Form SF-424 "Application for Federal Assistance"

What Is Form SF-424?

This is a legal form that was released by the U.S. Department of the Treasury and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest available edition released by the U.S. Department of the Treasury;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form SF-424 by clicking the link below or browse more documents and templates provided by the U.S. Department of the Treasury.

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Download Form SF-424 "Application for Federal Assistance"

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OMB Number: 4040-0004
Expiration Date: 12/31/2022
Application for Federal Assistance SF-424
* 1. Type of Submission:
* 2. Type of Application:
* If Revision, select appropriate letter(s):
Preapplication
New
* Other (Specify):
Application
Continuation
Changed/Corrected Application
Revision
* 3. Date Received:
4. Applicant Identifier:
5a. Federal Entity Identifier:
5b. Federal Award Identifier:
State Use Only:
6. Date Received by State:
7. State Application Identifier:
8. APPLICANT INFORMATION:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN):
* c. Organizational DUNS:
d. Address:
* Street1:
Street2:
* City:
County/Parish:
* State:
Province:
* Country:
USA: UNITED STATES
* Zip / Postal Code:
e. Organizational Unit:
Department Name:
Division Name:
f. Name and contact information of person to be contacted on matters involving this application:
Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
Title:
Organizational Affiliation:
* Telephone Number:
Fax Number:
* Email:
OMB Number: 4040-0004
Expiration Date: 12/31/2022
Application for Federal Assistance SF-424
* 1. Type of Submission:
* 2. Type of Application:
* If Revision, select appropriate letter(s):
Preapplication
New
* Other (Specify):
Application
Continuation
Changed/Corrected Application
Revision
* 3. Date Received:
4. Applicant Identifier:
5a. Federal Entity Identifier:
5b. Federal Award Identifier:
State Use Only:
6. Date Received by State:
7. State Application Identifier:
8. APPLICANT INFORMATION:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN):
* c. Organizational DUNS:
d. Address:
* Street1:
Street2:
* City:
County/Parish:
* State:
Province:
* Country:
USA: UNITED STATES
* Zip / Postal Code:
e. Organizational Unit:
Department Name:
Division Name:
f. Name and contact information of person to be contacted on matters involving this application:
Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
Title:
Organizational Affiliation:
* Telephone Number:
Fax Number:
* Email:
Application for Federal Assistance SF-424
* 9. Type of Applicant 1: Select Applicant Type:
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
* Other (specify):
* 10. Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
CFDA Title:
* 12. Funding Opportunity Number:
* Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
Add Attachment
Delete Attachment
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* 15. Descriptive Title of Applicant's Project:
Attach supporting documents as specified in agency instructions.
Add Attachments
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Application for Federal Assistance SF-424
16. Congressional Districts Of:
* a. Applicant
* b. Program/Project
Attach an additional list of Program/Project Congressional Districts if needed.
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17. Proposed Project:
* a. Start Date:
* b. End Date:
18. Estimated Funding ($):
* a. Federal
* b. Applicant
* c. State
* d. Local
* e. Other
* f. Program Income
* g. TOTAL
* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
.
a. This application was made available to the State under the Executive Order 12372 Process for review on
b. Program is subject to E.O. 12372 but has not been selected by the State for review.
c. Program is not covered by E.O. 12372.
* 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)
Yes
No
If "Yes", provide explanation and attach
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21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to
comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
** I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
* Title:
* Telephone Number:
Fax Number:
* Email:
* Signature of Authorized Representative:
* Date Signed:
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