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North Carolina Department of Health and Human Services <br />Division of Social Services /Economic and Family Services <br />OFFICE of,. --- <br />ECONOMIC OPPO f RTUNITY <br />Community Services Block Grant Program <br />Fiscal Year 2015.16 Application for Funding <br />Project Period July 1, 2015 - June 30, 2016 <br />Application Due Date: January 30, 2015 . <br />022 <br />Agency Information <br />Agency: <br />Johnston - Lee - Hamett Community Action, Inc. <br />Federal I.D. <br />560859623 <br />DUNS Number. <br />153233663 <br />Administrative Office Address: <br />1102 Massey Street, Smithfield, NC 27577 -0711 <br />Mailing Address (include the 4 -digit zip code <br />extension): <br />Post Office Drawer 711, Smithfield, NC 27577 -4951 <br />Telephone Number: <br />919 -934 -2145 <br />Fax Number. <br />919 -934 -6231 <br />Board Chairperson: <br />Mr. Robert W. Atkinson <br />Board Chairperson's Address: <br />where communications should be sent <br />4212 Massey-Holt Road, Princeton, NC 27569 <br />Board Chairperson's Term of Office (enter <br />beginning and end dates): <br />02/2006 - 0212016 <br />Executive Director. <br />Mrs. E. Marie Watson <br />Executive Director Email Address: <br />Jlhca@jlhcommunityaction.org <br />Agency Fiscal Officer: <br />Mrs. Lakisha Nichols <br />Fiscal Officer Email Address: <br />lanichols @jlhcommunityaction.org <br />CSBG Program Director. <br />Mrs. Tina Ray <br />CSBG Program Director Email Address: <br />tinarray @jlhcommunityaction.org <br />Counties Served with CSBG funds: <br />Johnston, Lee and Hamett <br />North Carolina Department of Health and Human Services <br />Office of Economic Opportunity - Verna P. Best, Director <br />2420 Mail Service Center / Raleigh, North Carolina 27699 -2420 <br />hftp:/ /www.ncdhhs.gov /oeo/ <br />Fiscal Year 2015 - 16 Community Services Block Grant Application DEC 1 2T� <br />Page 1 of 49 <br />