APPLICATION FOR 1991 GRANT FUNDS.docVIP

Office of Attorney General Use Only DVCPB Grant Number (1) Name of Subgrantee (City, County, State Agency) Phone Fax (2) Name of Authorized Official Title Street Address City State Zip Code Mailing Address if Different City State Zip Code (3) Name of Implementing Agency (4) Name of Project Director Title E-Mail Address Agency Phone Fax Street Address City State Zip Code Mailing Address if Different City State Zip Code (5) Name of Fiscal Officer Title E-Mail Address Agency Phone Fax Street Address City State Zip Code Mailing Address if Different City State Zip Code (6) Authorized Program Area Law Enforcement Prevention/Education Drug Treatment Crime Victim and Witness Programs (other than victim/witness compensation) Prosecution/Courts Corrections/Community Corrections Planning/Evaluation/Technology Improvement (7) Multi-agency Project? Yes No (8) Multijurisdictional Project? Yes No Project Period: Start Date 1 / 1 / 2012 Project Period: End Date 12 / 31 / 2012 (9) Subgrantees Level of Government (Check one) State County City/Town Indian Tribe (10) Implementing Agency Level of Government (Check one) State County City/Town Indian Tribe Non Government (11) Type of Implementing Agency (Check all that apply) Law Enforcement Prosecution Corrections Domestic Violence Treatment Courts Victim/Witness Other Budget Summary (Specific to Funds Requested in this Application) (12) PERSONNEL Note: Salary cap (wages benefits) $52,000 prosecutors and $42,000 all other personnel Positions Funded: Title: $ Title: $ Title: $ Title