Laserfiche WebLink
DISASTER ASSISTANCE APPLICATION DEM - 131 <br />Application Identifier:State Number: <br />Federal Disaster Number: <br />Federal Catalog Number: 97.036 Title: Public Assistance Grants <br />Declaration Date: <br />Applicant’s FEMA Project Application Number: <br />Legal Applicant Recipient: <br />Applicant’s Name: <br />Street Address: <br />Mailing Address: County: <br />City: State: Zip Code: <br />Applicant Agent: Contact Information: <br />Name:Phone: <br />Title:Fax: <br />E-mail: <br />Signature:Date: <br />Alternate Applicant Agent: <br />Name:Phone: <br />Title:Fax: <br />E-mail: <br />Signature:Date: <br />Type of Applicant: <br />A - State F - Higher Educational Institution <br />B - County G - Indian Tribe <br />C - City H - Private NonProfit <br />D - School District I - Other (Specify) __________________ <br />E - Special Purpose District <br />Enter Appropriate Letter _______ <br />Congressional District Number:_______________________ <br />State Legislative District Number:_______________________ <br />Governor's Authorized Representative: <br />Signature_______________________________ Date:________________ <br />NOTE: Shaded blocks for WA EMD use. <br />D20-189 <br />4481-DR-WA <br />March 22, 2020 <br />037-99037-00 <br />County of Kittitas <br />205 W 5th Ave Suite 105 <br />Kittitas <br />Ellensburg WA 98926 <br />Judy Pless 509-962-7502 <br />Budget Finance Manager <br />509-962-7687 <br />judy.pless@co.kittitas.wa.us <br />September 1, 2020 <br />Jerry Pettit 509-962-7557 <br />County Auditor <br />509-962-7687 <br />jerry.pettit@co.kittitas.wa.us <br />September 1, 2020 <br />Do not fill this in <br />B <br />8th <br />13th