|
<br />r: Ih" applicant has no o:h.r QaVemment auista~ to disclou. iI must
<br />cenity that this assenion is coned:.
<br />To avoid duplication. ifth.r. is oth.r po....rnm.nt Usllt.not und.r this
<br />Part and Part V,lh. &;>plunVr.cipi.nt.hould d>.o.th. appropriol.
<br />box in this Part and listth. inlormation in Part V, cl8ar~ dutgnatir.g
<br />which sources are o1her govemmenl assis1ance.
<br />D. P.rtIV. Int"nl.d I'Irtl...
<br />This Part i. to bt compl.,od by bolh applicant. r~ing applicant
<br />disclosure r.p)r'\s and r.opients filing updat. r.porta,
<br />Apprcants must providl information on:
<br />(1) All dev.bpers, contradorl, or consutlantl invoJve.d in the applica-
<br />tion for the assistanc. or in the planning, dlvebpmlnt. or impllmen-
<br />tation of thl projlct or aC'..;""r.y: and
<br />(2) Any olhor person who has a fin.ncial inl"..t In th. projod 0(
<br />adivi'ty for which the a.s.sis:anca ~ sought that .x~e<Js $50,000 or '0
<br />percent of the assis1a.")CI (whichlver is Iow.r).
<br />R~ipients must make the additional disclosures rltl.rre<J to in Sldion
<br />1.0.1..2.. or 4. abav..
<br />Nols,: A financial interest means any fsnanciaJ invotvlm.nt in th.
<br />project or ac:ivity, inchx:!i.~ (but not limiled to) s.ituations in which an
<br />individual or onlhy has an equity inlor..t in tho projtcl or aclivhy,
<br />shares in any profit on resale or any distnbutionof su~us cash or other
<br />assets of the projed or a:=',Nil'y, or receives compln~ation for any
<br />goods or slrvice-s provided in connld.ion whh thl pro}ed or activity.
<br />A..id.ncy of an individual in housing for which ...isIanco is being
<br />$ought is not, by itself, considlr~ a ccv.r~ financial intereSl
<br />Tj)il} information requited below must be provide<J,
<br />L Enter thl fuD names aM acSdr.ss.es of all persons ref.rr.cl \0 in
<br />paragraph It) or (2) ollhis Pan. ~ th. person is an onlily, tho listing
<br />must includ. the full name a each offtCer. director, and prirdj)al
<br />slockholdll olth. onlity. All nam.. must boo tis10d alphabetically. and
<br />Ih. nam.. 01 individuals mu.t be shown with tho~ last nam.. first.
<br />2. Enlry of th. Social Socurily Numbtr (SSN) or Employnldontif'oc:a-
<br />tion Number (EtN). as a;>proprialt, lor tad> porson lislod is oplionaL
<br />3. Entor th. Iype of panicipalion in tho projocl or aclivity lor tad>
<br />person tislOd: t... tho person's spocilic rol. In th. projtcl (..g.,
<br />contrador, eonsutl.ant. planner, investor),
<br />4. Enlll Ih. financial inl"'" in th. projtcl or aclivily for tad> person
<br />listed. The interest must be expressed both as a dollar amount and as
<br />a parcentage of the amount of thl HUD assista.nc:e invotv.d.
<br />~ thl applicant has no pers.ons wil.h financial int.rests to disclose, k
<br />must cenity tha11his as.sinion is correct,
<br />5. Part V. R.port on Sour... and UN' 01 FundI. This Part is 10 bt
<br />complet&d by b::Ith appfi:ants filing applicant dis.cbsurt r"POrts and'
<br />recipients filing upda~. r';>or..s.
<br />The apprant disc10sure repon must $pecify aJI .xp.ct.cS s.ources 01
<br />lunds - bothlrom HUe and from any other s.ource -thll'l haye be.n,
<br />or are to bI. made availabl. for the project or adivity, Non.HUD
<br />sources offunds typ)cally includl (bUl &f8 not limher \0) other gov8rn~
<br />ment assistance refen.d to in Part 111, equity, and' amount. from
<br />foundations and priva~e contributions. The report must also specify an
<br />~xp&d.d uses to which fur.ds are to be put. All sources and US4lS of
<br />1unds must be list&d, ft, bu.d on an assessment 01 all the circum-
<br />stances invo~.d, there art reasonabl. grour.ds to anticipat. that the
<br />:s.oUIC. or un win be tort~c:oming.
<br />Nolo that ~ any olth. sourea!uso Inlormalion roquirod by this llpotI
<br />has be.n provid.d ols.whor. in this application pac:l<ago, tho appIi.
<br />cant need not repe-'- thl intormation, but nMd only refer to thl fonn
<br />and Iocalion 10 incorporalt ~ inlo this llport. (h is 1i<.1y thai $Om. 01
<br />Ih. informalion IIqu~od by this llport has been providod on SF 424....
<br />and on various budg.tlorms accompanying tM appfeation.) "this
<br />Jeport reQuires intormation beyond thm provWjtd els.wh.,. in t.....
<br />
<br />a.pplic;tiOn packag., the applicant mUI' include in this rtport an the
<br />addiltonal information re-quir&d.
<br />Rt<:ipilna must submh an upd~. repon for any chang. in pr.viousty
<br />dis<:lo.od sources and us.. of lund. II p<ovidod in Soc:ion 1.0.5.,
<br />ahoy..
<br />G.n.rallnstrUdions - J.OUfces of funds
<br />Each raport.bI. $Ourca 01 fund. mu.'lndical.:
<br />a. The natfl.....nd addr.... clty, Stat., and zip code of th. individual or
<br />.nOty making the asaista.nce available. At ~ast on. organil.tbnal
<br />~Yel bebw thl ag.ncy nama shou'd be induded. For .xampll, U.S.
<br />D.partmont of Transponlllion. U.S. Coasl Guard; D.panm.nt 01
<br />Sof.ly. Highway Palrol.
<br />b. The prDglram name and arry r.llvant identifyinQ numb.rs, or other
<br />means 01 identifICation, for thl assistancI.
<br />c. The type of assis1a.1lC$ (I.g., loan. grant. loan insuranee).
<br />Specific instructions - sourCClS of funds.
<br />(') For progra.ms adminisl.rtd by the Assistant Secretaries for Fair
<br />Housing and Equal Opponunity and Policy Doy.lopmont and Ro.
<br />uaren, each source of funds mus1 indica1e th. lotal amount of
<br />approved, and reeaiY&d; and must be listed in descending order
<br />ac::cording to the amount i,..dicat~.
<br />(2) For programs adminis1er&d by the Assistant Seerelanes for
<br />Housing-F$der&l Housing Commissioner, Community Planning and
<br />O.yebpment. and Pubic and Indian Housing, each source of funds
<br />must indicalotho tolal amount oIlunds involvod, and must be [l$lod in
<br />descand'ing orO$r according to th. amount indicate<!,
<br />(3) If Tax Cre<Jits are invotved, thl report must indatt aa syndation
<br />proceeds and equity involvod.
<br />Gen.ral instrudion~s8S of funds,
<br />Each reportablou.. ollunds musl citaMyidontifytho purpos.to whid>
<br />th.y ar.1O be put. Rnsonabl. aggregations may be usod, such as
<br />.,otal strudur.. to indudl a number of struc::2uraJ costs, such as roof.
<br />.vevators. ext.rior masonry. .tc.
<br />SpeciftC instructions - us.s of funds,
<br />(') For program. administllod by Ih. Assistant Secrolws lor Fair
<br />Housing and Equal Opponunity and porcy D.v.lopmont and R..
<br />soarch, .ach us. of funds must indicalo tho tolal amount 01 funds
<br />Involvod: must bt brcl<.n down by amount commillod, budg.tod. and
<br />plannod; and must be ~S1od in doscending ordor according to tho
<br />amount iM'ica1.-d,
<br />~Q For programs adminis1ered by thl Assistant Secrltaries for
<br />Housing-F&dlraJ Housing Commissioner, Community Planning and
<br />Oey.bpment, and pubrc and lndian Housing, tach us. of funds must
<br />indica1. the total amoum of funds involv.d and must bI lis1ed in
<br />deSC8ndir.g order a.cc:ording 10 the amount inyotv~,
<br />(ill) If any program adminis11red by the Assistant SlCfltary for
<br />Housing-Fed..,al Housing Commission.r is involved, the report must
<br />indicat. all vses paid from HUD sources and oth.r sources. including
<br />syndication proceeds. Uses paid should includl the followinQ
<br />amounts.
<br />AMPO
<br />Archiled'S 1M - design
<br />Archit&d's fee - supervision
<br />Bond premium
<br />Builder's gen.ral overhead
<br />BuDdor's proll
<br />Construc.1.ion interlst
<br />Consutlant te.
<br />Contingency Rlserve
<br />Cost CQnlfieation audit 1ee
<br />FHA examination '.e
<br />FHA in~on '"
<br />
<br />p.~ 6 01 7
<br />
<br />iorm Hue-2nO
<br />
|