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Page 2 <br />CDBG Request Form <br />City of Ramsey <br />Name of Organization <br /> <br />ACCAP <br /> <br />Does your organization serve low to moderate income families or individuals? <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 individuals? <br /> <br /> over 80% <br /> <br />What percentage of low/moderate income persons served are Ramsey residents? <br /> <br /> 100% % <br /> <br />Will these funds be used for an expansion of an existing program? <br /> <br /> x Yes No <br /> <br />Will these funds be used for the creation of a new program? <br /> <br /> Yes x No <br /> <br />PLEASE PROVIDE THE FOLLOWING INFORMATION WITH YOUR APPLICATION: <br /> <br />enlcosed <br />enclosed <br />enclosed <br /> <br />enclosed <br />enclosed <br /> <br />1997 organization budget <br /> <br />Proposed budget for CDBG funds <br /> <br />Schedule for expenditure of CDBG funds <br /> <br />Name of individual(s) authorized to receive CDBG reimbursement checks <br />A copy of the organization's articles of incorporation <br /> <br />If you answer no, <br /> <br /> <br />