Helping Hand Emergency Fund Application

Please complete the following information on one page in this order:

1. Date

2. Organization's name

3. Organization's address

4. Contact person's name and title

5. Contact person's phone, fax, and email address

6. Freddie Mac Foundation grant-funded program for which you are requesting emergency funds
   Amount previously awarded and grant term

7. Purpose of funding request (1-2 sentences)

8. Total current organizational budget and fiscal year

9. Total program budget and fiscal year

10. Dollar amount requested for program

11. Signature of Executive Director and date

12. Signature of Board President and date

Please answer questions with a brief paragraph or a sentence. Completed application should not exceed 3 pages.

1. Describe the Freddie Mac Foundation grant-funded program for which you are requesting emergency funds including:

   • Services provided

   • Description of participants (number affected, age, ethnicity, income level)

   • Geographic area served

   • Frequency of program activities

2. Describe the nature of the emergency in your organization and how it has affected the program for which you are requesting funds. Include:

   • Why you are requesting funds

   • Services at risk of elimination or reduction

   • Nature of the risk to participants and the number of participants affected

3. What is the expected duration of the emergency?

4. What is the amount of the budget shortfall of the Foundation grant-funded program?

5. What is the amount of your request from the Freddie Mac Foundation?

6. How would emergency funds be used?

7. Describe your plan for raising the balance of the budget shortfall of the Foundation grant-funded program if a Freddie Mac Foundation emergency grant is awarded to your agency. For each category, include the following information:

   • Grants - committed, pending and proposed (sources and amounts)

   • Contracts - committed, pending and proposed (sources and amounts)

   • Loans - committed, pending and proposed (sources and amounts)

   • Other sources of funding - committed, pending and proposed (sources and amounts)

8. What efforts has your board made to address the organization's funding needs?

9. What actions will be taken if the additional funds needed for the program are not raised?

10. What alternative services or resources are available to your current program participants through your agency or any other in the event needed funds are not raised?

Attachments Required

1. Complete and submit the 12-month cash flow template[XLS 21K] for the Foundation grant-funded program for which you seek funds.

2. Previous year's (12-month) budget vs. actuals, (revenues and expenses, preferably audited). If audited financial statements for the previous year are unavailable, please submit unaudited statements for the previous year, as well as your most recent audited financial statements.

3. Copy of the most recent grant report for the Freddie Mac Foundation grant-funded program for which you seek support.

4. Copy of current IRS Determination Letter indicating 501(c)(3) and 509(a) tax-exempt status.

5. List of board of directors — indicating officers, occupations, places of employment and related community affiliations.

The Freddie Mac Foundation Emergency Fund will be evaluated and a decision will be made about its continuation in 2004.