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DCA Applicant Form 2
Georgia Department of Community Affairs
CDBG Program
Proposed Accomplishments
Total Proposed Accomplishments This Grant
Applicant: _______________________________________
Original
Amendment, Dated: _______________
Activity
Units
Persons
L/M Persons
Measure
Units
Persons
L/M Persons
Proposed Accomplishments
CDBG
Acquisition, Disposition
# of Structures
# of Parcels
Clearance
# of Structures
# of Parcels
Public Building
# of Facilities
# of Persons Served
# of Low and Moderate Income
Type: ____________________
Water and Sewer Facilities
# of Persons Served
# of Low and Moderate Income
Street and Flood/Drainage
Improvements
# of Persons Served
# of Low and Moderate Income
Other Public Facilities:
# of Persons Served
# of Low and Moderate Income
Type: ____________________
Public Services
# of Persons Served
# of Low and Moderate Income
Relocation Assistance
# of Businesses Relocated
# of Households Relocated
Housing Downpayment Assistance
# of Housing Units
# of Persons Served
Housing Rehabilitation
and Reconstruction
# of Housing Units
# of Persons Served
Public Housing Rehabilitation
# of Housing Units
# of Persons Served
Housing Development
# of Housing Units
# of Persons Served
Removal of Architectural Barriers
# of Persons Served
Economic Development
# of Businesses Assisted
# of Loans
# of Jobs Created
# of New Jobs for Low/Mod Persons
# of Jobs Retained
# of Retained Jobs for Low/Mod Persons
Private Investment ______________
[Reserved]
DCA Form 2 (2017) v.01