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BJA FY 09 Recovery Act Edward Byrne Memorial Justice Assistance Grant Program Loc,., Page ~ of Z <br />..~.-~. <br />.. ece ct ar yre ~or~ ~~ : .~.. <br />~; <br />,.C¢{ <br />... ~_y !RJ_4~Y :: ^~... ~}yq ~=y! y~+x~?~`'+1y wf~yAry~ ... .fi'iSr .:.. <br />.unr... 't '.' <br />Iicatian Carres~on~ence ~ Switch to .., _ <br />Application Handbook Assurances and Cer~if~cations <br />overview To the best of my knowledge and belief, all data in this <br />. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />applicationJpreapplication is true and correct, the document has been duly <br />A licant authorized by the governing body of the applicant and the applicant wil! <br />information comply with the attached assurances if the assistance is awarded, <br />Pro~,ect .~:nfor~atio.n Your typed name, in lieu of your signature represents your legal binding <br />acceptance of the terms of this application and your statement of the <br />Budget an~I veracity of the representations made in phis application The document has <br />~rog.ram been duly authorized by the governing body of the applicant and the <br />Attachments applicant will comply with the following; <br />Assurances and <br />Certifications <br />~ ~ Assurances <br />2, ~ertificationsi Regar~ing_I~obb; debarment Sus ensign and Other <br />des:pn.n..i..~.~..1..i.~.y...:M.~.~~~.rs.,:.....a.n.~.....a.~'.u..g..W..Fri.~....~1~:~1~.[~c~....~~.q.u,.r~~.n.~s.. <br />Review SE 4~4 <br />rf you are an applicant for any Violence Against Women grants, this <br />Submit.:~.p.p.l.c~.~.~.n: includes the Certification of Compliance with the Statutory Eligibility <br />..................................... <br />Requirements of the Violence Against Women Act, <br />Hel Fre uently <br />Ask~d....Questions <br />CMS dome <br /> <br />~Pr~i=ix. Mr, <br />a' <br />prefix (Other}; <br />~i~ir~t Name: :Jeffrey <br />Middie Ini~i~l; A <br />~l~as~ Name; Beahen <br />Sul:fix Suffix; <br />City: Elk River <br />County: Sherburne <br />'state; Minnesota <br />`zip Code; 55330 ' -~ 5600 <br />hops;flgrants,o~p.usdoj,govlgmse~terna~lapp~icationAssurance.do 04/07/209 <br />