Council Discretionary Funding Application

  • Instructions

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    This application must be completed by an officer or employee of the organization that is applying for discretionary funding. All requests for funding must to legible, organized, complete and accurate. Keep a copy of the completed application for your records before it is submitted. All sections of the application are mandatory unless otherwise noted.
    The person who completes this form must be authorized by the organization to complete it and must know enough about the organization to be able to fully, truthfully and accurately complete the form.

    Requests for funding that are submitted to the City Council are considered public documents.

    WHERE AND WHEN TO SUBMIT THIS APPLICATION:

    This application cannot be saved, however you can go back to a previously finished section to make changes. You must complete the entire application in one session. DO NOT close the browser window or navigate away from the page until you have finished and submitted the application.

    In the checklist you will be provided with everything you will need to have access to in order to complete the application. The same application used to apply to an individual Member, the Speaker, or for a Council Initiative.


      a.

    Requests for Funding from Council Members

    Check the appropriate box(s) in Section C.
         
      b.

    Requests for Funding Related to Speaker Initiatives and City-Wide Initiatives

    Check the appropriate box(s) in Section C.

    Please direct any questions to scrowley@council.nyc.gov.

    Once the application is complete you will be prompted to print and sign certain documents that are to be sent to the Council.  Do NOT send a printed version of the application.  Only mail the documents that are necessary.  Printed documents can be mailed to:

    Scott Crowley
    NYC Council, Finance Division
    250 Broadway, 15th Floor
    New York, NY 10007

  • Application Checklist

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    Below is a list of information you will need access to in order to complete the application.  Be sure to have this information handy as you cannot save this application.

    Information required:

    1. Federal Employer Identification # (FEIN)

    2. New York State Charities Bureau Registration Number

    3. Budget of Organization requesting funds

    4. Documentation concerning Independent Inquiries, Monitorships, Government Investigations, Inquiries or Audits (other than routine annual audit)

    5. Staffing information for the program you are requesting funds for

    6. Certificate of Incorporation (for those incorporated on or after July 1, 2010

    7. Adobe Reader is required for viewing and printing the Portable Document Format (PDF) documents at the end of this application. To download the latest version of Adobe Reader, please click here

  • Section A: Organization Information

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    Legal Name of Organization Requesting Funding:
     
    Organization Acronym and Other Names Used:
    Applicant Federal Employer Identification Number (FEIN)
     
    Current (FEIN):
     
    Is the organization's FEIN now, or has it in the past, ever been used by any other organization(s)?
     
     
    If "YES", please list the name of the organization(s)
     
     
    Does the organization now use, or in the past, used an FEIN other than the one provided
     
     
    If "YES", please list all FEIN(s) used for the past 10 years
     
     
     
     
    Is the organization tax exempt under the Internal Revenue Code?
    http://www.irs.gov/charities
     
     
    If "YES", is the organization's tax exempt status current with the Internal Revenue Service?
     
    Organization Web site
    Please provide the organization's Web site
     
    Administrative Address
     
    Street Address 1:
     
    Street Address 2:
     
    City:
     
    State:
     
    Zip Code:
    		 -
     
    Does the organization share office space, staff, equipment, or expenses with any other organization?
     
     
    If "YES", please name the organization(s) and the nature of the relationship
     
     
    Has the organization ever applied for Council funding in the past?
     
    Contact Person:
     
    Name:
     
    Title:
     
    Phone:
    		  Ext:
     
    Email:

  • Section B: Prequalification and Charitable Status

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    Was the organization incorporated before July 1, 2010?
     
     
    If no, please provide the date of incorporation
     
     
    Did the organization receive or apply for Prequalification through the Mayors Office of Contract Services (MOCS)?

    To access the current list of prequalified organizations, please visit:
    http://www.nyc.gov/html/dycd/downloads/pdf/PQL_PQL_5122011.pdf

    If "Yes" or if you have applied for prequalification, skip this section and select the Continue button to go directly to Section C. If "No" complete this section.
     
    Charitable Status
      To be eligible for funding organization must provide either a Charities Bureau identification number or qualify for an exemption.
    Is the organization registered with the Charities Bureau of the New York State Attorney General?
     
     
    If "Yes", Please Provide ID Number:
    Is the organization exempt from registering with the Charities Bureau?
     

  • Section C: Funding Information

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    Amount Requested:
    		 $
    Contracting Agency:
     
    Estimated budget for the organization's current fiscal year:
      $
    Is the organization seeking funding related to Speaker Initiatives and City-Wide Initiatives
    (If you select no, you must select Council Members or Delegations below to receive your funding request).
     
    City Council Members from whom the organization seeks funding:
    (To select multiple members, select the control key and click each member name.)
     
     
    Has the principal, authorized official or any executive member of the organization ever applied for funding as the representative of another organization (please provide year and outcome).
     
    Independent Inquiries, Monitorships, and Government Investigations, Inquiries, and Audits
     
    Within the last 5 years, has the organization been the subject of and independent inquiry, monitorship or government investigation or audit (by any local, state or federal government including any current or past audit by the City Comptroller, request for information or other inquiry from the Department of Investigation and any audit or inquiry by a licensing agency) other than a routine annual audit?
     
     

  • Section D: Purpose and Use of Funds

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    Please provide the organization the mission / goal.
     
     
    Please describe the specific programming/services to be funded; including a description on how the requested funds will be used?
     
    Who is the target population to be served?
     
     
    When will the program operate:
    (months, days of the week, hours, summer, seasonal, etc.)
     
     
    What geographic area will be served?
    (e.g. Citywide; Brooklyn; Council District 39; Community Board 6; Flatbush, etc.)
     
    Are the services that the funds are being requested for open to all members of the general public regardless of enrollment, membership or any affiliation?
     
     
    Please describe the community benefit of the program / services that is being considered for funding
     
     
    State the location / address where the services are to be provided.
    (if more than one, list all locations)
     
     
    If the services are legally provided in a residential dwelling (house, apartment, etc.) please provide the Department of Buildings’ Certificate of Occupancy
    (Please include a copy with the rest of the mailed portion of the application.)
     
    Briefly describe the staffing for the program, including number and qualifications, paid or volunteer, etc.
     
    Has the organization provided the proposed or similar services in the past?
     
     
    If "YES", please briefly describe how long the services have been offered
     
     
    If "NO", please explain why these services have not been provided before and what qualifications the organization has to start providing these services.
     
    Promotion
     
    Please describe what the organization does and plans to do that invites the community to participate in programs and services, including any advertising. Please include a copy of your advertisments with the rest of the mailed portions of the application.
     
    Performance Evaluations
     
    Please list all performance evaluations from federal and state entities for the last three years
    (include agency, rating and date)
     

  • Section E: Affiliation

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    Will the program be located in, operated by, or affiliated with a religious school?
     
     
    What percentage of the program participants do you estimate also attend the religious school?
      %
     
    Will the program be located in, operated by, or affiliated with a religious organization or place of worship?
     
     
    What percentage of the program participants do you estimate also are
    members of or participate in the religious organization or place of worship?
      %
     
    If "YES", (to either question) please describe what types of outreach and/ or advertising is done to invite the community/general public to participate in the programming/services being offered?
     

  • Section F: Confirmation/Notary

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    Discretionary Funding Disclosure Fund Confirmation

    Before you submit, print a copy of this form for your records. You will NOT be able to print the form after submission.

    Print Discretionary Funding Disclosure Form