NKH SIF Regulatory
Action Request
Subgrantee Name:
Contact Person:
Phone:
Email:
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Regulatory Action Description. Please include the following:
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Date or date range of project
Names and titles of individuals involved the project
Objective of project
Describe the process by which you intend to influence the administering agency
Explanation of how the project objectives will be obtained without attempting to influence a legislative
process
For SOS Use Only:
Date Approved By CNCS: _____________
SOS Approval
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Brittany L. Nixon, NKH SIF Financial Analyst
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Adrienne Allen, NKH SIF Director
PLEASE SUBMIT THIS FORM AT LEAST 10 BUSINESS DAYS PRIOR TO ENGAGING IN ANY REGULATORY
ACTIONS TO BE FUNDED UNDER THIS GRANT AWARD TO ALLOW FOR SUFFICIENT REVIEW TIME.