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Please complete the information below. Each item or question must be answered in full. All requested information <br />must be typed. <br />Previous editions of this application are obsolete and may not be used. <br />I. General Information <br />Applicant Organization's Legal Name: City of San Leandro <br />Applicant Agency EIN Number (assigned by the IRS; this number should be nine digits): 94-6000421 <br />[If the Office of Justice Programs has assigned your department an EIN Number, please use that assigned number Otherwise, your Internal <br />Revenue Service EIN number should be used. For further clarification, please refer to your Application Instruction Manual, page 3.J <br />Applicant Agency ORI Number: CA0011200 <br />[Assigned by the FBI for UCR reporting. This number should be seven digits long, beginning with the two letters of your state abbreviation. For <br />further clarification, please refer to your-Application Instruction Manztal, page 3.J <br />Federal Congressional District Number(s): 13 <br />Are you contracting for law enforcement services? ^ Yes $~ No <br />If 'yes, "enter the name and agency information of the contract law enforcement department in the Executive Information section below [For <br />.jrther clarification in determining if this applies to yoztr agencJ; please refer to the Application Instruction Manual, page 3.J <br />II. Executive Information <br />(Note: Please list the highest ranking official for each category) <br />Law Enforcement Executive's Name: Joseph W. Kitchen <br />Title: Chief of Police Agency Name: San Leandro Police Department <br />Address: 835 East 14th Street <br />City: San Leandro State: CA Zip Code: ~' <br />Telephone: ~d 1 gT577_32F ~ Fax: (510) 577-3275 <br />Email Address: kitchen@ci _san-leandro.ca.us <br />Type of Police Agency: <br />Municipal ^ State ^ County PD ^ Sheriff* ^ Tribal* ^ Transit* <br />^ School* ^ University/College* (^ Public or ^ Private?) <br />^Public Housing* ^ New Start-Up* (please specify type of agency): <br />^Other* (please specify): <br />*Departments applying from agency types with an asterisk next to them mztst complete the additional information questionnaires contained in the <br />Application Kit. This additional information must be submitted with your application. <br />Government Executive's Name: John _.Jermani s <br />Title: Cit. t Mt ~naaer Name ofGovermment Entity: City of San Leandro <br />Address: 835 East 14th Street <br />City : San Leandro State: CA Zip Code: 94577 <br />Telephone: (51n1 577-3390 Fax: (510) 577-3340 <br />Email Address: ~aermanis@ci.san-leandro.ca.us <br />COPS irl Schools Appficatian form 2 <br />