Region 10 Grants: Application Forms - Required and Optional

You will need Adobe Acrobat Reader, available as a free download, to view some of the following files. See EPA's PDF page to learn more about PDF, and for a link to the free Acrobat Reader. The forms marked are fill and print enabled. If your version of the Acrobat Reader supports that function, you may also be able to save the document after you have completed it. We have tested it on version 6.0 and it works. You may also be able to edit your entries once you have saved the document, depending on the version of the Adobe application you have. Fill and print/fill and save forms are offered as a courtesy where they are available. EPA Region 10 is not responsible for the functionality of your software.

Quick Info   Application Forms   Indirect Costs Policy   On-Line Resources   Submitting Grant Documents Go To   How to Apply   Grants Administration Home   Region 10 Grants Home

Application for Federal Assistance (SF-424) (PDF, 6pp, 1.1MB) Need a DUNS Number?		To apply for EPA assistance, this form must be filled out completely and accurately, according to the instructions provided with the form.
Budget Information (SF-424A) (PDF, 4pp, 119kb)		The Standard Form (SF) 424A is required for use in applying for any Federal Assistance. It goes with the Application for Federal Assistance form (SF-424). You are allowed to reproduce this form for use by your organization. You are not allowed to alter the form or revise its contents. Altered, revised or “home made” forms will not be accepted by EPA. This form is used to summarize all the financial information contained in the Detailed Budget for your project, and will constitute the financial portion of your assistance agreement. Please make sure this information accurately reflects the Detailed Budget. Please also double-check to see that all calculations are correct. These detailed guidelines will help you to complete this form correctly (PDF, 7pp, 42kb).
Pre-Award Compliance Review Report (EPA Form 4700-4) (PDF, 2pp, 20kb)		Required for all assistance agreement applications, unless included in a bundling package (see below). Not required when amending an existing agreement.
Assurances, Non-construction Programs Form (SF-424B) (PDF, 2pp, 19kb)		Required for new assistance agreement applications, unless included in a bundling package (see below). Not required for amendments to existing assistance agreements.
Survey of Recipient’s Management Systems (PDF, 3pp, 38kb)		Optional, but requested from first -time applicants, as it helps to determine if you have adequate standards and systems in place to meet federal requirements. Recommended from others. May be included in a bundling package (see below).
Certification Regarding Lobbying (PDF, 1 page, 60kb)		Required if the requested EPA funding is more than $100,000, OR if your application is for additional funding for a current grant, and the revised total EPA funding exceeds $100,000. May be included in a bundling package (see below).
Disclosure of Lobbying Activities (SF LLL) (PDF, 2pp, 45kb)		If EPA funding totals over $100,000 AND your organization is or will be conducting lobbying activities.
Procurement System Certification (EPA Form 5700-48) (PDF, 2pp, 94kb)		Required for Superfund program projects only. May be included in a bundling package (see below).
Key Contacts List (PDF, 1 page, 9kb) Please use this EPA Region 10 form. Please do not use the version on the EPA HQ Grant Forms site.		Optional, but helpful for EPA staff.

• Assurances - Non-Construction Programs (SF424B)
• Pre-award Compliance Review Report (EPA Form 4700-4)
• Survey of Recipient’s Management Systems (Optional Form)
• Certification Regarding Lobbying
• Procurement System Certification (EPA Form 5700-48) if applicable.

• Which applications are covered (for example: “ all environmental programs”);
• The time frame the certifications and assurances are valid (not to exceed one year, for example: January 1, 2004 to December 31, 2004 ); and
• A statement that if any changes occur during the period, or the annual certification(s) does not apply to a particular assistance application, EPA will be notified immediately, and revised/updated form(s) will be provided.