This notice contains collection-of-information requirements subject to the Paperwork Reduction Act. The use of Standard Forms 424, 424A, 424B, 424C, 424 D, and SF-LLL has been approved by the Office of Management and Budget (OMB) under the respective control numbers 0348-0043, 0348-0044, 0348-0040, 0348-0041, 0348-0042, and 0348-0046. Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the Paperwork Reduction Act, unless that collection displays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average 80 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send Comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Highway Administration, 1200 New Jersey Avenue, SE., Washington, DC 20590.
Download a Word version of this application: plhd2012appl.docx, 26 KB
The application has been standardized this year in compliance with OMB Paperwork Reduction Act requirements.
Only State transportation departments may submit applications for funding under this program. State government agencies, Federal Land Management Agencies, metropolitan planning organizations, local governments, and Tribal governments may also apply through States as sub-recipients.
The application for each project must be submitted by the deadline and include the following information. Applications that do not include these items are incomplete and may not be considered in the evaluation and selection process. Applications should only be submitted for projects that are ready to advance as provided in the solicitation. Contact information is requested as part of the Standard Form 424. FHWA will use this information to contact parties in the event that FHWA needs additional information about an application.
Application: The application consists of both the Standard Form 424 and Project Narrative.
Standard Form 424 (SF-424): Application for Federal Assistance
Link to SF-424 - http://www.fhwa.dot.gov/discretionary/sf424.pdf
Project Narrative: Attachment to SF 424
The project narrative must respond to the application requirements outlined below. FHWA recommends that the project narrative be prepared with standard formatting preferences (e.g. a single-spaced document, using a standard 12-point font, such as Times New Roman). An application must include information required for FHWA to assess each of the criteria specified in the Selection Criteria. These items are specifically referenced in the outline below.
The project narrative may not exceed 6 pages in length. Documentation supporting the assertions made in the narrative portion may also be provided, but should be limited to relevant information. To reinforce the applicant's assertion of a project's benefit to Federal or Tribal lands, a letter of support or e-mail communication from the respective Federal Land Management Agency or Tribal government should be included as an attachment. FHWA recommends use of appropriately descriptive file names (e.g., "Project Narrative," "Maps," "Letters of Support," etc.) for all attachments. Those attachments must be submitted electronically in PDF format along with the attachment to SF-424. This additional information should be identified by the State and Project Title that matches the SF-424.
Project Narrative Recommended Outline: FHWA recommends that the project narrative generally adhere to the following basic outline.
State: (This should match item #14 in the SF-424)
Descriptive Title of Applicant's Project: This should match item #15 on the SF-424 and be a very short project description that readily identifies the project, or is commonly used to describe the project.
Project Abstract: Describe project work that is to be completed under this particular request, the project purpose and benefit to federal or tribal land, and whether this is a complete project or part of a larger project with prior investment. (Maximum: 5 Sentences) It is important that your project abstract succinctly describes how this specific request for PLHD funds will be used to complete your project.
Provide a brief description of the proposed work:
Describe the scope of work that is to be completed with this funding request, whether this is a complete project or part of a larger phased project, and what the intended outcome is. Only include work that is eligible for PLHD funding. The narrative should also describe the way in which this project addresses the transportation needs, strategic goals or priorities of the appropriate Federal land management agency or Tribal government that directly ties into the project benefits and how each of those transportation needs, strategic goals or priorities will be addressed by completion of the project. This should include supporting documentation from the appropriate Federal land management agency or Tribal government. Project outcomes should also be clearly identified in context of PLHD eligibility, and other project selection criteria that will result from completion of the project, such as safety, "state of good repair," and livability.
Amount of PLHD Funds Requested:
Provide a cost estimate that is reflective of the total cost of the proposed work by line item. Each line item should be associated with a completed task, deliverable, or outcome that contributes to the completed funding request. In the event that partial funding is available, this information will aid in the development of funding recommendations and provide the applicant the opportunity to fully complete individual components of the funding request. If the applicant is willing to accept partial funding of the request, that should be indicated.
The anticipated project schedule (assuming the requested PLHD funding is provided) is required. The schedule should show how the work will be advanced in the fiscal year for which the funds are being requested, and the anticipated completion date of the work. This should directly reference each line item in the cost estimate. Applications should only be submitted for projects that are ready to advance if the minimum partial funding request is met.
Previous Federal funds contributed to this project:
Indicate the type of Federal funds, including previous PLHD funds that this project has received, the Federal fiscal year, and current status of any work associated with these funds.
Commitment of Other Funds:
Indicate the amounts and sources of any private or other public funding being provided as part of this project. Only indicate those amounts of funding that are firm and documented commitments from the entity controlling the funds.
Letter of Support from appropriate Federal land management agency or Tribal government:
To substantiate the assertion of a project's benefit to Federal or Tribal lands, a letter of support or e-mail communication from the respective Federal land management agency or Tribal government should be included as an attachment. Federal Land Management Agency Contact List (pdf)
Indicate whether the project is being administered by the State department of transportation, a Federal land management agency, a division of the Office of Federal Lands Highway, or an Indian tribe, and include a letter or e-mail communication that confirms this by the appropriate entity. This information is needed to determine to whom to allocate the funds if the project is selected for funding. If the project is to be allocated to other than the State department of transportation, indicate coordination with State department of transportation, the ability to act on behalf of the applicant jurisdiction, and ability to meet Federal funding requirements. If this information is not included in the application, the project will not be considered ready to advance.
Will the funds be obligated within one year of the date the funds are made available and will the funds be applied to a ready-to-advance project?
(Y/N and include the estimated Obligation Date and to whom)
If relevant, explain how the project addresses safety and the state of good repair (including whether the improvement or activity minimizes lifecycle costs) as well as any long term strategic benefits associated with the improvement or activity for which PLHD funding is sought.
If relevant, explain how the project or improvement promotes or improves livability in the surrounding area, such as improving transportation choices, improving accessibility and service for economically disadvantaged, non-drivers, seniors, etc., providing access to a community or a natural resource, or efforts resulting from a coordinated planning process with public participation.
Attachments. If the applicant desires to submit additional information, such as maps, pictures, copies of support letters etc., those items must be submitted as a PDF attachment to the SF-424 and Application. This additional information should be identified by the State and Project Title so that it is easily identified as part of your application. With the exception of support letters from the appropriate Federal land management agencies or tribal governments, and confirmation letter or e-mail communication for project administration, these additional items are not required and should not be relied upon to meet the application submission requirements above, but serve only to illustrate the information provided in the narrative.