would be taken to accomplish this.
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
DC. (The Conference is held for Adoption Opportunities and other 
Children's Bureau grantees to exchange information and address current 
child welfare trends and issues.)

    Federal Share of Project Cost: The maximum Federal share will not 
exceed $150,000 per 12-month budget period.
    Project Duration: The length of the project must not exceed 36 
months.
    Matching or Cost Sharing Requirement: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects: It is anticipated that a minimum of 
five projects will be funded.
1.06  Synthesis of Results of Post Legal-Adoption Projects
    Eligible Applicants: State or local, public or nonprofit agencies, 
organizations, or universities.
    Purpose: To collect, analyze, and synthesize current knowledge and 
results of projects funded by the Adoption Opportunities Program 
focused on post-legal adoption services since 1989.
    Background Information: In 1989, the Adoption Opportunities statute 
authorized funds for increased post-legal adoption services for 
families who adopted special needs children. Approximately 70 grants 
have been awarded to public and private agencies and adoptive parent 
groups to provide post-legal adoption services. These efforts resulted 
in some exemplary products that should be replicated. These include the 
provision of post-legal adoption services, respite care, and the 
training of mental health professionals; individual group and/or family 
counseling; curriculum for adoptive families; resource guides and 
directories; parent surveys of post-legal adoption services; adoption 
and the sexually abused child; practice manuals for workers and 
therapists; handbooks on the adoption of HIV positive children; and 
diagnostic and evaluation services for adopted children. In addition, a 
post-legal adoption consortium consisting of seven States funded 
initially in 1991 is addressing post-legal adoption practices and laws 
and is reviewing successful models in an effort to include post-legal 
services in the category of services to be provided by child welfare/
adoption agencies. The consortium final report will be available in 
late 1994.
    The ACYF is interested in supporting efforts to review the body of 
work in the field of post-legal adoption services; determining the 
number of projects which have continued beyond Federal funding and 
which are now an ongoing part of the agencies' programs; and determine 
the impact of these programs on preserving and maintaining the adoptive 
family unit.
    Information on funded projects can be obtained from the National 
Adoption Information Clearinghouse, 11426 Rockville Pike, suite 410, 
Rockville, Maryland 20852; telephone (301) 231-6512.
    Minimum Requirements for Project Design. In order to successfully 
compete under this priority area, the applicant should:

     Demonstrate an understanding of the literature and of the 
issues in post-legal adoption services.
     Describe how the findings from these projects would be 
analyzed and synthesized into reports which would be useful to the 
field.
     Describe how this report would be developed and would be 
useful to practitioners, policy makers and other related disciplines.
     Provide a plan for disseminating the report nationally.
     Provide assurances that the project would be staffed and 
implemented within 90 days of the notification of the grant award.
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
DC. (The Conference is held for Adoption Opportunities and other 
Children's Bureau grantees to exchange information and address current 
child welfare trends and issues.)

    Project Duration: The length of the project must not exceed 17 
months.
    Federal Share of Project Costs: The maximum Federal share of the 
project is $85,000.
    Matching or Cost Sharing Requirement: Grantee must provide at least 
25 percent of the total cost of the project.
    Anticipated Number of Projects to be Funded: It is anticipated that 
one project will be funded.
1.07  Regional Conference on the Adoption of Minority Children
    Eligible Applicants: State or local, public or nonprofit agencies, 
or organizations with experience in organizing a coordinated effort for 
sponsoring and conducting a Conference on the Adoption of Minority 
Children in one of the HHS Regions.
    Purpose: To support the planning for, and conduct of, a Regional 
Conference on the Adoption of Minority Children.
    Background Information: For the past two years, the ACYF has 
provided funds to its Regional Offices to conduct conferences in each 
Region which address issues in the adoption of minority children. 
Approximately 3,000 persons participated in the 2-day conferences. 
Because of the benefits and effectiveness of these conferences, 
participants requested that this effort be continued to build on 
established linkages and address issues across the regions. Successful 
applicants will work with the Regional Office to jointly plan the 
conference, arrange travel for participants and select a site. These 
conferences provide opportunities for agency directors, social workers, 
adoptive parents, volunteers and a broad range of other professionals 
to interact with adoption experts. Past conferences consisted of 
plenary and workshop sessions. These sessions focused on a variety of 
issues in agency practice and policies which create barriers to the 
adoption of minority children.
    Minimum Requirements for Project Design: In order to successfully 
compete under this priority area, the applicant should:

     Describe organization and management plans for planning 
the conference. Identify agencies, individuals, and organizations that 
would sponsor the conference and participate in its planning and 
implementation. Identify contributions expected from organizations in 
regard to personnel time and other costs.
     Discuss plans for identifying the conference site, 
including the availability of hotels, and conference space.
     Describe plans for developing the conference theme, 
proposed agenda topics and the forums to address critical issues in the 
field.
     Discuss the materials that would be included in a program 
packet/kit for the conference.
     Describe the steps to be taken to involve participants 
from various disciplines in the conference and the efforts that would 
be made to address racial, ethnic and cultural diversity.
     Describe plans for exhibits, resource tables, films and 
video tape forums.
     Propose a plan for evaluating the conference and describe 
how it would be conducted.

    Project Duration: The length of the project must not exceed 17 
months.
    Federal Share of Project Costs: The maximum Federal share is not to 
exceed $40,000.
    Matching or Cost Sharing Requirement: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects to be Funded: It is anticipated that 
ten projects will be funded, one in each HHS region. (These grants will 
be managed by the appropriate Regional Offices.)

1.08  Developing Collaborative Efforts between Foster Care and Adoption 
Staff to Improve Child Welfare Services From Intake to Permanency
    Eligible Applicants: Public State Child Welfare agencies in the 
Department of Health and Human Services Regions II (NY, PR, NJ, VI), 
III (DE, MD, VA, WV, PA, DC), IV (AL, FL, GA, KY, MS, NC, SC, TN), VII 
(MO, IA, NE, KS) and IX (HI, CA, NV and AZ) (Agencies in regions I, V, 
VI, VIII, and X were funded in FY 1993.) Only one agency per Federal 
Region will be awarded a grant.
    Purpose: To establish and improve collaboration and develop 
linkages between public child welfare agency foster care and adoption 
staff in order to improve practices related to one or more of the 
issues addressed in the Background section. The State that receives 
funding within its Region will be designated as the lead State. That 
State will assume responsibility for bringing together foster care and 
adoption staff in participating States within its Region to address 
effective intervention approaches to deal with placement issues.
    Background: It is the policy of all States to encourage adoption 
opportunities for children with special needs who lack permanent 
families and who could benefit from adoption. In most agencies, 
children enter the child welfare system through protective services 
units which determine whether the child is dependent, neglected or 
abandoned. Generally, children are placed temporarily in substitute 
care pending an assessment of the child's needs and the family's 
situation. When children are in substitute care, agencies must develop 
a case plan for each child and conduct periodic case reviews and 
dispositional hearings to monitor progress under the plan and to 
evaluate its appropriateness for attaining a permanent home.
    One of the three major issues to be addressed by projects funded 
under this priority area is the problem of many initially-temporary 
foster care and/or adoptive placements which ultimately become 
permanent. Over 60 percent of adopted special needs children have been 
adopted by their foster parents. Therefore, workers must consider this 
when selecting initial foster care placements. Consideration must be 
given to whether the best interests of the child would be served if the 
temporary placement becomes a permanent home. Attention must be given 
particularly to matters of race, ethnicity and culture. This is 
especially true for special needs children who may be older and aware 
of their cultural or ethnic histories, their siblings and their 
extended families.
    Recently, foster parents have resorted to the courts when children 
are removed from foster homes to be placed in adoptive homes that are 
determined by the social services agency to be more in the child's best 
interest. These cases generate a great deal of publicity and are very 
damaging to the children, who may be moved to yet another temporary 
placement until the court determines where the child is to permanently 
reside. The child welfare system must take responsibility for all 
placement decisions; therefore, better planning must be conducted to 
ensure that both the initial and the permanent placements for these 
children are timely and appropriate.
    A second issue to be addressed involves adopted children who 
require residential placements. These should be considered as interim 
placements in the hopes that the child will eventually return to the 
adoptive family. However, staff in residential facilities do not have 
access to training on adoption issues related to the child and the 
adoptive family. Consequently, staff may fail to work with families 
toward the reunification of the child with the family. Coordination 
needs to be effected among child welfare agencies and residential 
facilities to achieve comprehensive services for these children.
    A third issue which must be addressed is the organizational 
separation of foster care and adoption staff. This practice hinders 
communication, case planning and case management for children who move 
from foster care status to adoption status. Thus, barriers to 
permanency planning are created. The ACYF seeks proposals from States 
for projects which address the separation of foster care and adoption 
services within State agencies. States in each Federal Region will work 
together on issues and strategies to improve coordination of services 
to help resolve these issues through meetings, and the exchange of 
information and materials. The meetings should include appropriate 
agency staff who can plan and implement the necessary changes. The 
State agency in each Region which is awarded a grant will assume the 
leadership role of locating meeting sites, convening meetings, 
developing agendas and reporting on grant requirements. These three-
year grants will result in the development of a model of coordinated 
services designed and tested in each Region.
    Minimum Requirements for Project Design: In order to successfully 
compete under this priority area, the applicant should:

     Focus on addressing one or more of the issues addressed in 
the background section.
     Provide letters of support for the project from a minimum 
of three States in the Region (which includes the State submitting the 
application) that would participate in the project.
     Describe the existing organization of foster care/adoption 
services in States within the Region and the need to develop and 
implement a new approach for these two functions to work together more 
effectively.
     Identify and describe existing barriers to coordination in 
practice and policy in the States that would participate in the 
project.
     Describe how the agencies would incorporate the results of 
the project into their ongoing programs and how these efforts would be 
continued beyond the period of Federal support.
     Provide assurances that at least one key person from the 
project would attend the annual Child Welfare Conference in Washington, 
DC. (The Conference is held for Adoption Opportunities and other 
Children's Bureau grantees to exchange information and address current 
child welfare trends and issues.)
     Provide assurance that the project would be staffed and 
implemented within 90 days of the notification of the grant award.
     Provide for an evaluation of the project and include a 
discussion of the proposed evaluation design. The evaluation should 
focus on child and family outcome measures (e.g., number of families 
recruited, number of children placed, disruption rates, etc.).

    Project Duration: The length of the project must not exceed 36 
months.
    Federal Share of Project Costs: The maximum Federal share is not to 
exceed $75,000 per 12-month project period.
    Matching or Cost Sharing Requirements: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects to be funded: It is anticipated that 
five projects will be funded, one in each Region of the Department of 
Health and Human Services that did not receive funding in FY 1993.
1.09  Field Initiated Proposals to Improve Adoption Services to 
Children with Special Needs
    Eligible Applicants: State, Regional or local public child welfare 
or adoption agencies and voluntary child welfare or adoption agencies 
or organizations.
    Purpose: To improve adoption services for children with special 
needs through activities which are not addressed elsewhere in this 
announcement. This priority area provides public and voluntary agencies 
and organizations involved in the adoption process with an opportunity 
to present innovative ideas for improving child welfare and adoption 
systems.
    Background Information: Public child welfare workers who provide 
adoption services are overburdened because of the shortage of staff and 
the increasing child welfare caseload. In many public agencies, 
adoption staff are expected to provide services not only to children 
with special needs and their potential adoptive families, but also to 
families requesting independent, inter-country and other types of 
adoption. There is also a growing need to provide post-legal adoption 
services to preserve adoptive families as well as an increasing 
responsibility for search and reunion services. This places substantial 
burdens on limited adoption agency resources which are needed to serve 
the special needs population.
    At any given time, approximately 50,000 children are legally free 
for adoption. Minority children continue to be over-represented among 
this group. Older children and sibling groups also continue to present 
unique challenges. Other sub-populations, such as drug-exposed infants 
and medically-fragile infants, will be or are currently testing the 
capacity of adoption programs. Innovative efforts, embodying the spirit 
of public-private partnerships, are needed to provide permanent 
adoptive homes to all waiting children.
    Because there are so many different issues that face the public and 
voluntary sectors, ACYF is requesting field-initiated proposals that 
address the most problematic areas in serving children with special 
needs for whom adoption is the plan. These proposals must be 
innovative; they cannot be a replication of a previous project or be 
responsive to other priority areas identified in this announcement.
    Minimum Requirements for Project Design: In order to compete 
successfully under this priority area, the applicant should:
     Describe the agency's current adoption program and the 
specific problem(s) that would be addressed.
     Describe the approach that would be used to alleviate the 
problem(s).
     Document that this is a new approach that has not been 
used before, based on a review of the literature and any other relevant 
sources.
     Provide specific written commitments from cooperating or 
collaborating agencies, if appropriate.
     Provide for an evaluation of the project and include a 
discussion of the proposed evaluation design. The evaluation should 
focus on child and family outcome measures (e.g., number of families 
recruited, number of children placed, disruption rates, etc.).
     Describe how the agency would incorporate successful 
results of the project into its ongoing program.
     Provide assurances that at least one key person from the 
project would attend the Child Welfare Conference in Washington, DC 
(The conference is held for Adoption Opportunities and other Children's 
Bureau grantees to exchange information and to address current child 
welfare trends and issues.).
     Provide assurances that the project would be staffed and 
implemented within 90 days of the notification of the grant award.
     Describe the reports and/or other products that would be 
developed under the project, including the types of information that 
would be presented and the steps that would be undertaken to 
disseminate and promote the utilization of project products and 
findings.
    Project Duration: The length of the project must not exceed 24 
months.
    Federal Share of Project Costs: The maximum Federal share of the 
project is not to exceed $150,000 per 12-month budget period.
    Matching or Cost Sharing Requirements: Grantees must provide at 
least 25 percent of the total cost of the project.
    Anticipated Number of Projects to be Funded: It is anticipated that 
seven projects will be funded.

Part III--Instructions for the Development and Submission of 
Applications

    This Part contains information and instructions for submitting 
applications in response to this announcement. Application forms are 
provided along with a checklist for assembling an application package. 
Please copy and use these forms in submitting an application.
    Potential applicants should read this section carefully in 
conjunction with the information contained within the specific priority 
area under which the application is to be submitted. The priority area 
descriptions are in Part II.

A. Required Notification of the State Single Point of Contact

    The Adoption Opportunities Program is covered under Executive Order 
12372, Intergovernmental Review of Federal Programs, and 45 CFR part 
100, Intergovernmental Review of Department of Health and Human 
Services Program and Activities. Under the Order, States may design 
their own processes for reviewing and commenting on proposed Federal 
assistance under covered programs.
    All States and territories, except Alabama, Alaska, Connecticut, 
Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana, Nebraska, 
Oklahoma, Oregon, Pennsylvania, Virginia, Washington, American Samoa 
and Palau, have elected to participate in the Executive Order process 
and have established State Single Point of Contact (SPOCs). Applicants 
from these seventeen (17) jurisdictions need take no action regarding 
E. O. 12372. Applicants for projects to be administered by Federally-
recognized Indian Tribes are also exempt from the requirements of E.O. 
12372. Otherwise, applicants should contact their SPOCs as soon as 
possible to alert them of the prospective applications and receive any 
necessary instructions. Applicants must submit any required material to 
the SPOCs as soon as possible so that the program office can obtain and 
review SPOC comments as part of the award process. It is imperative 
that the applicant submit all required materials, if any, to the SPOC 
and indicate the date of this submittal (or the date of contact if no 
submittal is required) on the Standard Form 424, item 16a.
    Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application 
deadline to comment on proposed new or competing continuation awards.
    SPOCs are encouraged to eliminate the submission of routine 
endorsements as official recommendations.
    Additionally, SPOCs are requested to clearly differentiate between 
mere advisory comments and those official State process recommendations 
which they intend to trigger the accommodate or explain rule.
    When comments are submitted directly to ACF, they should be 
addressed to:

ADDRESSES: Applications may be mailed to the Department of Health and 
Human Services Administration for Children and Families, Division of 
Discretionary Grants, 370 L'Enfant Promenade, SW., 6th Floor East, OFM/
DDG, Washington, DC 20447.
    Hand delivered applications are accepted during normal working 
hours of 8 a.m. to 4:30 p.m., Monday through Friday, on or prior to the 
established closing date at: Administration for Children and Families, 
Division of Discretionary Grants, 6th Floor OFM/DDG, 901 D Street, SW., 
Washington, DC 20447.
    A list of the Single Points of Contact for each State and Territory 
is included as Appendix B of this announcement.

B. Deadline for Submission of Applications

    Deadline: Applications shall be considered as meeting the announced 
deadline if they are either:
    1. Received on or before the deadline date at:

ADDRESSES: Applications may be mailed to the Department of Health and 
Human Services Administration for Children and Families, Division of 
Discretionary Grants, 370 L'Enfant Promenade, SW., 6th Floor East, OFM/
DDG, Washington, DC 20447.
    Hand delivered applications are accepted during normal working 
hours of 8 a.m. to 4:30 p.m., Monday through Friday, on or prior to the 
established closing date at: Administration for Children and Families, 
Division of Discretionary Grants, 6th Floor OFM/DDG, 901 D Street, SW., 
Washington, DC 20447.
    2. Sent on or before the deadline date and received by the granting 
agency in time for the independent review under DHHS GAM Chapter 1-62. 
(Applicants are cautioned to request a legibly dated U.S. Postal 
Service postmark or to obtain a legibly dated receipt from a commercial 
carrier or U.S. Postal Service. Private Metered postmarks shall not be 
acceptable as proof of timely mailing.)
    Late Applications: Applications which do not meet the criteria 
stated above are considered late applications. The granting agency 
shall notify each late applicant that its application will not be 
considered in the current competition.
    Extension of Deadlines: The granting agency may extend the deadline 
for all applicants because of acts of God such as floods, hurricanes, 
etc, or when there is a widespread disruption of the mails. However, if 
the granting agency does not extend the deadline for all applicants, it 
may not waive or extend the deadline for any applicants.

C. Instructions for Preparing the Application and Completing 
Application Forms

    The SF 424, 424A, 424B, and certifications have been reprinted for 
your convenience in preparing the application. See Appendix A. You 
should reproduce single-sided copies of these forms from the reprinted 
forms in the announcement, typing your information onto the copies. 
Please do not use forms directly from the Federal Register 
announcement, as they are printed on both sides of the page.
    Please prepare your application in accordance with the following 
instructions:
1. SF 424 Page 1, Application Cover Sheet
    Please read the following instructions before completing the 
application cover sheet. An explanation of each item is included. 
Complete only the items specified.
    Top of Page. Enter the single priority area number under which the 
application is being submitted. An application should be submitted 
under only one priority area.
    Item 1. Type of Submission--Preprinted on the form.
    Item 2. Date Submitted and Applicant Identifier--Date application 
is submitted to ACYF and applicant's own internal control number, if 
applicable.
    Item 3. Date Received By State--State use only (if applicable).
    Item 4. Date Received by Federal Agency--Leave blank.
    Item 5. Applicant Information
    Legal Name--Enter the legal name of the applicant organization. For 
applications developed jointly, enter the name of the lead organization 
only. There must be a single applicant for each application.
    Organizational Unit--Enter the name of the primary unit within the 
applicant organization which will actually carry out the project 
activity. Do not use the name of an individual as the applicant. If 
this is the same as the applicant organization, leave the 
organizational unit blank.
    Address--Enter the complete address that the organization actually 
uses to receive mail, since this is the address to which all 
correspondence will be sent. Do not include both street address and 
P.O. Box number unless both must be used in mailing.
    Name and telephone number of the person to be contacted on matters 
involving this application (give area code)--Enter the full name 
(including academic degree, if applicable) and telephone number of a 
person who can respond to questions about the application. This person 
should be accessible at the address given here and will receive all 
correspondence regarding the application.
    Item 6. Employer Identification Number (EIN)--Enter the employer 
identification number of the applicant organization, as assigned by the 
Internal Revenue Service, including, if known, the Central Registry 
System suffix.
    Item 7. Type of Applicant--Self-explanatory.
    Item 8. Type of Application--Preprinted on the form.
    Item 9. Name of Federal Agency--Preprinted on the form.
    Item 10. Catalog of Federal Domestic Assistance Number and Title--
Enter the Catalog of Federal Domestic Assistance (CFDA) number assigned 
to the program under which assistance is requested and its title, as 
indicated in the relevant priority area description.
    Item 11. Descriptive Title of Applicant's Project--Enter the 
project title. The title is generally short and is descriptive of the 
project, not the priority area title.
    Item 12. Areas Affected by Project--Enter the governmental unit 
where significant and meaningful impact could be observed. List only 
the largest unit or units affected, such as State, county, or city. If 
an entire unit is affected, list it rather than subunits.
    Item 13. Proposed Project--Enter the desired start date for the 
project and projected completion date.
    Item 14. Congressional District of Applicant/Project--Enter the 
number of the Congressional district where the applicant's principal 
office is located and the number of the Congressional district(s) where 
the project will be located. If statewide, a multi-State effort, or 
nationwide, enter 00.
    Items 15. Estimated Funding Levels 
    In completing 15a through 15f, the dollar amounts entered should 
reflect, for a 17 month or less project period, the total amount 
requested. If the proposed project period exceeds 17 months, enter only 
those dollar amounts needed for the first 12 months of the proposed 
project.
    Item 15a. Enter the amount of Federal funds requested in accordance 
with the preceding paragraph. This amount should be no greater than the 
maximum amount specified in the priority area description.
    Items 15b-e. Enter the amount(s) of funds from non-Federal sources 
that will be contributed to the proposed project. Items b-e are 
considered cost-sharing or matching funds. The value of third party in-
kind contributions should be included on appropriate lines as 
applicable. For more information regarding funding as well as 
exceptions to these rules, see Part II, Sections E and F, and the 
specific priority area description.
    Item 15f. Enter the estimated amount of income, if any, expected to 
be generated from the proposed project. Do not add or subtract this 
amount from the total project amount entered under item 15g. Describe 
the nature, source and anticipated use of this income in the Project 
Narrative Statement.
    Item 15g. Enter the sum of items 15a-15e.
    Item 16a. Is Application Subject to Review By State Executive Order 
12372 Process? Yes.--Enter the date the applicant contacted the SPOC 
regarding this application. Select the appropriate SPOC from the 
listing provided at the end of Part III. The review of the application 
is at the discretion of the SPOC. The SPOC will verify the date noted 
on the application. If there is a discrepancy in dates, the SPOC may 
request that the Federal agency delay any proposed funding until 
September 1993.
    Item 16b. Is Application Subject to Review By State Executive Order 
12372 Process? No.--Check the appropriate box if the application is not 
covered by E.O. 12372 or if the program has not been selected by the 
State for review.
    Item 17. Is the Applicant Delinquent on any Federal Debt?--Check 
the appropriate box. This question applies to the applicant 
organization, not the person who signs as the authorized 
representative. Categories of debt include audit disallowances, loans 
and taxes.
    Item 18. To the best of my knowledge and belief, all data in this 
application/ preapplication 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.
--To be signed by the authorized representative of the applicant. A 
copy of the governing body's authorization for signature of this 
application by this individual as the official representative must be 
on file in the applicant's office, and may be requested from the 
applicant.

    Item 18a-c. Typed Name of Authorized Representative, Title, 
Telephone Number--Enter the name, title and telephone number of the 
authorized representative of the applicant organization.
    Item 18d. Signature of Authorized Representative--Signature of the 
authorized representative named in Item 18a. At least one copy of the 
application must have an original signature. Use colored ink (not 
black) so that the original signature is easily identified.
    Item 18e. Date Signed--Enter the date the application was signed by 
the authorized representative.
2. SF 424A--Budget Information--Non-Construction Programs
    This is a form used by many Federal agencies. For this application, 
Sections A, B, C, E and F are to be completed. Section D does not need 
to be completed.
    Sections A and B should include the Federal as well as the non-
Federal funding for the proposed project covering (1) the total project 
period of 17 months or less or (2) the first year budget period, if the 
proposed project period exceeds 17 months.
    Section A--Budget Summary. This section includes a summary of the 
budget. On line 5, enter total Federal costs in column (e) and total 
non-Federal costs, including third party in-kind contributions, but not 
program income, in column (f). Enter the total of (e) and (f) in column 
(g).
    Section B--Budget Categories. This budget, which includes the 
Federal as well as non-Federal funding for the proposed project, covers 
(1) the total project period if the proposed project period is 17 
months or less or (2) the first year budget period if the proposed 
project period exceeds 17 months. It should relate to item 15g, total 
funding, on the SF 424. Under column (5), enter the total requirements 
for funds (Federal and non-Federal) by object class category.
    A separate itemized budget justification for each line item is 
required. The types of information to be included in the justification 
are indicated under each category. For multiple year projects, it is 
desirable to provide this information for each year of the project. The 
budget justification should immediately follow the second page of the 
SF 424A.
    Personnel--Line 6a. Enter the total costs of salaries and wages of 
applicant/grantee staff. Do not include the costs of consultants, which 
should be included on line 6h, Other.
    Justification: Identify the principal investigator or project 
director, if known. Specify by title or name the percentage of time 
allocated to the project, the individual annual salaries, and the cost 
to the project (both Federal and non-Federal) of the organization's 
staff who will be working on the project.
    Fringe Benefits--Line 6b. Enter the total cost of fringe benefits, 
unless treated as part of an approved indirect cost rate.
    Justification: Provide a break-down of amounts and percentages that 
comprise fringe benefit costs, such as health insurance, FICA, 
retirement insurance, etc.
    Travel--6c. Enter total costs of out-of-town travel (travel 
requiring per diem) for staff of the project. Do not enter costs for 
consultant's travel or local transportation, which should be included 
on Line 6h, Other.
    Justification: Include the name(s) of traveler(s), total number of 
trips, destinations, length of stay, transportation costs and 
subsistence allowances.
    Equipment--Line 6d. Enter the total costs of all equipment to be 
acquired by the project. Equipment is defined as non-expendable 
tangible personal property having a useful life of more than one year 
and an acquisition cost of $5,000 or more per unit. For all other 
applicants, the threshold for equipment is $500 or more per unit. The 
higher threshold for State and local governments became effective 
October 1, 1988, through the implementation of 45 CFR Part 92, Uniform 
Administrative Requirements for Grants and Cooperative Agreements to 
State and Local Governments.
    Justification: Equipment to be purchased with Federal funds must be 
justified. The equipment must be required to conduct the project, and 
the applicant organization or its subgrantees must not have the 
equipment or a reasonable facsimile available to the project. The 
justification also must contain plans for future use or disposal of the 
equipment after the project ends.
    Supplies--Line 6e. Enter the total costs of all tangible expendable 
personal property (supplies) other than those included on Line 6d.
    Justification: Specify general categories of supplies and their 
costs.
    Contractual--Line 6f. Enter the total costs of all contracts, 
including: (1) Procurement contracts (except those which belong on 
other lines such as equipment, supplies, etc.) and (2) contracts with 
secondary recipient organizations, including delegate agencies. Also 
include any contracts with organizations for the provision of technical 
assistance. Do not include payments to individuals on this line. If the 
name of the contractor, scope of work, and estimated total costs are 
not available or have not been negotiated, include on Line 6h, Other.
    Justification: Attach a list of contractors, indicating the names 
of the organizations, the purposes of the contracts, and the estimated 
dollar amounts of the awards as part of the budget justification. 
Whenever the applicant/grantee intends to delegate part or all of the 
program to another agency, the applicant/grantee must complete this 
section (Section B, Budget Categories) for each delegate agency by 
agency title, along with the supporting information. The total cost of 
all such agencies will be part of the amount shown on Line 6f. Provide 
backup documentation identifying the name of contractor, purpose of 
contract, and major cost elements. Applicants who anticipate 
procurements that will exceed $5,000 (non-governmental entities) or 
$25,000 (governmental entities) and are requesting an award without 
competition should include a sole source justification in the proposal 
which at a minimum should include the basis for contractor's selection, 
justification for lack of competition when competitive bids or offers 
are not obtained and basis for award cost or price.

    Note: Previous or past experience with a contractor is not 
sufficient justification for sole source.)

    Construction--Line 6g. Not applicable. New construction is not 
allowable.
    Other--Line 6h. Enter the total of all other costs. Where 
applicable, such costs may include, but are not limited to: insurance; 
medical and dental costs; noncontractual fees and travel paid directly 
to individual consultants; local transportation (all travel which does 
not require per diem is considered local travel); space and equipment 
rentals; printing and publication; computer use; training costs, 
including tuition and stipends; training service costs, including wage 
payments to individuals and supportive service payments; and staff 
development costs. Note that costs identified as miscellaneous and 
honoraria are not allowable.
    Justification: Specify the costs included.
    Total Direct Charges--Line 6i. Enter the total of Lines 6a through 
6h.
    Indirect Charges--6j. Enter the total amount of indirect charges 
(costs). If no indirect costs are requested, enter none. Generally, 
this line should be used when the applicant (except local governments) 
has a current indirect cost rate agreement approved by the Department 
of Health and Human Services or another Federal agency.
    Local and State governments should enter the amount of indirect 
costs determined in accordance with HHS requirements. When an indirect 
cost rate is requested, these costs are included in the indirect cost 
pool and should not be charged again as direct costs to the grant. In 
the case of training grants to other than State or local governments 
(as defined in title 45, Code of Federal Regulations, part 74), the 
Federal reimbursement of indirect costs will be limited to the lesser 
of the negotiated (or actual) indirect cost rate or 8 percent of the 
amount allowed for direct costs, exclusive of any equipment charges, 
rental of space, tuition and fees, post-doctoral training allowances, 
contractual items, and alterations and renovations.
    For training grant applications, the entry under line 6j should be 
the total indirect costs being charged to the project. The Federal 
share of indirect costs is calculated as shown above. The applicant's 
share is calculated as follows:
    (a) Calculate total project indirect costs (a) by applying the 
applicant's approved indirect cost rate to the total project (Federal 
and non-Federal) direct costs.
    (b) Calculate the Federal share of indirect costs (b) at 8 percent 
of the amount allowed for total project (Federal and non-Federal) 
direct costs exclusive of any equipment charges, rental of space, 
tuition and fees, post-doctoral training allowances, contractual items, 
and alterations and renovations.
    (c) Subtract (b) from (a). The remainder is what the applicant can 
claim as part of its matching cost contribution.
    Justification: Enclose a copy of the indirect cost rate agreement. 
Applicants subject to the limitation on the Federal reimbursement of 
indirect costs for training grants should specify this.
    Total--Line 6k. Enter the total amounts of lines 6i and 6j.
    Program Income--Line 7. Enter the estimated amount of income, if 
any, expected to be generated from this project. Do not add or subtract 
this amount from the total project amount.
    Justification: Describe the nature, source, and anticipated use of 
program income in the Program Narrative Statement.
    Section C--Non-Federal Resources. This section summarizes the 
amounts of non-Federal resources that will be applied to the grant. 
Enter this information on line 12 entitled Totals. In-kind 
contributions are defined in 45 CFR part 74, as property or services 
which benefit a grant-supported project or program and which are 
contributed by non-Federal third parties without charge to the grantee, 
the subgrantee, or a cost-type contractor under the grant or subgrant.
    Justification: Describe third party in-kind contributions, if 
included.
    Section D--Forecasted Cash Needs. Not applicable.
    Section E--Budget Estimate of Federal Funds Needed For Balance of 
the Project. This section should only be completed if the total project 
period exceeds 17 months.
    Totals--Line 20. For projects that will have more than one budget 
period, enter the estimated required Federal funds for the second 
budget period (months 13 through 24) under column (b) First. If a third 
budget period will be necessary, enter the Federal funds needed for 
months 25 through 36 under (c) Second. Columns (d) and (e) are not 
applicable in most instances, since ACF funding is almost always 
limited to a three-year maximum project period. Columns (d) and (e) 
would be used in the case of a 60 month project.
    Section F--Other Budget Information.
    Direct Charges--Line 21. Not applicable.
    Indirect Charges--Line 22. Enter the type of indirect rate 
(provisional, predetermined, final or fixed) that will be in effect 
during the funding period, the estimated amount of the base to which 
the rate is applied, and the total indirect expense.
    Remarks--Line 23. If the total project period exceeds 17 months, 
you must enter your proposed non-Federal share of the project budget 
for each of the remaining years of the project.
3. Project Summary Description
    Clearly mark this separate page with the applicant name as shown in 
item 5 of the SF 424, the priority area number as shown at the top of 
the SF 424, and the title of the project as shown in item 11 of the SF 
424. The summary description should not exceed 300 words. These 300 
words become part of the computer database on each project.
    Care should be taken to produce a summary description which 
accurately and concisely reflects the proposal. It should describe the 
objectives of the project, the approaches to be used and the outcomes 
expected. The description should also include a list of major products 
that will result from the proposed project, such as software packages, 
materials, management procedures, data collection instruments, training 
packages, or videos (please note that audiovisuals should be closed 
captioned). The project summary description, together with the 
information on the SF 424, will constitute the project abstract. It is 
the major source of information about the proposed project and is 
usually the first part of the application that the reviewers read in 
evaluating the application.
    At the bottom of the page, following the summary description, type 
up to 10 key words which best describe the proposed project, the 
service(s) involved and the target population(s) to be covered. These 
key words will be used for computerized information retrieval for 
specific types of funded projects.
4. Program Narrative Statement
    The Program Narrative Statement is a very important part of an 
application. It should be clear, concise, and address the specific 
requirements mentioned under the priority area description in Part II.
    The narrative should provide information concerning how the 
application meets the evaluation criteria (see Section C, Part II), 
using the following headings:
    (a) Objectives and Need for Assistance;
    (b) Approach; and
    (c) Results and Benefits Expected;
    (d) Staff Background and Organization's Experience.
    The specific information to be included under each of these 
headings is described in Section C of Part II, Evaluation Criteria.
    The narrative should be typed double-spaced on a single-side of an 
8\1/2\'' x 11'' plain white paper, with 1'' margins on all sides. All 
pages of the narrative (including charts, references/footnotes, tables, 
maps, exhibits, etc.) must be sequentially numbered, beginning with 
Objectives and Need for Assistance as page number one. Applicants 
should not submit reproductions of larger size paper, reduced to meet 
the size requirement.
    The length of the application, including the application forms and 
all attachments, should not exceed 60 pages. A page is a single side of 
an 8\1/2\'' x 11'' sheet of paper. Applicants are requested not to send 
pamphlets, brochures or other printed material along with their 
application as these pose xeroxing difficulties. These materials, if 
submitted, will not be included in the review process if they exceed 
the 60-page limit. Each page of the application will be counted to 
determine the total length.
5. Organizational Capability Statement
    The Organizational Capability Statement should consist of a brief 
(two to three pages) background description of how the applicant 
organization (or the unit within the organization that will have 
responsibility for the project) is organized, the types and quantity of 
services it provides, and/or the research and management capabilities 
it possesses. This description should cover capabilities not included 
in the Program Narrative Statement. It may include descriptions of any 
current or previous relevant experience, or describe the competence of 
the project team and its demonstrated ability to produce a final 
product that is readily comprehensible and usable. An organization 
chart showing the relationship of the project to the current 
organization should be included.
6. Part IV--Assurances/Certifications
    Applicants are required to file an SF 424B, Assurances--Non-
Construction Programs and the Certification Regarding Lobbying. Both 
must be signed and returned with the application. In addition, 
applicants must certify their compliance with: (1) Drug-Free Workplace 
Requirements; and (2) Debarment and Other Responsibilities. Copies of 
these assurances/certifications are reprinted at the end of this 
announcement and should be reproduced, as necessary. A duly authorized 
representative of the applicant organization must certify that the 
applicant is in compliance with these assurances/certifications. A 
signature on the SF 424 indicates compliance with the Drug Free 
Workplace Requirements, and Debarment and Other Responsibilities 
certifications.
    For research projects in which human subjects may be at risk, a 
Protection of Human Subjects Assurance may be required. If there is a 
question regarding the applicability of this assurance, contact the 
Office for Research Risks of the National Institutes of Health at (301) 
496-7041.

D. Checklist for a Complete Application

    The checklist below is for your use to ensure that your application 
package has been properly prepared.

--One original, signed and dated application, plus two copies. 
Applications for different priority areas are packaged separately;
--Application is from an organization which is eligible under the 
eligibility requirements defined in the priority area description 
(screening requirement);
--Application length does not exceed 60 pages, unless otherwise 
specified in the priority area description.

    A complete application consists of the following items in this 
order:

--Application for Federal Assistance (SF 424, REV 4-88);
--Budget Information--Non-Construction Programs (SF 424A, Rev 4-88);
--Budget justification for Section B--Budget Categories;
--Table of Contents;
--Letter from the Internal Revenue Service to prove non-profit status, 
if necessary;
--Copy of the applicant's approved indirect cost rate agreement, if 
appropriate;
--Project summary description and listing of key words;
--Program Narrative Statement (See Part II, Section C);
--Organizational capability statement, including an organization chart;
--Any appendices/attachments;
--Assurances--Non-Construction Programs (Standard Form 424B, REV 4-88);
--Certification Regarding Lobbying; and
--Certification of Protection of Human Subjects, if necessary.

E. The Application Package

    Each application package must include an original and two copies of 
the complete application. Each copy should be stapled securely (front 
and back if necessary) in the upper left-hand corner. All pages of the 
narrative (including charts, tables, maps, exhibits, etc.) must be 
sequentially numbered, beginning with page one. In order to facilitate 
handling, please do not use covers, binders or tabs. Do not include 
extraneous materials as attachments, such as agency promotion 
brochures, slides, tapes, film clips, minutes of meetings, survey 
instruments or articles of incorporation.
    Do not include a self-addressed, stamped acknowledgment card. All 
applicants will be notified automatically about the receipt of their 
application. If acknowledgment of receipt of your application is not 
received within eight weeks after the deadline date, please notify ACYF 
by telephone at (202) 690-8243 or 690-6297.

    Dated: April 18, 1994.
Olivia A. Golden,
Commissioner, Administration on Children, Youth and Families.
BILLING CODE 4184-04-P

TN02MY94.005


BILLING CODE 4184-O1-C

Instructions for the SF 424

    This is a standard form used by applicants as a required 
facesheet for preapplications and applications submitted for Federal 
assistance. It will be used by Federal agencies to obtain applicant 
certification that States which have established a review and 
comment procedure in response to Executive Order 12372 and have 
selected the program to be included in their process, have been 
given an opportunity to review the applicant's submission.

Item and Entry

    1. Self-explanatory.
    2. Date application submitted to Federal agency (or State if 
applicable) & applicant's control number (if applicable).
    3. State use only (if applicable).
    4. If this application is to continue or revise an existing 
award, enter present Federal identifier number. If for a new 
project, leave blank.
    5. Legal name of applicant, name of primary organizational unit 
which will undertake the assistance activity, complete address of 
the applicant, and name and telephone number of the person to 
contact on matters related to this application.
    6. Enter Employer Identification Number (EIN) as assigned by the 
Internal Revenue Service.
    7. Enter the appropriate letter in the space provided.
    8. Check appropriate box and enter appropriate letter(s) in the 
space(s) provided:

--``New'' means a new assistance award.
--``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's 
financial obligation or contingent liability from an existing 
obligation.

    9. Name of Federal agency from which assistance is being 
requested with this application.
    10. Use the Catalog of Federal Domestic Assistance number and 
title of the program under which assistance is requested.
    11. Enter a brief descriptive title of the project. If more than 
one program is involved, you should append an explanation on a 
separate sheet. If appropriate (e.g., construction or real property 
projects), attach a map showing project location. For 
preapplications, use a separate sheet to provide a summary 
description of this project.
    12. List only the largest political entities affected (e.g., 
State, counties, cities).
    13. Self-explanatory.
    14. List the applicant's Congressional District and any 
District(s) affected by the program or project.
    15. Amount requested or to be contributed during the first 
funding/budget period by each contributor. Value of in-kind 
contributions should be included on appropriate lines as applicable. 
If the action will result in a dollar change to an existing award, 
indicate only the amount of the change. For decreases, enclose the 
amounts in parentheses. If both basic and supplemental amounts are 
included, show breakdown on an attached sheet. For multiple program 
funding, use totals and show breakdown using same categories as item 
15.
    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.
    17. 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.
    18. To be signed by the authorized representative of the 
applicant. A copy of the governing body's authorization for your to 
sign this application as official representative must be on file in 
the applicant's office. (Certain Federal agencies may require that 
this authorization be submitted as part of the application.)

BILLING CODE 4184-01-P

TN02MY94.006


TN02MY94.007


BILLING CODE 4184-01-C

Instructions for the SF-424A

General Instructions

    This form is designed so that application can be made for funds 
from one or more grant programs. In preparing the budget, adhere to 
any existing Federal grantor agency guidelines which prescribe how 
and whether budgeted amounts should be separately shown for 
different functions or activities within the program. For some 
programs, grantor agencies may require budgets to be separately 
shown by function or activity. For other programs, grantor agencies 
may require a breakdown by function or activity. Sections A, B, C, 
and D should include budget estimates for the whole project except 
when applying for assistance which requires Federal authorization in 
annual or other funding period increments. In the latter case, 
Sections A, B, C, and D should provide the budget for the first 
budget period (usually a year) and Section E should present the need 
for Federal assistance in the subsequent budget periods. All 
applications should contain a breakdown by the object class 
categories shown in Lines a-k of Section B.

Section A. Budget Summary Lines 1-4, Columns (a) and (b)

    For applications pertaining to a single Federal grant program 
(Federal Domestic Assistance Catalog number) and not requiring a 
functional or activity breakdown, enter on Line 1 under Column (a) 
the catalog program title and the catalog number in Column (b).
    For applications pertaining to a single program requiring budget 
amounts by multiple functions or activities, enter the name of each 
activity or function on each line in Column (a), and enter the 
catalog number in Column (b). For applications pertaining to 
multiple programs where none of the programs require a breakdown by 
function or activity, enter the catalog program title on each line 
in Column (a) and the respective catalog number on each line in 
Column (b).
    For applications pertaining to multiple programs where one or 
more programs require a breakdown by function or activity, prepare a 
separate sheet for each program requiring the breakdown. Additional 
sheets should be used when one form doe not provide adequate space 
for all breakdown of data required. However, when more than one 
sheet is used, the first page should provide the summary totals by 
programs.
    Lines 1-4, Columns (c) through (g.)
    For new applications, leave Columns (c) and (d) blank. For each 
line entry in Columns (a) and (b), enter in Columns (e), (f), and 
(g) the appropriate amounts of funds needed to support the project 
for the first funding period (usually a year).
    For continuing grant program applications, submit these forms 
before the end of each funding period as required by the grantor 
agency. Enter in Columns (c) and (d) the estimated amounts of funds 
which will remain unobligated at the end of the grant funding period 
only if the Federal grantor agency instructions provide for this. 
Otherwise, leave these columns blank. Enter in columns (e) and (f) 
the amounts of funds needed for the upcoming period. The amount(s) 
in Column (g) should be the sum of amounts in Columns (e) and (f).
    For supplemental grants and changes to existing grants, do not 
use Columns (c) and (d). Enter in Column (e) the amount of the 
increase or decrease of Federal funds and enter in Column (f) the 
amount of the increase or decrease of non-Federal funds. In Column 
(g) enter the new total budgeted amount (Federal and non-Federal) 
which includes the total previous authorized budgeted amounts plus 
or minus, as appropriate, the amounts shown in Columns (e) and (f). 
The amount(s) in Column (g) should not equal the sum of amounts in 
Columns (e) and (f).
    Line 5--Show the totals for all columns used.

Section B. Budget Categories

    In the column headings (1) through (4), enter the titles of the 
same programs, functions, and activities shown on Lines 1-4, Column 
(a), Section A. When additional sheets are prepared for Section A, 
provide similar column headings on each sheet. For each program, 
function or activity, fill in the total requirements for funds (both 
Federal and non-Federal) by object class categories.
    Lines 6a-i--Show the totals of Lines 6a to 6h in each column.
    Line 6j--Show the amount of indirect cost.
    Line 6k--Enter the total of amounts on Lines 6i and 6j. For all 
applications for new grants and continuation grants the total amount 
in column (5), Line 6k, should be the same as the total amount shown 
in Section A, Column (g), Line 5. For supplemental grants and 
changes to grants, the total amount of the increase or decrease as 
shown in Columns (1)-(4), Line 6k should be the same as the sum of 
the amounts in Section A, Columns (e) and (f) on Line 5.
    Line 7--Enter the estimated amount of income, if any, expected 
to be generated from this project. Do not add or subtract this 
amount from the total project amount. Show under the program 
narrative statement the nature and source of income. The estimated 
amount of program income may be considered by the federal grantor 
agency in determining the total amount of the grant.

Section C. Non-Federal-Resources

    Lines 8-11--Enter amounts of non-Federal resources that will be 
used on the grant. If in-kind contributions are included, provide a 
brief explanation on a separate sheet.
    Column (a)--Enter the program titles identical to Column (a), 
Section A. A breakdown by function or activity is not necessary.
    Columb (b)--Enter the contribution to be made by the applicant.
    Column (c)--Enter the amount of the State's cash and in-kind 
contribution if the applicant is not a State or State agency. 
Applicants which are a State or State agencies should leave this 
column blank.
    Column (d)--Enter the amount of cash and inkind contributions to 
be made from all other sources.
    Column (e)--Enter totals of Columns (b), (c), and (d).
    Line 12--Enter the total for each of Columns (b)-(e). The amount 
in Column (e) should be equal to the amount on Line 5, Column (f), 
Section A.

Section D. Forecasted Cash Needs

    Line 13--Enter the amount of cash needed by quarter from the 
grantor agency during the first year.
    Line 14--Enter the amount of cash from all other sources needed 
by quarter during the first year.
    Line 15--Enter the totals of amounts on Line 13 and 14.

Section E. Budget Estimates of Federal Funds Needed for Balance of the 
Project

    Lines 16-19--Enter in Column (a) the same grant program titles 
shown in Column (a), Section A. A breakdown by function or activity 
is not necessary. For new applications and continuation grant 
applications, enter in the proper columns amounts of Federal funds 
which will be needed to complete the program or project over the 
succeeding funding periods (usually in years). This section need not 
be completed for revisions (amendments, changes, or supplements) to 
funds for the current year of existing grants.
    If more than four lines are needed to list the program titles, 
submit additional schedules as necessary.
    Line 20--Enter the total for each of the Columns (b)-(e). When 
additional schedules are prepared for this Section, annotate 
accordingly and show the overall totals on this line.

Section F. Other Budget Information

    Line 21--Use this space to explain amounts for individual direct 
object-class cost categories that may appear to be out of the 
ordinary or to explain the details as required by the Federal 
grantor agency.
    Line 22--Enter the type of indirect rate (provisional, 
predetermined, final or fixed) that will be in effect during the 
funding period, the estimated amount of the base to which the rate 
is applied, and the total indirect expense.
    Line 23--Provide any other explanations or comments deemed 
necessary.

Assurances--Non-Construction Programs

    Note: Certain of these assurances may not be applicable to your 
project or program. If you have questions, please contact the 
awarding agency. Further, certain Federal awarding agencies may 
require applicants to certify to additional assurances. If such is 
the case, you will be notified.
    As the duly authorized representative of the applicant I certify 
that the applicant:
    1. Has the legal authority to apply for Federal assistance, and 
the institutional, managerial and financial capability (including 
funds sufficient to pay the non-Federal share of project costs) to 
ensure proper planning, management and completion of the project 
described in this application.
    2. Will give the awarding agency, the Comptroller General of the 
United States, and if appropriate, the State, through any authorized 
representative, access to and the right to examine all records, 
books, papers, or documents related to the award; and will establish 
a proper accounting system in accordance with generally accepted 
accounting standards or agency directives.
    3. Will establish safeguards to prohibit employees from using 
their positions for a purpose that constitutes or presents the 
appearance of personal or organizational conflict of interest, or 
personal gain.
    4. Will initiate and complete the work within the applicable 
time frame after receipt of approval of the awarding agency.
    5. Will comply with the Intergovernmental Personnel Act of 1970 
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for 
merit systems for programs funded under one of the nineteen statutes 
or regulations specified in Appendix A of OPM's Standards for a 
Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
    6. Will comply with all Federal statutes relating to 
nondiscrimination. These include but are not limited to: (a) Title 
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits 
discrimination on the basis of race, color or national origin; (b) 
Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on 
the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, 
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on 
the basis of handicaps; (d) the Age Discrimination Act of 1975, as 
amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination 
on the basis of age; (e) the Drug Abuse Office and Treatment Act of 
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the 
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 
(P.L. 91-616), as amended, relating to nondiscrimination on the 
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the 
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), 
as amended, relating to confidentiality of alcohol and drug abuse 
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 
U.S.C. Sec. 3601 et seq.), as amended, relating to nondiscrimination 
in the sale, rental or financing of housing; (i) any other 
nondiscrimination provisions in the specific statute(s) under which 
application for Federal assistance is being made; and (j) the 
requirements of any other nondiscrimination statute(s) which may 
apply to the application.
    7. Will comply, or has already complied, with the requirements 
of Titles II and III of the Uniform Relocation Assistance and Real 
Property Acquisition Policies Act of 1970 (P.L. 91-646) which 
provide for fair and equitable treatment of persons displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property acquired for project purposes regardless of Federal 
participation in purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
Secs. 1501-1508 and 7324-7328) which limit the political activities 
of employees whose principal employment activities are funded in 
whole or in part with Federal funds.
    9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40 
U.S.C. Sec. 276c and 18 U.S.C. Secs. 874), and the Contract Work 
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding 
labor standards for federally assisted construction subagreements.
    10. Will comply, if applicable, with flood insurance purchase 
requirements of Section 102(a) of the Flood Disaster Protection Act 
of 1973 (P.L. 93-234) which requires recipients in a special flood 
hazard area to participate in the program and to purchase flood 
insurance if the total cost of insurable construction and 
acquisition is $10,000 or more.
    11. Will comply with environmental standards which may be 
prescribed pursuant to the following: (a) institution of 
environmental quality control measures under the National 
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order 
(EO) 11514; (b) notification of violating facilities pursuant to EO 
11738; (c) protection of wetlands pursuant to EO 11990; (d) 
evaluation of flood hazards in floodplains in accordance with EO 
11988; (e) assurance of project conspiracy with the approved State 
management program developed under the Coastal Zone Management Act 
of 1972 (16 U.S.C. Secs.  1451 et seq.); (f) conformity of Federal 
actions to State (Clear Air) Implementation Plans under Section 
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. Sec. 7401 
et seq.); (g) protection of underground sources of drinking water 
under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered 
Species Act of 1973, as amended, (P.L. 93-205).
    12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
U.S.C. Secs. 1271 et seq.) related to protecting components or 
potential components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 470), EO 11593 (identification and protection of 
historic properties), and the Archaeological and Historic 
Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
    14. Will comply with P.L. 93-348 regarding the protection of 
human subjects involved in research, development, and related 
activities supported by this award of assistance.
    15. Will comply with the Laboratory Animal Welfare Act of 1966 
(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the 
care, handling, and treatment of warm blooded animals held for 
research, teaching, or other activities supported by this award of 
assistance.
    16. Will comply with the Lead-Based Paint Poisoning Prevention 
Act (42 U.S.C. Secs.  4801 et seq.) which prohibits the use of lead 
based paint in construction or rehabilitation of residence 
structures.
    17. Will cause to be performed the required financial and 
compliance audits in accordance with the Single Audit Act of 1984.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.
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Signature of Authorized Certifying Official
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Title
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Applicant Organization
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Date Submitted

Appendix B

Executive Order 12372--State Single Points of Contact

Arizona

Mrs. Janice Dunn, ATTN: Arizona State Clearinghouse, 3800 N. Central 
Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315

Arkansas

Tracie L. Copeland, Manager, State Clearinghouse, Office of 
Intergovernmental Services, Department of Finance and 
Administration, P.O. Box 3278, Little Rock, Arkansas 72203, 
Telephone (501) 682-1074

California

Glenn Stober, Grants Coordinator, Office of Planning and Research, 
1400 Tenth Street, Sacramento, California 95814, Telephone (916) 
323-7480

Colorado

State Single Point of Contact, State Clearinghouse, Division of 
Local Government, 1313 Sherman Street, Room 520, Denver, Colorado 
80203, Telephone (303) 866-2156

Delaware

Ms. Francine Booth, State Single Point of Contact, Executive 
Department, Thomas Collins Building, Dover, Delaware 19903, 
Telephone (302) 736-3326

District of Columbia

Rodney T. Hallman, State Single Point of Contact, Office of Grants 
Management and Development, 717 14th Street, N.W., Suite 500, 
Washington, D.C. 20005, Telephone (202) 727-6551

Florida

Florida State Clearinghouse, Intergovernmental Affairs Policy Unit, 
Executive Office of the Governor, Office of Planning and Budgeting, 
The Capitol, Tallahassee, Florida 32399-0001, Telephone (904) 488-
8441

Georgia

Mr. Charles H. Badger, Administrator, Georgia State Clearinghouse, 
254 Washington Street, S.W., Atlanta, Georgia 30334, Telephone (404) 
656-3855

Illinois

Steve Klokkenga, State Single Point of Contact, Office of the 
Governor, 107 Stratton Building, Springfield, Illinois 62706, 
Telephone (217) 782-1671

Indiana

Jean S. Blackwell, Budget Director, State Budget Agency, 212 State 
House, Indianapolis, Indiana 46204, Telephone (317) 232-5610

Iowa

Mr. Steven R. McCann, Division of Community Progress, Iowa 
Department of Economic Development, 200 East Grand Avenue, Des 
Moines, Iowa 50309, Telephone (515) 281-3725

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local 
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601, 
Telephone (502) 564-2382

Maine

Ms. Joyce Benson, State Planning Office, State House Station #38, 
Augusta, Maine 04333, Telephone (207) 289-3261

Maryland

Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of 
State Planning, 301 West Preston Street, Baltimore, Maryland 21201-
2365, Telephone (301) 225-4490

Massachusetts

Karen Arone, State Clearinghouse, Executive Office of Communities 
and Development, 100 Cambridge Street, Room 1803, Boston, 
Massachusetts 02202, Telephone (617) 727-7001

Michigan

Richard S. Pastula, Director, Michigan Department of Commerce, 
Lansing, Michigan 48909, Telephone (517) 373-7356

Mississippi

Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant 
Management and Reporting, 301 West Pearl Street, Jackson, 
Mississippi 39203, Telephone (601) 960-2174

Missouri

Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of 
Administration, P.O. Box 809, Room 430, Truman Building, Jefferson 
City, Missouri 65102, Telephone (314) 751-4834

Nevada

Department of Administration, State Clearinghouse, Capitol Complex, 
Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron 
Sparks, Clearinghouse Coordinator

New Hampshire

Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State 
Planning, Attn: Intergovernmental Review, Process/James E. Bieber, 
2\1/2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 
271-2155

New Jersey

Gregory W. Adkins, Acting Director, Division of Community Resources, 
N.J. Department of Community Affairs, Trenton, New Jersey 08625-
0803, Telephone (609) 292-6613

    Please direct correspondence and questions to: Andrew J. 
Jaskolka, State Review Process, Division of Community Resources, CN 
814, Room 609, Trenton, New Jersey 08625-0803, Telephone (609) 292-
9025.

New Mexico

George Elliott, Deputy Director, State Budget Division, Room 190, 
Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone 
(505) 827-3640, FAX (505) 827-3006

New York

New York State Clearinghouse, Division of the Budget, State Capitol, 
Albany, New York 12224, Telephone (518) 474-1605

North Carolina

Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., 
N.C. State Clearinghouse, 116 W. Jones Street, Raleigh, North 
Carolina 27603-8003, Telephone (919) 733-7232

North Dakota

N.D. Single Point of Contact, Office of Intergovernmental 
Assistance, Office of Management and Budget, 600 East Boulevard 
Avenue, Bismarck, North Dakota 58505-0170, Telephone (701) 224-2094

Ohio

Larry Weaver, State Single Point of Contact, State/Federal Funds 
Coordinator, State Clearinghouse, Office of Budget and Management, 
30 East Broad Street, 34th Floor, Columbus, Ohio 43266-0411, 
Telephone (614) 466-0698

Rhode Island

Mr. Daniel W. Varin, Associate Director, Statewide Planning Program, 
Department of Administration, Division of Planning, 265 Melrose 
Street, Providence, Rhode Island 02907, Telephone (401) 277-2656

    Please direct correspondence and questions to: Review 
Coordinator, Office of Strategic Planning.

South Carolina

Omeagia Burgess, State Single Point of Contact, Grant Services, 
Office of the Governor, 1205 Pendleton Street, Room 477, Columbia, 
South Carolina 29201, Telephone (803) 734-0494

South Dakota

Ms. Susan Comer, State Clearinghouse Coordinator, Office of the 
Governor, 500 East Capitol, Pierre, South Dakota 57501, Telephone 
(605) 773-3212

Tennessee

Mr. Charles Brown, State Single Point of Contact, State Planning 
Office, 500 Charlotte Avenue, 309 John Sevier Building, Nashville, 
Tennessee 37219, Telephone (615) 741-1676

Texas

Mr. Thomas Adams, Governor's Office of Budget and Planning, P.O. Box 
12428, Austin, Texas 78711, Telephone (512) 463-1778

Utah

Utah State Clearinghouse, Office of Planning and Budget, ATTN: 
Carolyn Wright, Room 116 State Capitol, Salt Lake City, Utah 84114, 
Telephone (801) 538-1535

Vermont

Mr. Bernard D. Johnson, Assistant Director, Office of Policy 
Research & Coordination, Pavilion Office Building, 109 State Street, 
Montpelier, Vermont 05602, Telephone (802) 828-3326

West Virginia

Mr. Fred Cutlip, Director, Community Development Division, West 
Virginia Development Office, Building #6, Room 553, Charleston, West 
Virginia 25305, Telephone (304) 348-4010

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department 
of Administration, 101 South Webster Street, P.O. Box 7864, Madison, 
Wisconsin 53707, Telephone (608) 266-0267

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building, 
4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-
7574

Guam

Mr. Michael J. Reidy, Director, Bureau of Budget and Management 
Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96910, 
Telephone (671) 472-2285

Northern Mariana Islands

State Single Point of Contact, Planning and Budget Office, Office of 
the Governor, Saipan, CM, Northern Mariana Islands 96950

Puerto Rico

Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning 
Board, Minillas Government Center, P.O. Box 41119, San Juan, Puerto 
Rico 00940-9985, Telephone (809) 727-4444

Virgin Islands

Jose L. George, Director, Office of Management and Budget, #41 
Norregade Emanicipation Garden Station, Second Floor, Saint Thomas, 
Virgin Islands 00802

    Please direct correspondence to: Linda Clarke, Telephone (809) 
774-0750

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Appendix D

Certification Regarding Debarment, Suspension, and Other 
Responsibility Matters--Primary Covered Transactions

    By signing and submitting this proposal, the applicant, defined 
as the primary participant in accordance with 45 CFR Part 76, 
certifies to the best of its knowledge and believe that it and its 
principals:
    (a) are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded from covered 
transactions by any Federal Department or agency;
    (b) have not within a 3-year period preceding this proposal been 
convicted of or had a civil judgment rendered against them for 
commission of fraud or a criminal offense in connection with 
obtaining, attempting to obtain, or performing a public (Federal, 
State, or local) transaction or contract under a public transaction; 
violation of Federal or State antitrust statutes or commission of 
embezzlement, theft, forgery, bribery, falsification or destruction 
of records, making false statements, or receiving stolen property;
    (c) are not presently indicted or otherwise criminally or 
civilly charged by a governmental entity (Federal, State or local) 
with commission of any of the offenses enumerated in paragraph (1) 
(b) of this certification; and
    (d) have not within a 3-year period preceding this application/
proposal had one or more public transactions (Federal, State, or 
local) terminated for cause or default.
    The inability of a person to provide the certification required 
above will not necessarily result in denial of participation in this 
covered transaction. If necessary, the prospective participant shall 
submit an explanation of why it cannot provide the certification. 
The certification or explanation will be considered in connection 
with the Department of Health and Human Services (HHS) determination 
whether to enter into this transaction. However, failure of the 
prospective primary participant to furnish a certification or an 
explanation shall disqualify such person from participation in this 
transaction.
    The prospective primary participant agrees that by submitting 
this proposal, it will include the clause entitled ``Certification 
Regarding Debarment, Suspension, Ineligibility, and Voluntary 
Exclusion--Lower Tier Covered Transaction.'' provided below without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.

Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion--Lower Tier Covered Transactions

(To Be Supplied to Lower Tire Participants)

    By signing and submitting this lower tier proposal, the 
prospective lower tier participant, as defined in 45 CFR Part 76, 
certifies to the best of its knowledge and belief that it and its 
principals:
    (a) are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded from 
participation in this transaction by any federal department or 
agency.
    (b) where the prospective lower tier participant is unable to 
certify to any of the above, such prospective participant shall 
attach an explanation to this proposal.
    The prospective lower tier participant further agrees by 
submitting this proposal that it will include this clause entitled 
``certification Regarding Debarment, Suspension, Ineligibility, and 
Voluntary Exclusion--Lower Tier Covered Transactions. ``Without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.

Appendix E--Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative 
Agreements

    The undersigned certifies, to the best of his or her knowledge 
and belief, that:
    (1) No Federal appropriated funds have been paid or will be 
paid, by or on behalf of the undersigned, to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or 
an employee of a Member of Congress in connection with the awarding 
of any Federal contract, the making of any Federal grant, the making 
of any Federal loan, the entering into of any cooperative agreement, 
and the extension, continuation, renewal, amendment, or modification 
of any Federal contract, grant, loan, or cooperative agreement.
    (2) If any funds other than Federal appropriated funds have been 
paid or will be paid to any person for influencing or attempting to 
influence an officer or employee of any agency, a Member of 
Congress, an officer or employee of Congress, or an employee of a 
Member of Congress in connection with this Federal contract, grant, 
loan or cooperative agreement, the undersigned shall complete and 
submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in 
accordance with its instructions.
    (3) The undersigned shall require that the language of this 
certification be included in the award documents for all subawards 
at all tiers (including subcontracts, subgrants, and contracts under 
grants, loans, and cooperative agreements) and that all 
subrecipients shall certify and disclose accordingly.
    This certification is a material representation of fact upon 
which reliance was placed when this transaction was made or entered 
into. Submission of this certification is a prerequisite for making 
or entering into this transaction imposed by section 1352, title 31, 
U.S. Code. Any person who fails to file the required certification 
shall be subject to a civil penalty of not less than $10,000 and not 
more than $100,000 for each such failure.

State for Loan Guarantee and Loan Insurance

    The undersigned states, to the best of his or her knowledge and 
belief, that:
    If any funds have been paid or will be paid to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or 
an employee of a Member of Congress in connection with this 
commitment providing for the United States to insure or guarantee a 
loan, the undersigned shall complete and submit Standard Form-LLL 
``Disclosure Form to Report Lobbying,'' in accordance with its 
instructions.
    Submission of this statement is a prerequisite for making or 
entering into this transaction imposed by section 1352, title 31, 
U.S. Code. Any person who fails to file the required statement shall 
be subject to a civil penalty of not less than $10,000 and not more 
than $100,000 for each such failure.

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    Signature
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    Title
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    Organization
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    Date

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[FR Doc. 94-10209 Filed 4-29-94; 8:45 am]
BILLING CODE 4184-01-C