SF-424.PDF

* 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
OMB Number: 4040-0004 
Expiration Date: 12/31/2022
Other
09CH012079
Early Education
Ms.
AZ: Arizona
866000472
MARICOPA, COUNTY OF
(602) 372-3710
Budget Revision
Human Services
MCHSD  Early Education Division
Fl 3
Thomas
09CH012079
N/A
USA: UNITED STATES
Phoenix
Maricopa County
MHLNFHVYWDD9
234 N Central Ave
Assistant  Director
85004-0948
Nikki
Nikki.Thomas@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
NON-FEDERAL SHARE WAIVER
County Government
N/A
93.600
Not Applicable
eGrants-N/A
Head Start
ACF-Head Start
Not Applicable
Maricopa County with  Exception of the City

* 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 218, 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:
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
** I AGREE
* 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
0
-4,649,547
AZ-005
jack.sellers@maricopa.gov
Mr.
Sellers
AZ-007
(602) 506-3416
0
07/01/2023
-4,649,547
Jack
Chairman, Maricopa County Board of Supervisor
06/30/2024