Grant Extension Request Form

Community Development Revolving Loan Fund
Grant Extension Request Form
This form must be completed by credit unions requesting to extend the grant expiration
date for reimbursement requests associated with the CDRLF program awards.
Credit unions must complete the following information and email this form to
[email protected]. The email subject line should be “Grant Extension Request”
and include the grant commitment number of the award.
NCUA will respond to the extension request by email. All extension requests require
approval in writing. The NCUA will not consider extending the grant expiration date for
more than three months after the original expiration date.
1. Date of Request:
2. Credit Union Name:
3. Charter Number:
4. Grant Initiative:
5. Commitment Number:
6. Application ID Number:
7. Authorized Credit Union
Contact Name:
8. Credit Union Contact
Email Address:
9. Credit Union Contact
Telephone #:
10. Authorized Credit Union
Contact Signature:
11. Original Commitment
Expiration Date:
12. Requested Commitment
Expiration Date:

1

Office of Credit Union Resources and Expansion
Grant Extension Request Form
OMB Control Number 3133-0138

13. Describe the project the credit union was initially awarded funds for in this
application.

14. Describe the reason(s) the credit union needs an extension to utilize the funds.

15. What percentage of the project has the credit union completed as of the date of
this extension request? Discuss the remaining tasks that must be performed to
complete the project.

2

Office of Credit Union Resources and Expansion
Grant Extension Request Form
OMB Control Number 3133-0138