Applicant Information

Please provide information about the organization.

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* 1. Contact Information

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* 2. Executive Director Contact Information (please provide for contracting purposes)

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* 3. Organization's Unique Entity ID (UEI)

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* 4. Does the organization have current status as a 501(c)3?

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* 5. Does the organization have any unresolved findings from IHCDA or an Entitlement City, or have any state or federal funds been recaptured due to non-compliance?

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