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OMB Number: 4040-0004 Expiration Date: 11/30/2025 * 1. Type of Submission: * 2. Type of Application: * 3. Date Received: 4. Applicant Identifier: 5a. Federal Entity Identifier: 5b. Federal Award Identifier: 6. Date Received by State: 7. State Application Identifier: * a. Legal Name: * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. UEI: * Street1: Street2: * City: County/Parish: * State: Province: * Country: * Zip / Postal Code: Department Name: Division Name: Prefix: * First Name: Middle Name: * Last Name: Suffix: Title: Organizational Affiliation: * Telephone Number: Fax Number: * Email: * If Revision, select appropriate letter(s): * Other (Specify): State Use Only: 8. APPLICANT INFORMATION: d. Address: e. Organizational Unit: f. Name and contact information of person to be contacted on matters involving this application: Application for Federal Assistance SF-424 Preapplication Application Changed/Corrected Application New Continuation Revision Maricopa County 86-6000472 JW5VMAWMCQR6 550 West Jackson Street Phoenix AZ: Arizona USA: UNITED STATES 85003-2412 Maricopa Cnty Sheriff's Office Special Investigations Cindy Kenney Grant Administrator 602-876-3266 cindyturner@mcso.maricopa.gov * 9. Type of Applicant 1: Select Applicant Type: Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 10. Name of Federal Agency: 11. Catalog of Federal Domestic Assistance Number: CFDA Title: * 12. Funding Opportunity Number: * Title: 13. Competition Identification Number: Title: 14. Areas Affected by Project (Cities, Counties, States, etc.): * 15. Descriptive Title of Applicant's Project: Attach supporting documents as specified in agency instructions. Application for Federal Assistance SF-424 B: County Government Office of National Drug Control Policy 95.001 HIDTA High Intensity Drug Trafficking Area High Intensity Drug Trafficking Area Program View Attachments Delete Attachments Add Attachments View Attachment Delete Attachment Add Attachment * a. Federal * b. Applicant * c. State * d. Local * e. Other * f. Program Income * g. TOTAL . Prefix: * First Name: Middle Name: * Last Name: Suffix: * Title: * Telephone Number: * Email: Fax Number: * Signature of Authorized Representative: * Date Signed: 18. Estimated Funding ($): 21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001) ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Application for Federal Assistance SF-424 * a. Applicant Attach an additional list of Program/Project Congressional Districts if needed. * b. Program/Project * a. Start Date: * b. End Date: 16. Congressional Districts Of: 17. Proposed Project: AZ AZ Add Attachment Delete Attachment View Attachment 01/01/2025 12/31/2026 695,511.00 695,511.00 a. This application was made available to the State under the Executive Order 12372 Process for review on b. Program is subject to E.O. 12372 but has not been selected by the State for review. c. Program is not covered by E.O. 12372. Yes No Add Attachment Delete Attachment View Attachment ** I AGREE Mr. Jack Sellers Chairman 602-506-1776 jack.sellers@maricopa.gov * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? If "Yes", provide explanation and attach HIDTA CY25 Application SF-424 Form 3a Maricopa County ATTEST: Juanita Garza Date Clerk of the Board of Supervisors APPROVED AS TO FORM This ____ day of ____________________, 20__ By: ___________________________________ Deputy Maricopa County Attorney