Page 2 of 9
Fill out the following form including every project location. Return it along with the Project Budget to the
Specialist indicated on the tentative funding notification. One form may be used for multiple locations and/or
If you have revised your project as a result of the offer, clearly indicate such on the Project Budget form under
"Project Description." Specifically, indicate which activities have been removed from the revised budget. For
example, because of the reduced funding amount a three-pronged project that included an outdoor mural was
reduced to a two-pronged project without the mural.
II. CURRENT AWARDEES:
Fill out the following form including every project location. Submit it to the Office of Grants Management at
firstname.lastname@example.org. If you are revising the budget too, indicate if the revised project no longer involves activities
or locations that require NEPA/NHPA review. One form may be used for multiple locations and/or activities.
Include maps and photographs of each location and property. Be as concise as possible.
If you have questions regarding NHPA / NEPA or the process, contact email@example.com.
Once the review is concluded you will receive an email indicating that your grant has been “cleared”.
Funds cannot be released until you have received the “cleared” email. Therefore, prompt and thorough
responses are appreciated.
ANSWER THE FOLLOWING NHPA / NEPA QUESTIONS
1. Provide a very clear description of all location(s) for all grant activities, including the address(es) and construction
dates, and historic significance designations, if known. If you don’t have a physical address, provide the block or other
geographic boundaries within which grant activities occur (area of potential effect). Describe the site(s), whether they
are public spaces, streets, vacant lots, buildings, parks, riverbanks, walking trails, etc. Include a map and/or
For the purposes of this review, historic properties are:
(1) any place* 50 years old or older,
(2) any place included in or eligible for inclusion in the National Register of Historic Places (NRHP), or
(3) any place located in a NRHP historic district.
*Places include those property types associated with the NRHP including districts, sites, buildings, structures,
landscapes or objects.