SF 424 Supp Survey on Ensuring Equal Opportunity for Approvals

SURVEY ON ENSURING EQUAL OPPORTUNITY FOR APPLICANTS
OMB NO. 1890-0014 EXP. 1/31/2006

Purpose: The Federal government is committed to ensuring that all qualified applicants, small or large, non-religious or faithbased, have an equal opportunity to compete for Federal funding. In order for us to better understand the population of applicants
for Federal funds, we are asking nonprofit private organizations (not including private universities) to fill out this survey.
Upon receipt, the survey will be separated from the application. Information provided on the survey will not be considered in any
way in making funding decisions and will not be included in the Federal grants database. While your help in this data collection
process is greatly appreciated, completion of this survey is voluntary.
Instructions for Submitting the Survey: If you are applying using a hard copy application, please place the completed survey in an
envelope labeled “Applicant Survey.” Seal the envelope and include it along with your application package. If you are applying
electronically, please submit this survey along with your application.

Applicant’s (Organization) Name: ______________________________________________________________
Applicant’s DUNS Number: ___________________________________________________________________
Grant Name: ____________________________________________________CFDA Number: _____________

1. Does the applicant have 501(c)(3) status?
Yes

No

2. How many full-time equivalent employees does
the applicant have? (Check only one box).
3 or Fewer

15-50

4-5

51-100

6-14

over 100

3. What is the size of the applicant’s annual budget?

4. Is the applicant a faith-based/religious
organization?
Yes

No

5. Is the applicant a non-religious community-based
organization?
Yes

No

6. Is the applicant an intermediary that will manage
the grant on behalf of other organizations?
Yes

No

(Check only one box.)
Less Than $150,000
$150,000 - $299,999

7. Has the applicant ever received a government
grant or contract (Federal, State, or local )?
Yes

No

$300,000 - $499,999
$500,000 - $999,999
$1,000,000 - $4,999,999

8. Is the applicant a local affiliate of a national
organization?
Yes

No

$5,000,000 or more
SF 424 Supplement

Survey Instructions on Ensuring Equal Opportunity for Applicants
Provide the applicant’s (organization)
name and DUNS number and the
grant name and CFDA number.
Paperwork Burden Statement
1. 501(c)(3) status is a legal designation
provided on application to the Internal
Revenue
Service
by
eligible
organizations. Some grant programs
may require nonprofit applicants to have
501(c)(3) status. Other grant programs do
not.
2. For example, two part-time employees
who each work half-time equal one fulltime equivalent employee.
If the
applicant is a local affiliate of a national
organization, the responses to survey
questions 2 and 3 should reflect the staff
and budget size of the local affiliate.
3. Annual budget means the amount of
money your organization spends each
year on all of its activities.
4. Self-identify.
5. An organization is considered a
community-based organization if its
headquarters/service location shares the
same zip code as the clients you serve.

According to the Paperwork Reduction Act of
1995, no persons are required to respond to a
collection of information unless such
collection displays a valid OMB control
number. The valid OMB control number for
this information collection is 1890-0014. The
time required to complete this information
collection is estimated to average five (5)
minutes per response, including the time to
review instructions, search existing data
resources, gather the data needed, and
complete and review the information
collection. If you have any comments
concerning the accuracy of the time
estimate(s) or suggestions for improving
this form, please write to: U.S. Department
of Housing and Urban Development, Office
of Departmental Grants Management and
Oversight, Room 3156, Washington, D.C.
20410.
If you have comments or concerns
regarding the status of your individual
submission of this form, write directly to
the address above.

6. An “intermediary” is an organization that
enables a group of small organizations to
receive and manage government funds
by administering the grant on their
behalf.
7. Self-explanatory.
8. Self-explanatory.

OMB No. 1890-0014 Exp. 1/31/2006
SF 424 Supplement