TEMPLATE Checklist Item A11 Fully Occupied.docx

**The state must submit documentation that the site of the project is in reasonable proximity to a sufficient concentration and population of veterans that are 65 years of age and older and that there is a reasonable basis to conclude that the facility when complete will be fully occupied. Note that this is a template, and you are free to adapt as needed or submit supplemental documentation to meet this requirement. Delete any instructions that are italicized once updated. Submit as PDF.**

February 10, 2019 (Insert date)

Anna Gaug Program Manager U.S. Department of Veterans Affairs State Home Construction Grant Program (10NA5) 810 Vermont Avenue NW Washington, D.C. 20005

Re: Insert project title or description, location (city or county, state)

Dear Ms. Gaug, This document is to fulfill checklist item A.8. and certifies that the site of the project is in reasonable proximity to a sufficient concentration and population of veterans that are 65 years of age and older and that there is a reasonable basis to conclude that the facility when complete will be fully occupied. Reference supporting documentation/demographic information.

All correspondence in regards to insert project description may be directed to insert full name of authorized state representative who can be reached at insert telephone number.

Sincerely, Insert signature

Insert signature block