Office of Senator Kirsten Gillibrand
Fiscal Year 2010 Defense Appropriations/Authorization Form
Please Complete and Submit No Later Than February 27, 2009 to 
Appropriations@Gillibrand.Senate.gov 
Contact Kate Beale at Kate_Beale@Gillibrand.Senate.gov with any questions

Date Submitted:      					

Project Title:	     					

Company Name:       

Address (we only accept applications from NY companies):       

County:       

Project Description (2-3 specific sentence description of how the federal funding is intended to 
be spent):       

Priority (If submitting multiple projects):        out of     

Why does this project warrant federal funds? (2-3 specific sentence description):        

Amount of funding requested for FY 10:       

Total Project Cost:       			President's Budget:       

If not included in the President's budget, is your project listed on the Air Force, Army, Marine 
Corps or Navy unfunded requirements/unfunded projects lists?  Pick ONE

*If yes, which?       
					
Account:       					
Budget Line Number (RDT&E and Procurement projects):       
PE Number (RDT&E projects only):       				
Budget Activity (O&M projects only):       	
Sub-activity Group (O&M projects only):       
Committee Analyst (if known):       

House Member:       					House Staffer(s):       

If you have previously received federal funding, please list the amount of money this project
has received over the last four fiscal years.
FY09 Appropriation:       				FY08 Appropriation:       

FY07 Appropriation:       				FY06 Appropriation:       

Relationship with DoD (Please attach one short paragraph discussing your institution's relationship 
with DoD, including previous work done for DoD, and contact information for Program Manager who 
is supportive of your request for Congressionally-directed funding):       

Has your institution ever been barred from bidding on contracts by any of the Military 
Services, DoD, or any other federal government agency?  Pick ONE

*If yes, please provide an attachment explaining the details.        

How many people does your company employ based in New York?       

Staff Contact Information at the Institution:
Name:       
Address:       
Email:	     						Phone:       

Lobbyist/Government Affairs Representative for the Institution (not required)
Name:       
Address:       
Email:	     						Phone:       

Please attach a one paragraph description of the project, amount requested, exactly how the 
money will be spent and how it meets the criteria of the Program Title selected.       

Letter of Support:  Please attach ONE letter of support from the military, an agency, local government 
official or an organization that supports your request for funding.  A letter from the military is preferred.  
Only the first letter received will be accepted, any additional letters will be discarded.  

If there is any additional information that you think would be helpful in evaluating this project, 
please also attach it to this form.