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<br />Local Government Statement <br />Comprehensive Grant Program (.l <br />" <br /> <br />U.s. Deparbnent of Housing OMS Approval No. 2577-<)157 (exp. 7131/98) <br />and Urban Development . <br />Office of Public and Indian Housin <br /> <br />II <br /> <br />Public reporting burdentorthis collection ofinformation is estimated to average 5 minutes per response. induding the time for reviewing instructions. searching existing <br />data sources. gathering and maintaining the data needed. and completing and reviewing the collection of information. Send comments regalding this burden estimate <br />or any other aspect of this collection of information. inclUding suggestions for reducing this bUrden, to the Reports Management Officer. Paperwork Reduction ProJect <br />(2577~157). Office of Information Technology, U.S. Department ot HOUSing and Urban Development. WaShington, D.C. 2041Q..3600. This agency may not conduct <br />or sponsor, and a person is not required to respond to. a collection of information unM!ss that collection displays a valid OMS control number. <br />Do not send this farm to the above address. <br />This collection of information requires that each e!igible applicant submit information to HUe in order to receive its annual formula grant This information will be used <br />by HUe to determine whether the annual submission meets statutory and regulatory requirements for the annual formula grant. Responses to the collection are reQuired <br />by Section 14{e)(1)(E) of the U.S. Housing Act of 1937. as amended. The information requested does not lend itself to confidentiality. <br /> <br />I <br /> <br />As Chief Executive Officer of the unit of general local govemmentllndian tribe known as <br /> <br />in which the (name of Public Housing Agency (pHA) or Indian Housing Authority (!HA)) <br /> <br />I certiIY to the following: <br /> <br />1. The HA developed the Comprehensive Plan! Annual State- <br />ment in consultation with local government officials! <br />Indian tribal officials and with residents of the develop- <br />ments covered by the Comprehensive Plan! Annual Stale- <br />ment, in accordance with the requirements oftheCompre- <br />hensive Grant Program; <br /> <br />2a. For PHAs, the Comprehensive Plan/Annual Statement is <br />consistent with the unit of general local government's <br />assessment of its low-income housing needs (as evi- <br />denced by its Consolidated Plan under24 CFRPart 91, if <br />applicable), and that the unit of general local government <br />will cooperate in providing resident programs and <br />services; or <br /> <br />2b. For lHAs, the Comprehensive Plan/Annual Statement is <br />consistent with the appropriate governing body's assess- <br />ment of its low-income housing needs and that the <br />appropriate governing body will cooperate in providing <br />resident programs and services; and <br /> <br />Not.: The Comprehen,ivc Plan include, the Action Plan. <br />Name of Chief Executive Officer: <br /> <br />operates, <br /> <br />3. The HA's proposed drug and crime elimination activities <br />are coordinated with and supportiveoflocal strategies and <br />neighborhood improvement programs, if applicable. <br />Under the Cooperation Agreement, the locaJ/tribal gov- <br />ernment is providing public services and facilities of the <br />same character and to the same extent to Public and Indian <br />housing as are furnished to other dwellings and residents <br />of the locality. Where additional on-duty police are being <br />funded under the Com prehensive Grant Program. such <br />police will only provide additional security and protective <br />services over and above those for which the local/tribal <br />government is contracrually obligated to provide under <br />the Cooperation Agreement. <br /> <br />Signature of Chief Executive Officer and Date: <br /> <br />Warning: HUe will prosecute false claims and statements. Conviction may result in criminal and/orcivil penalties. (18 U S.C. 1001, ~010. 1012; 31 U.S.C. 3729. 3802) <br /> <br />Page 1 of 1 <br /> <br />form HUD-52835 (10/98) <br />ref Handbook 7485.3 <br />