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Page 2 <br />CT)BO Request Form <br />City of Ra_msey <br />Name of Organization <br /> <br />I <br />I <br /> <br />boas your organization se~, !ow to mode:., ate income femilies or individuals? If you answer no, <br />.,,out'organization is not eligible to receive ~BG fund~, <br /> t'/ Ye ' No <br /> <br />'~, 7hat percentt.~e of persons z:~r,,,ed are Iow(moderate inc :;me individr 'is? <br /> <br />W:L'I these fm :,k; be used fo~,' al expansion c>f an existing program? <br /> <br /> ¥~,~ <br /> <br />.No <br /> <br />W/Il these funds be used f'c:" the creation ,~f a new pro% -m? <br /> Yes <br /> <br />No <br /> <br />PLEASE PRCirlDE THE X OLLOWIN~ ]q'FORMAT;ON WITH '70UR APPLICATION: <br /> X// l~99organization budge~ <br /> '~'/ Proposed budget for C-'DE ~ funds <br /> k//_ Schedule for expenditure of CDBG funds ' ' <br /> 'k~ Name of individual(s) aufl~orized to receive CDBG reimbursement checks' <br /> <br />A copy of the organization's articles of incorporation <br /> <br /> <br />