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2. Community Development - Information Request Form
   Please fill out the questions below to help us send you the correct information.
4. First Name
5. Last Name
7. Organization
9. Address
11. Address Line 2
13. City
14. State
15. Zip Code
16. Country
18. Email Address*
20. Do you serve Jefferson County residents?*

    1. Yes

    1. No
22. Are you a non-profit 501(c) 3?*

    1. Yes

    1. No
26. Request Information
    Please check all information that you are interested in receiving.
28. Community Development Block Grant

    1. Annual Plan
    2. Consolidated Annual Performance Evaluation Report
    3. Consolidated Plan
    4. General Information
    5. Guidelines
30. Home Investment Partnerships Grant

    1. General Information
    2. Guidelines
    3. Relocation Act Information
32. Community Services Block Grant

    1. General Information
    2. Guidelines
    3. ROMA Information
34. Comments / Other Requests
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field