Application for Federal Assistance

This example was created for training and is not official agency text.

• Before

  This form will be used by Federal agencies to obtain applicant certification that States which have established a review and comment procedure in response to Executive Order 12372 and have selected the program to be included in their process, have been given an opportunity to review the applicant’s submission.

• After

  If your State requires an opportunity to review your application, use this form to certify that you have done so. Include the form in your application.