Court Applying for Grant(Required) Date MM slash DD slash YYYY Contact Person for ApplicantName(Required) First Last Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email(Required) Phone(Required)FaxAmount of this request(Required)Funds needed by MM slash DD slash YYYY Timeframe in which funds will be used: From(Required) To(Required) Purpose of request: Please describe below the reasons the Court is seeking these funds at this time and how the administration of justice would be enforced if the grant request were approved. Please attach back-up documentation (bids, quotes, etc.):(Required)Back-up Documentation Drop files here or Select files Max. file size: 50 MB. How did you determine this was the best price or alternative (i.e. did you look at other options and why was this was chosen)?(Required)NameThis field is for validation purposes and should be left unchanged.