Application For Assistance For Homeless Children And You

U.S. Department of Education Office of Elementary and Secondary Education Office of Safe and Healthy Students Washington, D.C. 20202-6450 ELEMENTARY AND SECONDARY EDUCATION 2018 APPLICATION FOR ASSISTANCE FOR HOMELESS CHILDREN AND YOUTH
STATE	DUNS NUMBER		CFDA NUMBER 84.938B
SEA NAME : STREET/P.O. BOX : CITY : COUNTY : STATE & ZIP :
CONTACT PERSON NAME : TITLE : PHONE : FAX : E-MAIL :
I certify that the statements and all of the data included in this application are, to the best of my knowledge and belief, true, complete, and correct. I certify that I am authorized to make the representations and commitments in this application, for and on behalf of the applicant, and otherwise to act as the applicant’s authorized representative in submitting this application for funding.
NAME AND TITLE OF AUTHORIZED REPRESENTATIVE		SIGNATURE		DATE

U.S. Department of Education Office of Safe and Healthy Students Washington, D.C. 20202-6450	2018 APPLICATION FOR ASSISTANCE FOR HOMELESS CHILDREN AND YOUTH
SEA NAME :
Displaced and Homeless Student Counts:
Total number of displaced children and youth, as defined in the authorizing statute, enrolled in public schools in the State during the 2017-18 school year:
Of the total number of displaced students reported above, the total number who were homeless children and youth, as defined by section 725(2) of the McKinney-Vento Homeless Assistance Act:
Demonstrated Need:
The total number of homeless children and youth, as defined in section 725(2) of the McKinney-Vento Homeless Assistance Act who were enrolled in public schools in the State during the 2017-18 school year; whose primary nighttime residence changed as a result of the covered disaster or emergency; and who do not meet the definition of displaced student:
(Optional) Additional information on, or description of, demonstrated need for funding:

U.S. Department of Education Office of Safe and Healthy Students Washington, D.C. 20202-6450

2018 APPLICATION FOR ASSISTANCE FOR HOMELESS CHILDREN AND YOUTH ADDITIONAL CERTIFICATIONS & ASSURANCES

The Authorized Representative assures that the State will comply with all of the requirements that apply to the Assistance for Homeless Children and Youth program including the following:

1. The State will comply with reporting requirements (see 2 CFR 200.333-200.337), including additional reporting required by the Improper Payments Information Act of 2002 (31 U.S.C. 3321 note).
   
   

2. The State will cooperate with any Inspector General examination of records under the program.
   
   
   

3. Any LEA receiving funding under this program will have on file with the State a set of assurances that meets the requirements of section 442 of the General Education Provisions Act (GEPA) (20 U.S.C. 1232e).
   
   
   

4. To the extent applicable, an LEA will include in its local application a description of how the LEA will comply with the requirements of section 427 of GEPA (20 U.S.C. 1228a).
   
   
   

5. The State and other entities will comply with the provisions of all applicable acts, regulations and assurances; the following provisions of Education Department General Administrative Regulations (EDGAR) 34 CFR parts 76, 77, 81, 82, 84, 97, 98, and 99; The OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement) in 2 CFR part 180, as adopted and amended as regulations of the Department in 2 CFR part 3485; and The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards in 2 CFR part 200, as adopted and amended as regulations of the Department in 2 CFR part 3474.

NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

SIGNATURE

DATE

Appendix: Definitions

Displaced student

The term "displaced student'' means a student who enrolled in an elementary school or secondary school (other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area) because such student resides or resided on the date that is one week prior to the date that the major disaster or emergency was declared for the area, in an area for which a major disaster or emergency declared by the President in accordance with section 401 or 501, respectively, of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170), related to a covered disaster or emergency.

Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title VIII of P.L. 115-123, the “Bipartisan Budget Act of 2018.”

Homeless Children and Youths

The term “homeless children and youths” means individuals who lack a fixed, regular, and adequate nighttime residence. The term includes—

• Children and youths who are:

• sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason (sometimes referred to as “doubled-up”);

• living in motels, hotels, trailer parks, or camping grounds due to lack of alternative adequate accommodations;

• living in emergency or transitional shelters; or

• abandoned in hospitals;

• Children and youths who have a primary nighttime residence that is a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings;

• Children and youths who are living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings; and

• Migratory children who qualify as homeless because they are living in circumstances described above.

Section 725(2) of the McKinney-Vento Homeless Assistance Act (42 U.S.C. § 11434a).

Paperwork Burden Statement 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 1810-New. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.

Form Approved:

PAGE 2 – OMB number 1810-XXX

– Expiration date: XXXX