Qualifying Block Grantees

The National Opioid Abatement Trust II (“NOAT II”) Agreement allows certain Qualifying Local Governments to become “Qualifying Block Grantees” by electing to receive NOAT II Funds through Local Government Block Grants. If a county, parish, or city believes it meets the conditions set forth in the NOAT II Trust Distribution Procedures to become a Qualifying Block Grantee and wishes to make such an election, it may engage NOAT II by completing and submitting the contact initiation form below. NOAT II, then, will coordinate with that county, parish, or city on potential Abatement Distributions.

* Indicates required information

State

Qualifying Local Government

Local Government’s Website

Name of Authorized Person Completing Form

Title of Authorized Person Completing Form

Email Address of Authorized Person Completing Form

Phone Number of Authorized Person Completing Form

Street Address 1 of Authorized Person Completing Form

Street Address 2 of Authorized Person Completing Form

Zip Code of Authorized Person Completing Form

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