Grant Extension Request
Grant recipients may request a grant extension to adjust their project timeline accordingly. This form must be completed 45 days prior to the original completion date AND by April 9th, whichever is soonest. Any requests that extend beyond the end of the fiscal year must be voted on and approved by the HCTDA Board of Directors.
Organization Name:
*
Organization Contact:
*
First Name
Last Name
Contact Email:
*
example@example.com
Contact Phone:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Project Name:
*
Reason for Extension Request:
*
Original Project Completion Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
New Estimated Project Completion Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supporting Documents
Browse Files
Drag and drop files here
Choose a file
Please upload any supporting documentation here, including a request letter on department letterhead.
Cancel
of
Today's Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Signature
*
Continue
Continue
Should be Empty: