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• <br />_ire- <br />N T OFyOGiP <br />4 �� II Z <br />i * * 1 S F 424 <br />z 1111 <br />o �, The SF 424 is part of the CPMP Annual Action Plan. SF 424 form <br />Gas `dz fields are included in this document. Grantee information is linked <br />qH DEV from the 1CPMP.xls document of the CPMP tool. <br />SF 424 <br />Complete the fillable fields (blue cells) in the table below. The other items are pre -filled with values from the <br />Grantee Information Worksheet. <br />Date Submitted <br />Applicant Identifier Type of Submission <br />Date Received by state <br />State Identifier Application <br />Pre -application <br />Date Received by HUD <br />Federal Identifier 0 Construction <br />• Construction <br />0 Non Construction <br />■ Non Construction <br />Applicant Information <br />County of Hawaii <br />H1159999 HAWAII STATE PROGRAM <br />50 Wailuku Drive <br />09-463-6073 <br />Suite 102 <br />Office of Housing & Community Development <br />Hilo <br />Hawaii <br />Office of Management <br />96720 <br />U.S.A. <br />Housing <br />Employer Identification Number (EIN): <br />Hawaii County <br />99-6000567 <br />Applicant Type: <br />Specify Other Type if necessary: <br />Local Government: County <br />Specify Other Type <br />Program Funding <br />U.S. Department of <br />Housing and Urban Development <br />Catalogue of Federal Domestic Assistance Numbers; Descriptive Title of Applicant Project(s); Areas Affected by <br />Project(s) (cities, Counties, localities etc.); Estimated Funding <br />Community Development Block Grant <br />14.218 Entitlement <br />Description of Areas <br />Leveraged <br />Grant <br />Affected by CDBG Project(s) <br />Describe <br />CDBG Project Titles Hale Ohana <br />Renovations, West Hawaii Domestic <br />Renovations, West Hawaii Homeless <br />Improvements, Kulaimano Elderly <br />Hale Maluhia Men's Shelter Accessibility <br />Kiheipua Family Shelter Certified <br />Boys and Girls Club Accessibility <br />Administration, Planning & Fair Housing <br />Domestic <br />Abuse <br />Emergency <br />Housing <br />Improvements, <br />Kitchen <br />Improvements, <br />Abuse Shelter <br />Shelter <br />Shelter <br />Renovations, <br />Improvements, <br />$Additional HUD Grant(s) <br />$CDBG Grant Amount $2,500,000.00 <br />$Additional Federal Funds Leveraged <br />$Additional State Funds Leveraged <br />$Locally Leveraged Funds <br />$Grantee Funds Leveraged <br />$Anticipated Program Income $100,000 00 <br />Other (Describe) <br />Total Funds Leveraged for CDBG-based Project(s) <br />Home Investment Partnerships Program <br />14.239 HOME <br />HOME Project Titles Habitat for Humanity Puna Self Help <br />Housing <br />Description of Areas Affected by HOME Pro ect(s) <br />SF 424 <br />Page 1 <br />Version 2.0 <br />