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I <br />I <br /> <br /> I <br /> I <br /> <br />I <br />I <br />I <br /> <br />I <br /> <br />I <br /> <br />Page 2 <br />CDBG Request Form <br />City of Ramsey <br />Name of Organization <br /> <br />North Anoka Meals on Whee%$ <br /> <br /> Does your organization serve Iow to moderate income families or individuals? If you answer no, <br /> your organization is not eligible to receive CDBG funds. <br /> <br /> x Yes No <br /> <br />What percentage of persons served are low/moderate income individua/s? <br /> <br /> . ,80 % <br /> <br />What percentage of Iow/moderate income persons served are Ramsey residents.'? <br /> <br /> · t5 % <br /> <br />Will these funds be used for an expansion of an existing program? <br /> Yes x No <br /> <br />Will these funds be used for the creation of a new program? <br /> Yes x No <br /> <br />PLEASE PROVIDE THE FOI J .OWING I]W'FORMATIC' ,1' WITH YOUR APPLICATION: <br /> <br /> ,r 199~' organization budget ~ ~'' c <br /> <br /> . ,~ Proposed budget for CDBG funds <br /> ,~ Schedule for expenditure of CDBG funds <br /> ,, Name of individual(s) authorized to receive CDBG reimbursement checks <br /> <br /> ~ A copy of the organization's articles of incorporation <br /> <br /> <br />