Asap Information Request Form

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ASAP.gov Information Request Form
Please provide the information requested below so that we may begin the enrollment process for
your organization. Please return this request, along with three copes of the FNS-529 with original
signatures (signed in blue ink), to:
USDA Food and Nutrition Service (FNS)
Grants and Fiscal Policy Division
3101 Park Center Drive, Suite 740
Alexandria, VA 22302
January 1, 2016
1.
EIN Number
_______________________________________
2.
DUNS Number
_______________________________________
3.
Organization Type
_______________________________________
4.
FINANCIAL CONTACT INFORMATION
a. First Name
_______________________________________
b. Last Name
_______________________________________
c. Organization Name _______________________________________
d. Address
_______________________________________
e. City
_______________________________________
f. State
_______________________________________
g. Zip Code (+4)
_______________________________________
h. Phone Number
_______________________________________
i. E-mail Address
_______________________________________

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