The National Spina Bifida Patient Registry at the University of Pittsburgh

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APPLICATION FOR FEDERAL ASSISTANCE SF 424 (R&R) 3. DATE RECEIVED BY STATE 0MB Number: 4040-0001 Exoiration Date: 10/31/2019 State Application Identifier 1. TYPE OF SUBMISSION [ ] Pre-application [XI Application [ ] Changed/Corrected Application 2. DATE SUBMITTED Appllcant Identifier 4. a. Federal Identifier b. Agency Routing Identifier c. Previous Grants.gov Tracking ID 5. APPLICANT INFORMATION Legal Name: University of Pittsburgh Department: Office of Research Street 1: 123 University Place Street 2: 821 University Club City: Pittsburgh State: PA: Pennsylvania Country: USA: UNITED STATES Organizational DUNS: 004514360 Division: County/Parish: Province: ZIP/ Postal Code: 15213-2303 Person to be contacted on inatters involving this application Prefix: First Name: Jennifer Middle Name: E. Last Name: Woodward Suffix: PosltionfTitle: Vice Chancellor for Research Operations Street 1: 123 University Place Street 2: B21 University Club City: Pittsburgh County/Parish: State: PA: Pennsylvania Province: Country: USA: UNITED STATES ZIP/ Postal Code: 15213-2303 Phone Number: 412-624-7400 Fax Number: Email: offres@pitt.edu 6. EMPLOYER IDENTIFICATION (E/N) or (TIN): 125-0965591 A6 7. TYPE OF APPLICANT: X: Other (specify) other (Specify): Private, non-profit, state-related, educ inst Small Business Organization Type [ J Women Owned [ ] Socially and Economically Disadvantaged 8. TYPE OF APPLICATION: [XI New [ ] Resubmission [ ] Renewal [ ] Continuation [ ] Revision If Revision, mark appropriate box(es). [ ] A. Increase Award [ ] B. Decrease Award [ ] C. Increase Duration [ ] D. Decrease Duration I I E, Other (specify): Is this application being submitted to other agencies? Yes 11 No [XI What other Agencies? 9. NAME OF FEDERAL AGENCY: 110. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 93.315 Centers for Disease Control and Prevention - ERA TITLE: Rare Disorders: Research, Surveillance, Health Promotion, and Education 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: The National Spina Bifida Patient Registry at the University of Pittsburgh 12. PROPOSED PROJECT: Start Date Ending Date 09/01/2019 08/31/2024 13. CONGRESSIONAL DISTRICT OF APPLICANT PA-018