Congressman Paul D. Tonko
FY2010 Appropriations Request Form

Please return electronically to:
Joseph.Eaves@mail.house.gov and Nick.Viggiani@mail.house.gov
No Later Than:
Friday, February 27, 2009


1. Date Submitted:

2.  Name of Submitting Organization: 

3.  Primary Official's Contact Information:

       Name:
       Title:
       Address:
       Phone:
       Fax:
       Email:	
       Website:

4.  Staff Contact Information:

       Name:
       Title:
       Address:
       Phone:
       Fax:
       Email:	
       Website:

5.  Briefly describe your organization's main activities (public, private, non-profit, academic 
institution, etc.) and their regional and national significance:


6. Has your organization retained an external lobbying firm to assist with this request? (If Yes, 
please list):

       Name of Firm:
Lobbyist or Point of Contact:

Project Information

1. Project Title:


2. Project Description (Briefly describe the project and its regional / national significance): 

3. Have you submitted this request to another Congressional Office? (If yes, which Members of 
Congress and/or Senators?):


4. Does this project have confirmed support from other Members of Congress or Senators?  


5. Which Congressional District and Counties within New York State will this project impact?


6. Does this project involve any other organizations in New York State or other states? (If yes, 
list the organizations and states): 


Funding

1. Total project cost (i.e., including all funding sources and all years):

 
2. Amount you are requesting for this project in Fiscal Year 2010 (your FY2010 request should 
not exceed the amount that will be used in one year): 


3. Is this project funded in the President's FY2010 Budget Request? 


4. Provide a complete break down/budget of the amount you are requesting for this project in 
Fiscal Year 2010 (i.e. salary $40,000; computers $3,000, etc.): * Please note that other than 
Health related programs within the Labor-HHS bill, construction funds will not be granted)


5. What other funding sources are contributing to this project?  What amount does each of these 
funding sources contribute?


6. Is the potential recipient currently receiving funding for this project from any Federal agency?


7. Has the potential recipient received funding for this project from any Federal agency in the 
past four years?  (If yes, include information on the amount of funds, the Fiscal Years received, 
and the name of the Federal agency and program providing the funding.)
       
        

        FY2009
       Amount:
       Agency:
       Program:

        FY2008
       Amount:
Agency:
       Program:
FY2007
Amount:
Agency:
Program:

FY2006
Amount:
Agency:
Program:



8. Select the Federal Appropriations Bill from which you would like to request this funding. (If 
known): 





       __ Agriculture
       __ Commerce/Justice/Science
       __ Defense
       __ Energy and Water
       __ Financial Services
       __ Homeland Security
__ Interior and Environment
__ Labor/HHS/Education
__ Military Construction/Veterans Affairs
__ State/Foreign Operations
__ Transportation/HUD



9. List the Federal Agency and Account from which you would like to request funding. (If 
unknown, leave blank): 
       
       Agency:	
       Account:  

10. For Defense Projects Only:

       Budget Line Number:
       PE Number:
       Military Contact that has knowledge of your project (Full Name, Rank, Phone Number):
       

* Please note that the Defense Appropriations Subcommittee requires its own, additional forms 
for Defense and Military Construction requests. If you need these forms please ask for a copy.





****************** Project Narrative ******************

Please attach a ONE PAGE project narrative or abstract describing the project including 
background, need, use of funding, and how the project meets the criteria of the bill and federal 
program you have selected.


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