Your Information Prefix: Please Select PrefixMs.MissMrs.Mx.Mr.Mr. and Mrs.Rev.Dr.The HonorableRabbi First Name: MI: Last Name: Organization Suffix: Street Address: Street Address Continued: City: State: Zip: Email: Community Project Project Request Apprpriations Subcommitteee Please Select Appropriations SubcommitteeeInterior, Environment, and Related AgenciesEnergy and Water Development, and Related AgenciesCommerce, Justice, Science, and Related AgenciesDefenseMilitary Construction, Veterans Affairs, and Related AgenciesFinancial Services and General GovernmentHomeland SecurityState, Foreign Operations, and Related ProgramsLabor, Health and Human Services, Education, and Related AgenciesAgriculture, Rural Development, Food and Drug Administration, and Related AgenciesLegislative BranchTransportation, Housing and Urban Development Is the funding requested by a governmental entity, or a non-profit organization as described under section501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such code?: Please SelectGovernmental EntityNon-Profit Organization Positive Impact for California's Third District:* Funding Amount Requested Total Cost Requested Total Cost to Complete Project (federal and non-federal funds Description of Funds Available from Other Sources for Project (amount, description of source(s), and whether that funding is already secured)* Have you submitted this request to another Congressional office? If so, please list: Please list any stakeholder groups or elected officials who support the request: Have you submitted this request to another Congressional office? If so, please list: Please list any stakeholder groups or elected officials who support the request: Is the requestor currently in material non-compliance of a prior grant award made by the proposed Federal funding agency?: Please SelectYesNo Can the project obligate all requested funds by no later than 12 months after enactment of the Appropriations Act?: Please SelectYesNo If the Appropriations Committee is not able to provide the full amount of funding requested, can this project spend a smaller amount of appropriated funds within 12 months of the enactment of the Appropriations Act?: Please SelectYesNo Estimated Project Start Date Estimated project completion date: Please describe the current developmental status of this project: Please disclose whether the project is being requested in another Appropriations bill. If yes, which one(s)?: Submit
