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<br /> <br />City of Roseville <br />Non-profit Application for use of ARPA Funds <br />SUPPORTING DOCUMENTATION <br />• IRS Form 990 from most recent tax filing - ATTACHED. <br />• Current year budget for organization – ATTACHED. <br />APPLICANT SIGNATURE <br />By signing below, the applicant represents, warrants, and certifies that the information provided herein is true, <br />correct, and complete. I also certify that I have the authority on behalf of the organization to submit this <br />application and legally bind the organization. <br /> <br /> <br />Authorized Signer: ______________________________________________________________________ <br />Date: _________________________________________________________________________________ <br />Print Name: Angela Lewis Dmello__________________________________________________________ <br />Organization Name: Northeast Youth and Family Services_______________________________________ <br />2.13.2023 <br />Attachment F