14-HUD Form 50071 - Certification of Payments to Influence Federal Transactions - exp 11.30.2023.pdf
HUD Form Nov 30, 2023 PDF 336 KB Posted
- Attached to
- Scattered Sites General Construction Services
- Solicitation number
- 2026-03
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
This is a HUD Form 50071 Certification of Payments to Influence Federal Transactions issued by the U.S. Department of Housing and Urban Development, with an OMB approval number 2577-0157 expiring November 30, 2023. The form serves as a mandatory certification requirement for applicants receiving federal grant funding through HUD programs. The certification requires the applicant's authorized official to attest that no federal appropriated funds have been or will be paid to influence officers or employees of federal agencies, Members of Congress, or Congressional staff in connection with federal contracts, grants, loans, or cooperative agreements. The form applies to all subawards at all tiers, including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements, with all sub-recipients required to certify and disclose accordingly.
Any person or entity failing to file the required certification is subject to a civil penalty of not less than $10,000 and not more than $100,000 for each failure. If any non-federal funds have been or will be paid for influencing federal transactions, the applicant must complete and submit Standard Form LLL, Disclosure Form to Report Lobbying, in accordance with its instructions. The certification is a material representation of fact upon which reliance was placed when the transaction was made or entered into, and submission is a prerequisite for transaction execution under Section 1352, Title 31, U.S. Code. False claims and statements are subject to prosecution under 18 U.S.C. Sections 1001, 1010, and 1012, and 31 U.S.C. Sections 3729 and 3802, potentially resulting in criminal and civil penalties. The public reporting burden is estimated at 30 minutes per submission.
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Text version
OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of HousingCertification of Payments and Urban Developmentto Influence Federal Transactions Office of Public and Indian Housing
Applicant Name
Program/Activity Receiving Federal Grant Funding
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be (3) The undersigned shall require that the language of this paid, by or on behalf of the undersigned, to any person for certification be included in the award documents for all subawards influencing or attempting to influence an officer or employee of at all tiers (including subcontracts, subgrants, and contracts an agency, a Member of Congress, an officer or employee of under grants, loans, and cooperative agreements) and that all Congress, or an employee of a Member of Congress in connec- sub recipients shall certify and disclose accordingly.
tion with the awarding of any Federal contract, the making of any
This certification is a material representation of fact upon whichFederal grant, the making of any Federal loan, the entering into reliance was placed when this transaction was made or enteredof any cooperative agreement, and the extension, continuation, into. Submission of this certification is a prerequisite for makingrenewal, amendment, or modification of any Federal contract, or entering into this transaction imposed by Section 1352, Titlegrant, loan, or cooperative agreement.
31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than(2) If any funds other than Federal appropriated funds have $10,000 and not more than $100,000 for each such failure.been paid or will be paid to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying, in accordance with its instructions.
I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
Name of Authorized Official Title
Signature Date (mm/dd/yyyy)
Previous edition is obsolete form HUD 50071 (01/14)
Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality.
HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number.
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| ProgramActivity_Receiving_Federal_Grant_Funding: |
| Signature: |
| Date_mmddyyyy: |
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File details come from the government source that posted it. Updated .