OFFICE OF CONGRESSWOMAN CAROLYN B. MALONEY
FISCAL YEAR 2010 NON-DEFENSE APPROPRIATIONS REQUEST FORM
(PLEASE COMPLETE THE ENTIRE FORM)

1.  Date Submitted:	

2.  Project Name:

3.  Name of Submitting Institution:	

4.  Address (City, State and Zip):

5.  Phone number:  

6.  E-mail address: 

7.  Project Description (PLEASE limit to a one or two sentence description of how 
money will be spent - not a summary of the organization):

8.  Statutory Authorization for Requested for Requested Project (if applicable):

9.  Funding Request Amount for FY 10:

10.  Please identify which bill your request fits into (There are 12 appropriations 
bills):	

1.  Agriculture (AG)
2.  Commerce, Justice, Science (CJS)
3.  Defense (separate form for this bill) (DOD)
4.  Financial Services (FS)
5.  Energy and Water Development (E&W)
6.  State/Foreign Operations (For Ops)
7.  Homeland Security - this bill is not earmarked (DHS)
8.  Interior and Environment (I&E)
9.  Labor, Health and Human Services, and Education (Labor HHS)
10.  Legislative Branch (Leg. Branch)
11.  Military Construction/ Veterans Affairs (MilCon)
12.  Transportation, Housing Urban Development (TTHUD)

11.  Project Agency (e.g., Dept of Education)

12.  Project Account (e.g., Fund for the Improvement of Education (FIE):

13.  If you have previously received federal funding, please list the amount of money 
this project has received over the last six fiscal years.

FY09 Appropriation: 					FY08 Appropriation: 	

FY07 Appropriation:					FY06 Appropriation:	

FY05 Appropriation:					FY04 Appropriation:		

FY03 Appropriation:
			
14.  Is this project in the President's Budget?:					

15.  Please list the Total Project Cost:

16.  Please list the Non-Federal Cost Share and list ALL anticipated/received sources 
of funding for the project, and the amount you expect to receive/have already 
received from each source. (e.g. State, Local, Private):
 
17.  Project Budget Breakout (e.g., salaries, equipment, construction, etc.):

18.  Contact Information:

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


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


Highest Level Person at the Institution (who the Congresswoman may contact directly):
Institution:	
Name and Title:
Address:	
Email:		
Phone: 			
Cell:			

Lobbyist/Government Affairs Representative for the Institution 
Name:
Address:
Email:							
Phone:
Cell:				


Please provide a one page description of the project, amount requested, and its significance 
to the 14th Congressional district and/or national significance.

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