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$Additional Federal Funds Leveraged $Additional State Funds Leveraged <br /> $Locally Leveraged Funds $Grantee Funds Leveraged <br /> $Anticipated Program Income Other(Describe) <br /> Total Funds Leveraged for HOME-based Project(s) <br /> Housing Opportunities for People with AIDS 14.241 HOPWA <br /> HOPWA Project Titles Description of Areas Affected by HOPWA Project(s) <br /> $HOPWA Grant Amount $Additional HUD Grant(s) Leveraged Describe <br /> $Additional Federal Funds Leveraged $Additional State Funds Leveraged <br /> $Locally Leveraged Funds $Grantee Funds Leveraged <br /> $Anticipated Program Income Other(Describe) <br /> Total Funds Leveraged for HOPWA-based Project(s) <br /> Emergency Shelter Grants Program 14.231 ESG <br /> ESG Project Titles Description of Areas Affected by ESG Project(s) <br /> $ESG Grant Amount $Additional HUD Grant(s) Leveraged Describe <br /> $Additional Federal Funds Leveraged Additional State Funds Leveraged <br /> $Locally Leveraged Funds Grantee Funds Leveraged <br /> $Anticipated Program Income ther(Describe) <br /> Total Funds Leveraged for ESG-based Project(s) <br /> Congressional Districts of: Is application subject to review by state Executive Order <br /> Applicant Districts—2nd Project Districts— 12372 Process? <br /> 2nd <br /> Is the applicant delinquent on any federal debt?If ❑ Yes This application was made available to the <br /> "Yes" please include an additional document state EO 12372 process for review on DATE <br /> explaining the situation. X No Program is not covered by EO 12372 <br /> ❑ Yes X No ❑ N/A Program has not been selected by the state <br /> for review <br /> Person to be contacted regarding this application <br /> Stephen J. Arnett <br /> Housing Administrator 808/961-8379 808/961-8685 <br /> ohcdcdbg @co.hawaii.hi.us <br /> Signature of Authorized Representative Date Signed <br /> SF 424 Page 2 Version 2.0 <br />