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Click ‘Get Form’ to open it in the editor.
Begin by entering the date and contract period at the top of the form. This information is crucial for record-keeping.
In the Grantee Certification section, ensure you accurately list all current officers and board members. This must align with your agency's bylaws.
For each board member, provide their name, mailing address, and title or office held. If applicable, specify any neighborhood representation for low-income sector members.
Categorize each member according to federal requirements: business, industry, labor, religious, law enforcement, education, or other major groups.
Complete the sections for elected public officials and representatives of low-income individuals and families. Ensure that you note total seats and vacancies accurately.
If additional space is needed for more members, utilize the provided pages to continue listing names and addresses.

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