HTML Preview Fax First Page page number 1.
The Impact Aid Program
G5 e-APPLICATION COVER SHEET
IMPACT AID PROGRAM
FY 2015 - SECTION 8003
Fax
TO: Impact Aid Program SCHOOL DISTRICT NAME:
FAX: 1-866-799-1272
IMPACT AID NUMBER:
CONTACT NAME:
CONTACT PHONE:
COMMENTS:
Use this cover page to fax your e-Application signature pages by January 31, 2014. These documents
must be signed and dated on or before the January 31, 2014 due date. Remember to keep your fax
confirmation sheet showing the date and time sent.
Filled out Fax Cover Page
Signed and Dated Application Cover Page
Signed and Dated Assurances Page
• U.S. Department of Education • Office of Elementary and Secondary Education • Impact Aid Program •
400 Maryland Avenue S.W. Washington, DC 20202