Form Naa-01 - Connecticut Neighborhood Assistance Act (Naa) Program Proposal - 2003 Page 5
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5PART IV — MUNICIPAL INFORMATION
To be completed by the municipal agency overseeing implementation of the program
Name of Municipal Agency Overseeing Implementation of the Program: ____________
_____________________________________________________________________
Mailing address: ________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Name of Municipal Liaison: _______________________________________________
(
)
Telephone Number: ______________________________________________________
(
)
Fax Number: __________________________________________________________
Post-Project Review
Is a post-project review required for this proposal?
Yes
No
If yes, date post-project review due:
____/____/____
Form NAA-01 (Rev. 3/03)
Page 5 of 5
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