Form 10-168b OMB Approved

Rev. 12/90 No. 1024-0009

CONTINUATION / AMENDMENT SHEET

+-----------------------+------------------------+---------------------+
| **     **             | ##                     | #                   |
|                       |                        |                     |
|                       | ##                     |                     |
|                       | Historic Preservation  |                     |
+-----------------------+------------------------+---------------------+
| Property Name         | ### Cer                | #                   |
|                       | tification Application |                     |
+-----------------------+------------------------+---------------------+
|                       |                        |                     |
+-----------------------+------------------------+---------------------+
| Property Address      |                        |                     |
+-----------------------+------------------------+---------------------+

**Instructions.** Read the instruction carefully before completing.
Type, or print clearly in black ink. Use this sheet to continue sections
of the Part 1 and Part 2 application, or to amend an application already
submitted. Photocopy additional sheets as needed.

This sheet: continues Part 1 continues Part 2 amends Part 1 amends Part
2 NPS Project
Number:[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Name Signature Date

Street City

State Zip Daytime Telephone Number

#### NPS Office Use Only

-   The National Park Service has determined that these project
    amendments meet the Secretary of the Interior's "Standards for
    Rehabilitation."

-   The National Park Service has determined that these project
    amendments will meet the Secretary of the Interior's "Standard for
    Rehabilitation" if the attached conditions are met.

-   The National Park Service had determined that these project
    amendments do not meet the Secretary of the Interior's "Standards
    for Rehabilitation."

Date National Park Service Authorized Signature National Park Service
Office/Telephone No.

-   See Attachments

CONTINUATION / AMENDMENT SHEET

+-----------------------+------------------------+---------------------+
| **     **             | ##                     | #                   |
|                       |                        |                     |
|                       | ##                     |                     |
|                       | Historic Preservation  |                     |
+-----------------------+------------------------+---------------------+
| Property Name         | ### Cer                | #                   |
|                       | tification Application |                     |
+-----------------------+------------------------+---------------------+
|                       |                        |                     |
+-----------------------+------------------------+---------------------+
| Property Address      |                        |                     |
+-----------------------+------------------------+---------------------+

Form 10-168b OMB Approved

Rev. 12/90 No. 1024-0009

CONTINUATION / AMENDMENT SHEET

+-----------------------+------------------------+---------------------+
| **     **             | ##                     | #                   |
|                       |                        |                     |
|                       | ##                     |                     |
|                       | Historic Preservation  |                     |
+-----------------------+------------------------+---------------------+
| Property Name         | ### Cer                | #                   |
|                       | tification Application |                     |
+-----------------------+------------------------+---------------------+
|                       |                        |                     |
+-----------------------+------------------------+---------------------+
| Property Address      |                        |                     |
+-----------------------+------------------------+---------------------+

**Instructions.** Read the instruction carefully before completing.
Type, or print clearly in black ink. Use this sheet to continue sections
of the Part 1 and Part 2 application, or to amend an application already
submitted. Photocopy additional sheets as needed.

This sheet: continues Part 1 continues Part 2 amends Part 1 amends Part
2 NPS Project
Number:[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Name Signature Date

Street City

State Zip Daytime Telephone Number

#### NPS Office Use Only

-   The National Park Service has determined that these project
    amendments meet the Secretary of the Interior's "Standards for
    Rehabilitation."

-   The National Park Service has determined that these project
    amendments will meet the Secretary of the Interior's "Standard for
    Rehabilitation" if the attached conditions are met.

-   The National Park Service had determined that these project
    amendments do not meet the Secretary of the Interior's "Standards
    for Rehabilitation."

Date National Park Service Authorized Signature National Park Service
Office/Telephone No.

-   See Attachments

CONTINUATION / AMENDMENT SHEET

+-----------------------+------------------------+---------------------+
| **     **             | ##                     | #                   |
|                       |                        |                     |
|                       | ##                     |                     |
|                       | Historic Preservation  |                     |
+-----------------------+------------------------+---------------------+
| Property Name         | ### Cer                | #                   |
|                       | tification Application |                     |
+-----------------------+------------------------+---------------------+
|                       |                        |                     |
+-----------------------+------------------------+---------------------+
| Property Address      |                        |                     |
+-----------------------+------------------------+---------------------+