HUD 52752 Certification of Consistency with the Indian Housing Plan (003).pdf
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- Attached to
- ROSS Resident Opportunity and Self-Sufficiency Service Coordinator Program - FY2024 - NOFO
- Opportunity number
- FR-6800-N-05
About this file
This document is a Certification of Consistency with the Indian Housing Plan form (HUD-52752) required to be submitted with a Resident Opportunity and Self-Sufficiency Service Coordinator (ROSS-SC) program grant application.
The form certifies that the proposed project activities are consistent with the applicant's current, approved Indian Housing Plan. It requires the applicant to provide information such as the project name, location, federal program(s) being applied for, and details about the certifying jurisdiction. The form must be signed by an authorized official, and includes warnings about making false claims or statements.
The related federal grant opportunity is the ROSS-SC Program - FY2024 NOFO, a grant program administered by the Department of Housing and Urban Development. This program provides funding to hire service coordinators who link public and Indian housing residents to training and supportive services to help them achieve economic and housing self-sufficiency. Eligible applicants include public housing authorities, non-profit organizations, and tribal governments.
HUD 52752 Certification of Consistency with the Indian Housing Plan (003).pdf
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Text version
CERTIFICATION OF
CONSISTENCY WITH THE
INDIAN HOUSING PLAN
U.S. DEPARTMENT OF HOUSING
AND URBAN DEVELOPMENT
OFFICE OF PUBLIC AND INDIAN HOUSING
OMB Approval No. 2577-0229 Expiration Date: 08-31-2026
Instructions for completing this form: All tribes/TDHEs must submit this form in conjunction with their ROSS application.
I certify that the proposed activities/projects in the application are consistent with the jurisdiction’s current, approved Indian Housing Plan.
Applicant Name:
Project Name:
Location of the Project:
Name of the Federal Program(s) to which the applicant is applying:
Name of Certifying Jurisdiction:
Title:
Signature:
Date:
Public reporting burden for the collection of information is estimated to average fifteen minutes per response. This includes the time for collecting, reviewing, and reporting the data. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions to reduce this burden the Reports Management Officer, REE, Department of Housing and Urban
Development, 451 7th Street SW, Room 8210, Washington, DC 20410–5000. When providing comments, please refer to OMB Control
No. 2577-0229. The information will be used to determine eligibility for the ROSS SC grant. Response to this request for information is required in order to receive the benefits to be derived. This agency may not collect this information, and you are not required to complete this form unless it displays a currently valid OMB control number. This information does not lend itself to confidentiality.
form HUD-52752 (12/2011)
I, the undersigned, certify under penalty of perjury that the information provided above is true and correct. WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012; 31 U.S.C. §3729, 3802)
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