HUD-53231_Resident&Comm-Involvement-Cert.pdf

OMB Approval No. 2501-0044

(exp. 2/28/2027)

HUD-53231

CHOICE NEIGHBORHOODS – IMPLEMENTATION GRANTS

Resident and Community Involvement Certification

This collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of the requested information. Comments regarding the accuracy of this burden estimate and any suggestions for reducing this burden can be sent to: U.S. Department of Housing and Urban Development, Office of the Chief Data Officer, R, 451 7th Street SW, Room 8210, Washington, DC 20410-5000. Do not send completed forms to this address. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid OMB control number. This agency is authorized to collect this information under Section 102 of the Department of Housing and Urban Development Reform Act of 1989. The information you provided will enable HUD to carry out its responsibilities under this Act and ensure greater accountability and integrity in the provision of certain types of assistance administered by HUD. This information is required to obtain the benefit sought in the grant program. Failure to provide any required information may delay the processing of your application and may result in sanctions and penalties including the administrative and civil money penalties specified under 24 CFR § 4.38. This information will not be held confidential and may be made available to the public in accordance with the Freedom of Information Act (5 U.S.C.

§ 552). The information contained on the form is not retrieved by a personal identifier, therefore it does not meet the threshold for a Privacy Act Statement.

Lead Applicant:

Name of Target Public Housing Site(s):

Resident Involvement requirement:

In accordance with section 24(e)(2)(D) of the 1937 Act, applicants must involve affected residents and other stakeholders at the beginning and during the planning process for the transformation program, prior to the submission of an application. You are required to involve the affected public and/or assisted housing residents in the planning process and implementation of your Transformation Plan.

This involvement must be continuous from the beginning of the planning process through the implementation and management of the grant, if awarded.

I certify that the Resident and Community Involvement requirement, as detailed in the NOFO, has been met.

I/We, the undersigned, certify under penalty of perjury that the information provided on this form is true, accurate, 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 and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802).

Name of Lead Applicant Executive Officer:

Title:

Signature: Date: _____________

Dates of Resident Meeting(s):

Date(s) of Public Meeting(s): ______________________________________________________