ED 424

![](media/image1.wmf)Application for Federal **U.S. Department of
Education**

# Education Assistance (ED 424)

**Applicant Information** Organizational Unit

**1.** Name and Address

Legal
Name:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_

City State County ZIP Code + 4

**2.** Applicant's D-U-N-S Number
\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|
**6.** Novice Applicant \_\_\_Yes \_\_\_No

**3.** Applicant's T-I-N \|\_\_\_\|\_\_\_\| -
\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\| **7.** Is the
applicant delinquent on any Federal debt? ­\_\_\_Yes \_\_\_No

*(If "Yes," attach an explanation.)*

**4.** Catalog of Federal Domestic Assistance #:
**84.\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**8.** Type of Applicant *(Enter appropriate letter in the box.)
\|\_\_\_\_\|*

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**5.** Project
Director:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_

City State Zip code + 4

Tel. #: ( ) \_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_ Fax #: (
)\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_

**9.** State Application Identifier
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

E-Mail Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Application Information**

**10.** Type of Submission: **13.** Are any research activities
involving human subjects planned at

*-PreApplication -Application* any time during the proposed project
period?

\_\_\_ Construction \_\_\_ Construction ­­\_\_\_ Yes (Go to 13a.) \_\_\_
No (Go to item 14.)

\_\_\_ Non-Construction \_\_\_ Non-Construction

**13a.** Are **all** the research activities proposed designated to be

**11.** Is application subject to review by Executive Order 12372
process? exempt from the regulations?

\_\_\_ Yes (*Date made available to the Executive Order 12372* \_\_\_
Yes (Provide Exemption(s) #):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*process for review):* \_\_\_\_/\_\_\_\_/\_\_\_\_\_\_\_\_\_

**\_\_\_** No (Provide Assurance #):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_ No *(If "No," check appropriate box below.)*

\_\_\_ Program is not covered by E.O. 12372. **14.** Descriptive Title
of Applicant's Project:

\_\_\_ Program has not been selected by State for review.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**12.** Proposed Project Dates: \_\_\_\_/\_\_\_\_/\_\_\_\_\_\_\_\_
\_\_\_\_/\_\_\_\_/\_\_\_\_\_\_\_\_\_

**Start Date: End Date:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Estimated Funding** **Authorized Representative Information**

**16.** To the best of my knowledge and belief, all data in this
preapplication/application are true

**15a.** Federal **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00** and
correct. The document has been duly authorized by the governing body of
the applicant

**b.** Applicant **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00** and the
applicant will comply with the attached assurances if the assistance is
awarded.

**c.** State **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 a.** Authorized
Representative (*Please type or print name clearly*.)

**d.** Local **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**e.** Other **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 b.** Title:
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**f.** Program Income **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 c.**
Tel. #: ( ) \_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_ Fax #: ( )
\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_

**d.** E-Mail Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**g. TOTAL \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 e. Signature of
Authorized Representative**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date:\_\_\_/\_\_\_\_/\_

ED 524

+--------+----+--------+--------+--------+--------+---+-----+---------+
| ![]    | #  |        |        |        |        |   | OMB |         |
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|        | OF |        |        |        |        |   | 004 |         |
|        |  E |        |        |        |        |   |     |         |
|        | DU |        |        |        |        |   | E   |         |
|        | CA |        |        |        |        |   | xpi |         |
|        | TI |        |        |        |        |   | rat |         |
|        | ON |        |        |        |        |   | ion |         |
|        |    |        |        |        |        |   | Da  |         |
|        | #  |        |        |        |        |   | te: |         |
|        | BU |        |        |        |        |   | 1   |         |
|        | DG |        |        |        |        |   | 0-3 |         |
|        | ET |        |        |        |        |   | 1-2 |         |
|        |  I |        |        |        |        |   | 007 |         |
|        | NF |        |        |        |        |   |     |         |
|        | OR |        |        |        |        |   |     |         |
|        | MA |        |        |        |        |   |     |         |
|        | TI |        |        |        |        |   |     |         |
|        | ON |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|        | #  |        |        |        |        |   |     |         |
|        | NO |        |        |        |        |   |     |         |
|        | N- |        |        |        |        |   |     |         |
|        | CO |        |        |        |        |   |     |         |
|        | NS |        |        |        |        |   |     |         |
|        | TR |        |        |        |        |   |     |         |
|        | UC |        |        |        |        |   |     |         |
|        | TI |        |        |        |        |   |     |         |
|        | ON |        |        |        |        |   |     |         |
|        |  P |        |        |        |        |   |     |         |
|        | RO |        |        |        |        |   |     |         |
|        | GR |        |        |        |        |   |     |         |
|        | AM |        |        |        |        |   |     |         |
|        | S  |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| > Name |    |        |        | Appl   |        |   |     |         |
| > of   |    |        |        | icants |        |   |     |         |
| >      |    |        |        | requ   |        |   |     |         |
| Instit |    |        |        | esting |        |   |     |         |
| ution/ |    |        |        | f      |        |   |     |         |
| Organi |    |        |        | unding |        |   |     |         |
| zation |    |        |        | for    |        |   |     |         |
|        |    |        |        | only   |        |   |     |         |
|        |    |        |        | one    |        |   |     |         |
|        |    |        |        | year   |        |   |     |         |
|        |    |        |        | should |        |   |     |         |
|        |    |        |        | co     |        |   |     |         |
|        |    |        |        | mplete |        |   |     |         |
|        |    |        |        | the    |        |   |     |         |
|        |    |        |        | column |        |   |     |         |
|        |    |        |        | under  |        |   |     |         |
|        |    |        |        | \"P    |        |   |     |         |
|        |    |        |        | roject |        |   |     |         |
|        |    |        |        | Year   |        |   |     |         |
|        |    |        |        | 1.\"   |        |   |     |         |
|        |    |        |        | Appl   |        |   |     |         |
|        |    |        |        | icants |        |   |     |         |
|        |    |        |        | requ   |        |   |     |         |
|        |    |        |        | esting |        |   |     |         |
|        |    |        |        | f      |        |   |     |         |
|        |    |        |        | unding |        |   |     |         |
|        |    |        |        | for    |        |   |     |         |
|        |    |        |        | mult   |        |   |     |         |
|        |    |        |        | i-year |        |   |     |         |
|        |    |        |        | grants |        |   |     |         |
|        |    |        |        | should |        |   |     |         |
|        |    |        |        | co     |        |   |     |         |
|        |    |        |        | mplete |        |   |     |         |
|        |    |        |        | all    |        |   |     |         |
|        |    |        |        | appl   |        |   |     |         |
|        |    |        |        | icable |        |   |     |         |
|        |    |        |        | co     |        |   |     |         |
|        |    |        |        | lumns. |        |   |     |         |
|        |    |        |        | Please |        |   |     |         |
|        |    |        |        | read   |        |   |     |         |
|        |    |        |        | all    |        |   |     |         |
|        |    |        |        | instru |        |   |     |         |
|        |    |        |        | ctions |        |   |     |         |
|        |    |        |        | before |        |   |     |         |
|        |    |        |        | comp   |        |   |     |         |
|        |    |        |        | leting |        |   |     |         |
|        |    |        |        | form.  |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| ## *   |    |        |        |        |        |   |     |         |
| *SECTI |    |        |        |        |        |   |     |         |
| ON A - |    |        |        |        |        |   |     |         |
|  BUDGE |    |        |        |        |        |   |     |         |
| T SUMM |    |        |        |        |        |   |     |         |
| ARY :* |    |        |        |        |        |   |     |         |
| * U.S. |    |        |        |        |        |   |     |         |
|  DEPAR |    |        |        |        |        |   |     |         |
| TMENT  |    |        |        |        |        |   |     |         |
| OF EDU |    |        |        |        |        |   |     |         |
| CATION |    |        |        |        |        |   |     |         |
|  FUNDS |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| Budget |    | P      | P      | P      | P      | P |     | Total   |
| Cate   |    | roject | roject | roject | roject | r |     |         |
| gories |    | Year 1 | Year 2 | Year 3 | Year 4 | o |     | \(f\)   |
|        |    |        |        |        |        | j |     |         |
|        |    | \(a\)  | \(b\)  | \(c\)  | \(d\)  | e |     |         |
|        |    |        |        |        |        | c |     |         |
|        |    |        |        |        |        | t |     |         |
|        |    |        |        |        |        | Y |     |         |
|        |    |        |        |        |        | e |     |         |
|        |    |        |        |        |        | a |     |         |
|        |    |        |        |        |        | r |     |         |
|        |    |        |        |        |        | 5 |     |         |
|        |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        | \ |     |         |
|        |    |        |        |        |        | ( |     |         |
|        |    |        |        |        |        | e |     |         |
|        |    |        |        |        |        | \ |     |         |
|        |    |        |        |        |        | ) |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 1\.    |    |        |        |        |        |   |     |         |
| Per    |    |        |        |        |        |   |     |         |
| sonnel |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 2\.    |    |        |        |        |        |   |     |         |
| Fringe |    |        |        |        |        |   |     |         |
| Be     |    |        |        |        |        |   |     |         |
| nefits |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 3\.    |    |        |        |        |        |   |     |         |
| Travel |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 4\.    |    |        |        |        |        |   |     |         |
| Equ    |    |        |        |        |        |   |     |         |
| ipment |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 5\.    |    |        |        |        |        |   |     |         |
| Su     |    |        |        |        |        |   |     |         |
| pplies |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 6\.    |    |        |        |        |        |   |     |         |
| Contr  |    |        |        |        |        |   |     |         |
| actual |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 7\.    |    |        |        |        |        |   |     |         |
| Constr |    |        |        |        |        |   |     |         |
| uction |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 8\.    |    |        |        |        |        |   |     |         |
| Other  |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 9\.    |    |        |        |        |        |   |     |         |
| Total  |    |        |        |        |        |   |     |         |
| Direct |    |        |        |        |        |   |     |         |
| Costs  |    |        |        |        |        |   |     |         |
| (lines |    |        |        |        |        |   |     |         |
| 1-8)   |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 10\.   |    |        |        |        |        |   |     |         |
| In     |    |        |        |        |        |   |     |         |
| direct |    |        |        |        |        |   |     |         |
| C      |    |        |        |        |        |   |     |         |
| osts\* |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 11\.   |    |        |        |        |        |   |     |         |
| Tr     |    |        |        |        |        |   |     |         |
| aining |    |        |        |        |        |   |     |         |
| St     |    |        |        |        |        |   |     |         |
| ipends |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| 12\.   |    |        |        |        |        |   |     |         |
| Total  |    |        |        |        |        |   |     |         |
| Costs  |    |        |        |        |        |   |     |         |
| (lines |    |        |        |        |        |   |     |         |
| 9-11)  |    |        |        |        |        |   |     |         |
+--------+----+--------+--------+--------+--------+---+-----+---------+
| >      |    |        |        |        |        |   |     |         |
| **\*In |    |        |        |        |        |   |     |         |
| direct |    |        |        |        |        |   |     |         |
| > Cost |    |        |        |        |        |   |     |         |
| >      |    |        |        |        |        |   |     |         |
|  Infor |    |        |        |        |        |   |     |         |
| mation |    |        |        |        |        |   |     |         |
| > *(To |    |        |        |        |        |   |     |         |
| > Be   |    |        |        |        |        |   |     |         |
| > Com  |    |        |        |        |        |   |     |         |
| pleted |    |        |        |        |        |   |     |         |
| > by   |    |        |        |        |        |   |     |         |
| > Your |    |        |        |        |        |   |     |         |
| > Bu   |    |        |        |        |        |   |     |         |
| siness |    |        |        |        |        |   |     |         |
| >      |    |        |        |        |        |   |     |         |
|  Offic |    |        |        |        |        |   |     |         |
| e*):** |    |        |        |        |        |   |     |         |
| >      |    |        |        |        |        |   |     |         |
| > If   |    |        |        |        |        |   |     |         |
| > you  |    |        |        |        |        |   |     |         |
| > are  |    |        |        |        |        |   |     |         |
| > requ |    |        |        |        |        |   |     |         |
| esting |    |        |        |        |        |   |     |         |
| > r    |    |        |        |        |        |   |     |         |
| eimbur |    |        |        |        |        |   |     |         |
| sement |    |        |        |        |        |   |     |         |
| > for  |    |        |        |        |        |   |     |         |
| > in   |    |        |        |        |        |   |     |         |
| direct |    |        |        |        |        |   |     |         |
| >      |    |        |        |        |        |   |     |         |
|  costs |    |        |        |        |        |   |     |         |
| > on   |    |        |        |        |        |   |     |         |
| > line |    |        |        |        |        |   |     |         |
| > 10,  |    |        |        |        |        |   |     |         |
| >      |    |        |        |        |        |   |     |         |
| please |    |        |        |        |        |   |     |         |
| >      |    |        |        |        |        |   |     |         |
| answer |    |        |        |        |        |   |     |         |
| > the  |    |        |        |        |        |   |     |         |
| > fol  |    |        |        |        |        |   |     |         |
| lowing |    |        |        |        |        |   |     |         |
| > ques |    |        |        |        |        |   |     |         |
| tions: |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
| (1) Do |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|    you |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|   have |    |        |        |        |        |   |     |         |
|     an |    |        |        |        |        |   |     |         |
|     In |    |        |        |        |        |   |     |         |
| direct |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|   Cost |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|   Rate |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|    Agr |    |        |        |        |        |   |     |         |
| eement |    |        |        |        |        |   |     |         |
|     ap |    |        |        |        |        |   |     |         |
| proved |    |        |        |        |        |   |     |         |
|     by |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|    the |    |        |        |        |        |   |     |         |
|     F  |    |        |        |        |        |   |     |         |
| ederal |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|  gover |    |        |        |        |        |   |     |         |
| nment? |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|  \_\_\ |    |        |        |        |        |   |     |         |
| _\_Yes |    |        |        |        |        |   |     |         |
|     \_ |    |        |        |        |        |   |     |         |
| \_\_\_ |    |        |        |        |        |   |     |         |
|     No |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
| (2) If |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
|   yes, |    |        |        |        |        |   |     |         |
|        |    |        |        |        |        |   |     |         |
| please |    |        |        |        |        |   |     |         |
|     p  |    |        |        |        |        |   |     |         |
| rovide |    |        |        |        |        |   |     |         |
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> ED 524

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+---------+---------+--------+---------+---------+---------+----------+
| **      |         |        |         |         |         |          |
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| 1\.     |         |        |         |         |         |          |
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| 2\.     |         |        |         |         |         |          |
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| 8\.     |         |        |         |         |         |          |
| Other   |         |        |         |         |         |          |
+---------+---------+--------+---------+---------+---------+----------+
| 9\.     |         |        |         |         |         |          |
| Total   |         |        |         |         |         |          |
| Direct  |         |        |         |         |         |          |
| Costs   |         |        |         |         |         |          |
|         |         |        |         |         |         |          |
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| 1-8)    |         |        |         |         |         |          |
+---------+---------+--------+---------+---------+---------+----------+
| 10\.    |         |        |         |         |         |          |
| I       |         |        |         |         |         |          |
| ndirect |         |        |         |         |         |          |
| Costs   |         |        |         |         |         |          |
+---------+---------+--------+---------+---------+---------+----------+
| 11\.    |         |        |         |         |         |          |
| T       |         |        |         |         |         |          |
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| S       |         |        |         |         |         |          |
| tipends |         |        |         |         |         |          |
+---------+---------+--------+---------+---------+---------+----------+
| 12\.    |         |        |         |         |         |          |
| Total   |         |        |         |         |         |          |
| Costs   |         |        |         |         |         |          |
|         |         |        |         |         |         |          |
| (Lines  |         |        |         |         |         |          |
| 9-11)   |         |        |         |         |         |          |
+---------+---------+--------+---------+---------+---------+----------+
| **      |         |        |         |         |         |          |
| SECTION |         |        |         |         |         |          |
| C --    |         |        |         |         |         |          |
| BUDGET  |         |        |         |         |         |          |
| NARR    |         |        |         |         |         |          |
| ATIVE** |         |        |         |         |         |          |
| (see    |         |        |         |         |         |          |
| instru  |         |        |         |         |         |          |
| ctions) |         |        |         |         |         |          |
+---------+---------+--------+---------+---------+---------+----------+

427 Statement

OMB Control No. 1890-0007 (Exp. 11/30/2007)

**NOTICE TO ALL APPLICANTS**

The purpose of this enclosure is to inform you about a new provision in
the Department of Education\'s General Education Provisions Act (GEPA)
that applies to applicants for new grant awards under Department
programs. This provision is Section 427 of GEPA, enacted as part of the
Improving America\'s Schools Act of 1994 (Public Law (P.L.) 103-382).

**To Whom Does This Provision Apply?**

Section 427 of GEPA affects applicants for new grant awards under this
program. **ALL APPLICANTS FOR NEW AWARDS MUST INCLUDE INFORMATION IN
THEIR APPLICATIONS TO ADDRESS THIS NEW PROVISION IN ORDER TO RECEIVE
FUNDING UNDER THIS PROGRAM.**

(If this program is a State-formula grant program, a State needs to
provide this description only for projects or activities that it carries
out with funds reserved for State-level uses. In addition, local school
districts or other eligible applicants that apply to the State for
funding need to provide this description in their applications to the
State for funding. The State would be responsible for ensuring that the
school district or other local entity has submitted a sufficient section
427 statement as described below.)

**What Does This Provision Require?**

Section 427 requires each applicant for funds (other than an individual
person) to include in its application a description of the steps the
applicant proposes to take to ensure equitable access to, and
participation in, its Federally-assisted program for students, teachers,
and other program beneficiaries with special needs. This provision
allows applicants discretion in developing the required description. The
statute highlights six types of barriers that can impede equitable
access or participation: gender, race, national origin, color,
disability, or age. Based on local circumstances, you should determine
whether these or other barriers may prevent your students, teachers,
etc. from such access or participation in, the Federally-funded project
or activity. The description in your application of steps to be taken to
overcome these barriers need not be lengthy; you may provide a clear and
succinct description of how you plan to address those barriers that are
applicable to your circumstances. In addition, the information may be
provided in a single narrative, or, if appropriate, may be discussed in
connection with related topics in the application.

Section 427 is not intended to duplicate the requirements of civil
rights statutes, but rather to ensure that, in designing their projects,
applicants for Federal funds address equity concerns that may affect the
ability of certain potential beneficiaries to fully participate in the
project and to achieve to high standards. Consistent with program
requirements and its approved application, an applicant may use the
Federal funds awarded to it to eliminate barriers it identifies.

**What are Examples of How an Applicant Might Satisfy the Requirement of
This Provision?**

The following examples may help illustrate how an applicant may comply
with Section 427.

\(1\) An applicant that proposes to carry out an adult literacy project
serving, among others, adults with limited English proficiency, might
describe in its application how it intends to distribute a brochure
about the proposed project to such potential participants in their
native language.

\(2\) An applicant that proposes to develop instructional materials for
classroom use might describe how it will make the materials available on
audio tape or in braille for students who are blind.

\(3\) An applicant that proposes to carry out a model science program
for secondary students and is concerned that girls may be less likely
than boys to enroll in the course, might indicate how it intends to
conduct \"outreach\" efforts to girls, to encourage their enrollment.

We recognize that many applicants may already be implementing effective
steps to ensure equity of access and participation in their grant
programs, and we appreciate your cooperation in responding to the
requirements of this provision.

**Estimated Burden Statement for GEPA Requirements**

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is **1890-0007.** The time
required to complete this information collection is estimated to average
1.5 hours per response, including the time to review instructions,
search existing data resources, gather the data needed, and complete and
review the information collection. **If you have any comments concerning
the accuracy of the time estimate(s) or suggestions for improving this
form, please write to:** Director, Grants Policy and Oversight Staff,
U.S. Department of Education, 400 Maryland Avenue SW, Washington, DC
20202-4250.

**424B OMB Approval No. 0348-0040**

**ASSURANCES - NON-CONSTRUCTION PROGRAMS**

Public reporting burden for this collection of information is estimated
to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project (0348-0040), Washington, DC 20503

**PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.**

**Note:** Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the awarding
agency. Further, certain Federal awarding agencies may require
applicants to certify to additional assurances. If such is the case, you
will be notified.

As the duly authorized representative of the applicant I certify that
the applicant:

1\. Has the legal authority to apply for Federal assistance, and the
institutional, managerial and financial capability (including funds
sufficient to pay the non-Federal share of project cost) to ensure
proper planning, management, and completion of the project described in
this application.

2\. Will give the awarding agency, the Comptroller General of the United
States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books,
papers, or documents related to the award; and will establish a proper
accounting system in accordance with generally accepted accounting
standards or agency directives.

3\. Will establish safeguards to prohibit employees from using their
positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.

4\. Will initiate and complete the work within the applicable time frame
after receipt of approval of the awarding agency.

5\. Will comply with the Intergovernmental Personnel Act of 1970 (42
U.S.C. 4728-4763) relating to prescribed standards for merit systems for
programs funded under one of the 19 statutes or regulations specified in
Appendix A of OPM\'s Standards for a Merit System of Personnel
Administration (5 C.F.R. 900, Subpart F).

6\. Will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights
Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of
race, color or national origin; (b) Title IX of the Education Amendments
of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits
discrimination on the basis of handicaps; (d) the Age Discrimination Act
of 1975, as amended (42 U.S.C. 6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on
the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public
Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee 3), as
amended, relating to confidentiality of alcohol and drug abuse patient
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601
et seq.), as amended, relating to nondiscrimination in the sale, rental
or financing of housing; (i) any other nondiscrimination provisions in
the specific statute(s) under which application for Federal assistance
is being made; and (j) the requirements of any other nondiscrimination
statute(s) which may apply to the application.

7\. Will comply, or has already complied, with the requirements of
Titles II and III of the uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair
and equitable treatment of persons displaced or whose property is
acquired as a result of Federal or federally assisted programs. These
requirements apply to all interests in real property acquired for
project purposes regardless of Federal participation in purchases.

8\. Will comply, as applicable, with the provisions of the Hatch Act (5
U.S.C. 1501-1508 and 7324-7328) which limit the political activities of
employees whose principal employment activities are funded in whole or
in part with Federal funds.

9\. Will comply, as applicable, with the provisions of the Davis-Bacon
Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18
U.S.C. 874) and the Contract Work Hours and Safety Standards Act (40
U.S.C. 327-333), regarding labor standards for federally assisted
construction subagreements.

10\. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster Protection Act of
1973 (P.L. 93-234) which requires recipients in a special flood hazard
area to participate in the program and to purchase flood insurance if
the total cost of insurable construction and acquisition is \$10,000 or
more.

11\. Will comply with environmental standards which may be prescribed
pursuant to the following: (a) institution of environmental quality
control measures under the National Environmental Policy Act of 1969
(P.L. 91-190) and Executive Order (EO) 11514; (b) notification of
violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in
accordance with EO 11988; (e) assurance of project consistency with the
approved State management program developed under the Coastal Zone
Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of
Federal actions to State (Clear Air) Implementation Plans under Section
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et
seq.); (g) protection of underground sources of drinking water under the
Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h)
protection of endangered species under the Endangered Species Act of
1973, as amended, (P.L. 93-205).

12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.
1721 et seq.) related to protecting components or potential components
of the national wild and scenic rivers system.

13\. Will assist the awarding agency in assuring compliance with Section
106 of the National Historic Preservation Act of 1966, as amended (16
U.S.C. 470), EO 11593 (identification and protection of historic
properties), and the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. 469a-1 et seq.).

14\. Will comply with P.L. 93-348 regarding the protection of human
subjects involved in research, development, and related activities
supported by this award of assistance.

15\. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L.
89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care,
handling, and treatment of warm blooded animals held for research,
teaching, or other activities supported by this award of assistance.

16\. Will comply with the Lead-Based Paint Poisoning Prevention Act (42
U.S.C. 4801 et seq.) which prohibits the use of lead- based paint in
construction or rehabilitation of residence structures.

17\. Will cause to be performed the required financial and compliance
audits in accordance with the Single Audit Act Amendments of 1996 and
OMB Circular No. A-133, Audits of States, Local Governments, and
Non-Profit Organizations.

18\. Will comply with all applicable requirements of all other Federal
laws, executive orders, regulations and policies governing this program.

  ----------------------------------------- -------- ---------------------
  SIGNATURE OF AUTHORIZED CERTIFYING        TITLE    
  OFFICIAL                                           

  APPLICANT ORGANIZATION                             DATE SUBMITTED
  ----------------------------------------- -------- ---------------------

**Standard Form 424B (Rev. 7-97) Back**

# **80-0013**

# CERTIFICATION REGARDING LOBBYING

Applicants must review the requirements for certification regarding
lobbying included in the regulations cited below before completing this
form. Applicants must sign this form to comply with the certification
requirements under 34 CFR Part 82, \"New Restrictions on Lobbying.\"
This certification is a material representation of fact upon which the
Department of Education relies when it makes a grant or enters into a
cooperative agreement.

As required by Section 1352, Title 31 of the U.S. Code, and implemented
at 34 CFR Part 82, for persons entering into a Federal contract, grant
or cooperative agreement over \$100,000, as defined at 34 CFR Part 82,
Sections 82.105 and 82.110, the applicant certifies that:

\(a\) No Federal appropriated funds have been paid or will be paid, by
or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the making of any Federal grant,
the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal grant
or cooperative agreement;

\(b\) If any funds other than Federal appropriated funds have been paid
or will be paid to any person for influencing or attempting to influence
an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in
connection with this Federal grant or cooperative agreement, the
undersigned shall complete and submit Standard Form - LLL, \"Disclosure
Form to Report Lobbying,\" in accordance with its instructions;

\(c\) The undersigned shall require that the language of this
certification be included in the award documents for all subawards at
all tiers (including subgrants and contracts under grants and
cooperative agreements) and that all subrecipients shall certify and
disclose accordingly.

As the duly authorized representative of the applicant, I hereby certify
that the applicant will comply with the above certification.

  -----------------------------------------------------------------------
  NAME OF APPLICANT PR/AWARD NUMBER AND / OR PROJECT NAME

  PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

  SIGNATURE DATE
  -----------------------------------------------------------------------

ED 80-0013 06/04

**Certification Regarding Debarment, Suspension, Ineligibility and**

**Voluntary Exclusion \-- Lower Tier Covered Transactions**

This certification is required by the Department of Education
regulations implementing Executive Order 12549, Debarment and
Suspension, 34 CFR Part 85, for all lower tier transactions meeting the
threshold and tier requirements stated at Section 85.110.

**Instructions for Certification**

1\. By signing and submitting this proposal, the prospective lower tier
participant is providing the certification set out below.

2\. The certification in this clause is a material representation of
fact upon which reliance was placed when this transaction was entered
into. If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition
to other remedies available to the Federal Government, the department or
agency with which this transaction originated may pursue available
remedies, including suspension and/or debarment.

3\. The prospective lower tier participant shall provide immediate
written notice to the person to which this proposal is submitted if at
any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by
reason of changed circumstances.

4\. The terms \"covered transaction,\" \"debarred,\" \"suspended,\"
\"ineligible,\" \"lower tier covered transaction,\" \"participant,\" \"
person,\" \"primary covered transaction,\" \" principal,\" \"proposal,\"
and \"voluntarily excluded,\" as used in this clause, have the meanings
set out in the Definitions and Coverage sections of rules implementing
Executive Order 12549. You may contact the person to which this proposal
is submitted for assistance in obtaining a copy of those regulations.

5\. The prospective lower tier participant agrees by submitting this
proposal that, should the proposed covered transaction be entered into,
it shall not knowingly enter into any lower tier covered transaction
with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency with which this
transaction originated.

6\. The prospective lower tier participant further agrees by submitting
this proposal that it will include the clause titled Certification
Regarding Debarment, Suspension, Ineligibility, and Voluntary
Exclusion-Lower Tier Covered Transactions,without modification, in all
lower tier covered transactions and in all solicitations for lower tier
covered transactions.

7\. A participant in a covered transaction may rely upon a certification
of a prospective participant in a lower tier covered transaction that it
is not debarred, suspended, ineligible, or voluntarily excluded from the
covered transaction, unless it knows that the certification is
erroneous. A participant may decide the method and frequency by which it
determines the eligibility of its principals. Each participant may but
is not required to, check the Nonprocurement List.

8\. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith
the certification required by this clause. The knowledge and information
of a participant is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business
dealings.

9\. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly enters
into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal
Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or
debarment.

**Certification**

\(1\) The prospective lower tier participant certifies, by submission of
this proposal, that neither it nor its principals are presently
debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any
Federal department or agency.

\(2\) Where the prospective lower tier participant is unable to certify
to any of the statements in this certification, such prospective
participant shall attach an explanation to this proposal.

  -----------------------------------------------------------------------
  NAME OF APPLICANT PR/AWARD NUMBER AND/OR PROJECT NAME

  PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

  SIGNATURE DATE
  -----------------------------------------------------------------------

ED 80-0014, 9/90 (Replaces GCS-009 (REV.12/88), which is obsolete)

Approved by OMB

0348-0046

**Disclosure of Lobbying Activities**

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.
1352

(See reverse for public burden disclosure)

+----------------------+----------+---------+-------------------------+
| 1.  **Type of        | 2.       |         | 3.  **Report Type:**    |
|     Federal          | **Status |         |                         |
|     Action:**        |     of   |         | a\. initial filing      |
|                      |          |         |                         |
| a\. contract         |  Federal |         | \_\_\_\_\_ b. material  |
|                      |     A    |         | change                  |
| \_\_\_\_ b. grant    | ction:** |         |                         |
|                      |          |         | **For material change   |
| c\. cooperative      | a\.      |         | only:**                 |
| agreement            | bid/o    |         |                         |
|                      | ffer/app |         | Year \_\_\_\_\_\_\_     |
| d\. loan             | lication |         | quarter \_\_\_\_\_\_\_  |
|                      |          |         |                         |
| e\. loan guarantee   | \_       |         | Date of last            |
|                      | \_\_\_\_ |         | repor                   |
| f\. loan insurance   | b.       |         | t\_\_\_\_\_\_\_\_\_\_\_ |
|                      | initial  |         |                         |
|                      | award    |         |                         |
|                      |          |         |                         |
|                      | c\.      |         |                         |
|                      | po       |         |                         |
|                      | st-award |         |                         |
+----------------------+----------+---------+-------------------------+
| 4.  **Name and       |          | 5       |                         |
|     Address of       |          | .  **If |                         |
|     Reporting        |          |     Re  |                         |
|     Entity:**        |          | porting |                         |
|                      |          |         |                         |
| \_\_\_\_ Prime       |          |  Entity |                         |
| \_\_\_\_\_           |          |     in  |                         |
| Subawardee           |          |     No. |                         |
|                      |          |     4   |                         |
| > Tier\_\_\_\_\_\_,  |          |     is  |                         |
| > if Known:          |          |         |                         |
|                      |          |  Subawa |                         |
| **Congressional      |          | rdee,** |                         |
| District, if         |          |         |                         |
| known:**             |          |   Enter |                         |
|                      |          |         |                         |
|                      |          |    Name |                         |
|                      |          |     and |                         |
|                      |          |         |                         |
|                      |          | Address |                         |
|                      |          |     of  |                         |
|                      |          |         |                         |
|                      |          |  Prime: |                         |
|                      |          |         |                         |
|                      |          | *       |                         |
|                      |          | *Congre |                         |
|                      |          | ssional |                         |
|                      |          | Di      |                         |
|                      |          | strict, |                         |
|                      |          | if      |                         |
|                      |          | k       |                         |
|                      |          | nown:** |                         |
+----------------------+----------+---------+-------------------------+
| 6.  **Federal        |          | **7.    |                         |
|                      |          | Federal |                         |
| Department/Agency:** |          | Program |                         |
|                      |          | Name/   |                         |
|                      |          | Descrip |                         |
|                      |          | tion:** |                         |
|                      |          |         |                         |
|                      |          | CFDA    |                         |
|                      |          | Number, |                         |
|                      |          | *if     |                         |
|                      |          | appli   |                         |
|                      |          | cable*: |                         |
|                      |          | \       |                         |
|                      |          | _\_\_\_ |                         |
|                      |          | \_\_\_\ |                         |
|                      |          | _\_\_\_ |                         |
|                      |          | \_\_\_\ |                         |
|                      |          | _\_\_\_ |                         |
+----------------------+----------+---------+-------------------------+
| 7.  **Federal Action |          | **9.    |                         |
|     Number,** *if    |          | Award   |                         |
|     known:*          |          | Am      |                         |
|                      |          | ount**, |                         |
|                      |          | *if     |                         |
|                      |          | known:* |                         |
|                      |          |         |                         |
|                      |          | **\$**  |                         |
+----------------------+----------+---------+-------------------------+
| **10. a. Name and    |          | **b.    |                         |
| Address of Lobbying  |          | Indi    |                         |
| Registrant**         |          | viduals |                         |
|                      |          | Per     |                         |
| *(if individual,     |          | forming |                         |
| last name, first     |          | Ser     |                         |
| name, MI):*          |          | vices** |                         |
|                      |          | *(in    |                         |
|                      |          | cluding |                         |
|                      |          | address |                         |
|                      |          | if      |                         |
|                      |          | di      |                         |
|                      |          | fferent |                         |
|                      |          | from    |                         |
|                      |          | No.     |                         |
|                      |          | 10a)*   |                         |
|                      |          |         |                         |
|                      |          | *(last  |                         |
|                      |          | name,   |                         |
|                      |          | first   |                         |
|                      |          | name,   |                         |
|                      |          | MI):*   |                         |
+----------------------+----------+---------+-------------------------+
| **11. Information    |          | **Sig   |                         |
| requested through    |          | nature: |                         |
| this form is         |          | \_\_\_\ |                         |
| authorized by title  |          | _\_\_\_ |                         |
| 31 U.S.C. section    |          | \_\_\_\ |                         |
| 1352. This           |          | _\_\_\_ |                         |
| disclosure of        |          | \_\_\_\ |                         |
| lobbying activities  |          | _\_\_\_ |                         |
| is a material        |          | \_\_\_\ |                         |
| representation of    |          | _\_\_\_ |                         |
| fact upon which      |          | \_\_\_\ |                         |
| reliance was placed  |          | _\_\_** |                         |
| by the tier above    |          |         |                         |
| when this            |          | **Print |                         |
| transaction was made |          | Name:   |                         |
| or entered into.     |          | \_\_\   |                         |
| This disclosure is   |          | _\_\_** |                         |
| required pursuant to |          |         |                         |
| 31 U.S.C. 1352. This |          | *       |                         |
| information will be  |          | *Title: |                         |
| reported to the      |          | \_\_\   |                         |
| Congress             |          | _\_\_** |                         |
| semi-annually and    |          |         |                         |
| will be available    |          | **Te    |                         |
| for public           |          | lephone |                         |
| inspection. Any      |          | No.:    |                         |
| person who fails to  |          | \_\     |                         |
| file the required    |          | _\_\_\_ |                         |
| disclosure shall be  |          | \_\_\_\ |                         |
| subject to a civil   |          | _\_\_\_ |                         |
| penalty of not less  |          | Date:   |                         |
| than \$10,000 and    |          | \_      |                         |
| not more than        |          | \_\_\_\ |                         |
| \$100,000 for each   |          | _\_\_** |                         |
| such failure.**      |          |         |                         |
+----------------------+----------+---------+-------------------------+
| **Federal Use Only** |          | **Aut   |                         |
|                      |          | horized |                         |
|                      |          | for     |                         |
|                      |          | Local   |                         |
|                      |          | Reprodu |                         |
|                      |          | ction** |                         |
|                      |          |         |                         |
|                      |          | **S     |                         |
|                      |          | tandard |                         |
|                      |          | Form -  |                         |
|                      |          | LLL     |                         |
|                      |          | (Rev.   |                         |
|                      |          | 7-97)** |                         |
+----------------------+----------+---------+-------------------------+