W. Va. Code R. § 61-24-5 - Grant application by nonprofit spay neuter organizations or programs

5.1. In order to participate as a grantee, a nonprofit spay neuter organization or program shall complete and file the form provided by the Commissioner. The application shall contain at a minimum:

5.1.a. The applicant's name, physical address, mailing address, e-mail address, phone number, and primary contact person;

5.1.b. The applicant's federal employer identification number (FEIN);

5.1.c. The applicant's business registration account number from the W. Va. State Tax Department;

5.1.d. A description of the applicant's business, mission or purpose;

5.1.e. A copy of the applicant's latest financial statement, annual budget, or current balance sheet;

5.1.f. If the applicant is a 501(c)(3) entity, the most recent IRS Form 990, 990-EZ or 990-N;

5.1.g. A listing of the applicant's officers, executive director (if applicable) and a primary contact person;

5.1.h. The amount of the grant requested;

5.1.i. A detailed description of how the applicant intends to use the grant to advance spay neuter services, including a project budget, intended outcomes, and the expected amount of time in which the grant funds will be used;

5.1.j. Information regarding previous participation in the spay neuter program; and

5.1.k. Attestation that the information provided by the applicant is true and accurate to the best of the applicant's knowledge.

Notes

W. Va. Code R. § 61-24-5