Applicants must submit their requests for assistance on EPA Form 5700-12, “Application for Federal Assistance.” Applicants must submit the original and two copies of the application to EPA. If the assistance agreement is to be awarded by EPA Headquarters, the applicant must send the application to the Environmental Protection Agency, Grants Administration Division, (3903R), 1200 Pennsylvania Ave., NW., Washington, DC 20460. If the assistance agreement is to be awarded by an EPA Regional Office, the applicant must send the application to the appropriate Regional Office.

(Approved by the Office of Management and Budget under control number 2010-0004)