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JLH 'A, Inc. 069 Community Services Block Grant Program Fiscal Year 2016-17 Application for Funding Certification and Assurances Public Hearing on the Initial Plan We herein certify that a public hearing as required by 10A NCAC 97B .0402 Citizen Participation in the Application Process occurred on December 8,9,10, 2014 for the initial planning process for the agency's current project plan and the agency has maintained documentation to confirm the process of the public hearing. For multi -county providers, indicate -the date and the.county the hearing was held. Date County Date County December 16, 2014 Lee December 17, 2014 Harnett December 18, 2014 Johnston County Commissioners' Review We herein certify that the application for this project period was submitted to the Board of County Commissioners for review and comment on December 21, 2015 as required by 10A NCAC 97C .0111(b)(1)(A). For multi -county providers, indicate the county and date the application for funding was presented to the Board of County Commissioners as required by 10A NCAC 97C .0111(6). Date County Date County December 21, 2015 Johnston December 21, 2015 Lee December 21, 2015 Harnett Board of Directors Approval of the Application I hereby certify that the information contained in the attached application is true and the Board of Directors has reviewed and approved this application for the Community Services Block Grant Program. Date of Board Approval: Board Chairperson: Finance Committee Chairperson: (Signature) (Signature) Fiscal Year 2016-17 Community Services Block Grant Application Page 3 of 33 (Date) (Date)