Disaster Relief Application for Support

PURPOSE

To invest resources supporting individuals and various entities of Fulton, Graves, Hickman, and Marshall counties to ensure they have sufficient capacity to respond to the Federally Declared Disaster 4630-DR-KY, the Kentucky tornado disaster of December 10-11, 2021, herein known as “4630-DR-KY”. Funding can be used to support disaster recovery for individuals impacted by 4360-DR-KY and the rebuilding of the community. Only organizations or churches with 501c3 status that have a need to expend a maximum of $250,000 within six months of grant receipt will be considered for funding. Accurate expenditure reporting will be required. All United Way funding is required to be expended prior to the request for additional funding. 

Contact Information of Applicant
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Application Information

Impact area requested. Check all that apply. 
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Funds are required to be expended within six months of receipt unless a written request for an extension has been approved by the United Way (30) days prior to the original expenditure deadline. 
Are you willing to collaborate with the Long-term Recovery Group in your county? (an answer of yes or no will not exclude you from funding)
All funds received by an applicant hereunder must be utilized for the sole purpose of facilitating disaster recovery, rebuilding, and sustainability of the impacted individuals and communities after 4630-DR-KY, in accordance with the request(s) outlined in this application.  The grantee shall promptly return to United Way of Western Kentucky any such funds which are used for any purpose other than that which is outlined in this request.
 
Funds must be expended within six months of receipt unless a written request for an extension has been approved in writing by the United Way of Western Kentucky at least thirty (30) days prior to the original deadline.  Any funds not expended within six months of receipt, or the agreed-upon deadline if extended, shall be promptly returned to the United Way of Western Kentucky.
 
Reporting requirements: detailed reporting of expenditures is required within three months of receipt of any grant funds and upon the complete expenditure of grant funds awarded. Reporting must include names and addresses of fund recipients, the date in which funds were allocated, and a complete list of expenses funded by this grant. 
1) Applicant confirms that it is an organization that is currently recognized by the Internal Revenue Service as an IRC Section 501(c)(3) organization and a public charity under IRC Section 509(a), and if approved for funding, the grantee will inform the granting United Way immediately of any change in, or IRS proposed or actual revocation (whether or not appealed) of its tax status described above.
2) This grant may be used only for the specific purposes outlined herein, and shall also be applied consistent with the grantee’s charitable purposes consistent with IRC Section 501(c)(3). No amount shall be used to lobby or
otherwise attempt to influence legislation, to influence the outcome of any public election, or to carry on any voter registration drive.
3) This grant must be used for the sole purpose listed in this application – to facilitate disaster recovery, rebuilding, and sustainability of the impacted individuals and communities after 4630-DR-KY. Recovery services funded by this grant must not be eligible for recovery by private insurance, direct FEMA relief, or any other duplicative source. If funds are identified from another source to address the same individual loss or recovery service, the United Way grant will be returned to the granting United Way by the grantee.
4) Expenditure of grant funds shall uphold state and federal laws and shall not discriminate on the basis of race, color, religion, sex, sexual orientation, national origin, age, disability or any other characteristic protected by law. 
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