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' Instructions ITEMS
<br /> ' ~ General IA. "Applicant" means any entity that files an application or
<br /> unsolicited proposal or otherwise requests EPA assistance.
<br /> Recipients of Federal financial assistance from the U.S.
<br /> Environmental Protection Agency must comply with the following IB. `Recipient" means any entity, other than applicant, which will
<br /> ' statutes. actually receive EPA. assistance.
<br /> Title VI of the Civil Rights Acts of 1964 provides that no person in IC. Self-explanatory.
<br /> the United States shall, on the grounds of race, color, or national
<br /> origin, be excluded from pazticipation in, be denied the benefits of, II. Self-explanatory.
<br /> or be subjected to discrimination under any program or activity .
<br /> receiving Federal financial assistance. The Act goes on to explain III. "Civil rights lawsuits" means any lawsuit or complaint alleging
<br /> that the title shall not be construed to authorize action with respect to discrimination on the basis of race, color, national origin, sex,
<br /> any employment practice of any employer, employment agency, or age, or handicap pending against the applicant and/or entity
<br /> labs organization (except where the primary objective of theFederal .which actually benefits from the grant. For example, if a city is
<br /> financial assistance is to provide employment). the named applicant but the grant will actually benefit the
<br /> Department of Sewage, civil rights lawsuits involving both the
<br /> Section 13 of the 1972 Amendments to the Federal Water Pollution city and the Department of Sewage should be listed.
<br /> Control Act provides that no person in the United States shall on the . .
<br /> j ground of sex, be excluded from pazticipation in, be denied the IV. "Civil rights compliancereview" means anyreviewassessing the
<br /> benefits of,~or be subjected to discrimination under the Federal Water applicant's and/or recipient's compliance with laws prohibiting
<br /> Pollution Control Act, as amended. Employment discrimination on discrimination on the basis of race, color, national origin, sex,
<br /> the basis of sex is prohibited in all such programs or activities. age, or handicap. If any part of the review covered the entity
<br /> which will actually benefit from the grant, it should be listed.
<br /> Section 504 of The Rehabilitation Act of 1973 provides that no
<br /> otherwise qualified handicapped individual shall solely by reason of V. Self-explanatory:
<br /> handicap be excluded from participation in, be denied the benefit of, -
<br /> or besubjected to discrimination under any program or activity VI. The word "community" refers tp the area under the applicant's
<br /> receiving Federal financial assistance. Employment discrimination and/or recipient's jurisdiction. The "community" might be a
<br /> on the basis of handicap is prohibited in all such programs or . university or laboratory campus, or a community~within a lazge
<br /> activities. city. If there • is significant disparity between minority and
<br /> ece've service no[ otherwise
<br /> nonminorit ulations to r i
<br /> Y PoP
<br /> The Age Discrimination Act of 1975 provides. that no person on the satisfactorily explained, the Regional office may require a map
<br /> I!, basis of age shall be excluded from pazticipation under any program which indicates the minority and nonminority population served
<br /> ~t_a~tivtyreceiving ~ederai rtfinancial--assistance.---Employment by-this-project,-program or-aetivit~ -
<br /> discrimination is not covered. Age discrimination in employment is •
<br /> prohibited by °the.Age Discrimination in Employment Act VII. This information is required so that reviewers maydetermine-if
<br /> administered by the Equal Employment Opportunity Commission. a disparity in the proposed provision of services will exist in the
<br /> event the application is approved for funding. Give population
<br /> Title IX of the Education Amendments of 1972 provides that no of recipient's jurisdiction, broken out by categories as specified.
<br /> person on the basis of sex shall be ex~lttded from participatitm in, be
<br /> denied the benefit of, or be subjectedto discrimination under.any In the event the applicant cannot--provide the requested
<br /> education program ~ activityreceiving Federal financial assistance. information because the funds will be distributed over a wide .
<br />
<br /> i Employment discrimination on the basis of sex is prohibited in all demographic area which is yet lobe determined, an explanation
<br /> `such education programs or activities. Note: an education program -may be provided on aseparate-sheet. For example, a State
<br /> ---or-activity is--not--limited to only those-conducted-by a- formal-------applying- for a capitalization-grant-under-the-State-Revolving..------.
<br /> institution. Fundprogrammaynotknowwhichcitiesandcountieswillapply
<br /> _ _ _ _ _
<br /> __.W w_ __.~for,-and_receive SRF_ oans___--_-
<br /> The information on this form is required to enable the U.S.
<br /> Environmental Protection Agency to determine whether applicants VIII. Self-explanatory.
<br /> and prospective recipients are developing projects, programs and
<br /> activities on a nondiscriminatory basis as required by the above IX. "Jurisdiction" means thegeographical azeaover which applicant
<br /> statutes. has the authority to provide service.
<br /> Submit this form with the original and required copies of X. Self-explanatory.
<br /> applications, requests for extensions, requests for. increase of funds, '
<br /> etc. Updates of information are all that aze required after the initial `Burden Disclosure Statement"
<br /> application submission.
<br /> EPA estimates public reporting burden for the preparation of this form
<br /> If any item is not relevant to the project for which assistance is to average 30 minutes per response. This estimate includes the time
<br /> requested, write "NA" for "Not Applicable." forreviewinginstructions,gatheringandmaintainingthedataneeded
<br /> and completing and reviewing the form Send comments regarding the
<br /> In the event applicant is uncertain about how to answer certain burden estimate, including suggestions for reducing this burden, to
<br /> questions, EPA program officials should be contacted for Chief, Information Policy Branch, PM-223, U.S. Environmental
<br /> clarification. Protection Agency, 401 M Street, S. W., Washington, D.C. 20460; and
<br /> to the Office of Information and Regulatory Affairs,
<br /> Office of Management and Budget, Washington, D.C. 20503. '
<br /> EPA FORM 4700-4 (Rev. 1/90) Reverse
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