Fillable SF429 V1.0- Real Property Status (Denali Commission)

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SF429 V1.0- Real Property Status (Denali Commission)

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Country of origin: US
File type: PDF

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REAL PROPERTY STATUS REPORT SF-429
(COVER PAGE)
OMB Number: 4040-0016
Expiration Date: 01/31/2019
1. Federal Agency and Organizational Element to Which Report is Submitted:
4a. DUNS Number:
Recipient Organization Name:
Street1:
Street2:
City:
ZIP / Postal Code:
Country:
County:
Province:
2. Federal Grant(s) or Other Identifying Number(s) Assigned by
Federal Agency(ies):
3. Recipient Organization (name and complete address including zip code):
4b. EIN:
5. Recipient Account or Identifying Number:
7. Report End Date:
(MM/DD/YYYY)
First Name:
Middle Name:
Last Name:
Suffix:
Prefix:
6. Contact Person for this Report:
Phone:
Email:
Fax:
8. Real Property Status Report – Attachments: [check the applicable block(s)]:
: Attachment C (Disposition Request) attached
: Attachment B (Request to Acquire, Improve or Furnish) attached
: Attachment A (General Reporting) attached
9. Comments:
10. Certification: I certify to the best of my knowledge and belief that all information presented in this report is true, correct and complete
and constitutes a material representation of fact upon which the Federal government may rely.
11a. Typed or Printed Name and Title of Authorized Certifying Official:
Prefix:
First Name:
Middle Name:
Last Name:
Suffix:
Title:
11b. Signature of Authorized Certifying Official:
11c. Telephone (area code, number, extension):
11d. Email Address:
11e. Date Report Submitted (MM/DD/YYYY):
12. Agency use only
USA: UNITED STATES
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SF429 V1.0- Real Property Status (Denali Commission)

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Completed 18 July 2020

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