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ECHIBtT 1. PlakRtNCtPANTS 1N TH~ ~PPL1II~►►Tl4N 1NFORN►ATION <br />PART B. PREVIOUS PARTICIPATION AND BACKGROUND CERTIFICATION FORM <br />SECTION 3. NATIONAL PREVIOUS PARTICIPATION AND BACKGROUND CERTIFICATION FORM <br />SubSeCtion (a). Applicant's Authorization to Release Request for Compliance Status (To be completed by Applicant.) <br />The Applicant named below is applying for funding ftom the Texas Department of Housing and Community Affairs (TDHCA) for the <br />following developments (List the °Applicant Legal Name" for each current or pending TDHCA applicafion of the Applicant): Ci of <br />Paris Texas <br />The under signed, hereby requests and authorizes the agency named in Subsection (b) to release to TDHCA information regarding <br />any low-income housing development that the agency monitors and in which this Applicant has or is participating. A description of the <br />ApplicanYs participation in this state's affordable housing programs is provided in Subsection (c). <br />ApplicanYs Signature <br />Date <br />Kevin Carruth <br />ApplicanYs Printed Name <br />Subsecfion (b~ State Agency Responseto Requestfor Compliance Status (To be completed by State Agency.) <br />The information disclosed on this form will be taken into consideration by TDHCA when making funding decisions for the 2005 <br />calendar year. <br />State Agency Name: Contact: <br />Address: <br />City: State: ZIP: Phone: <br />1. Has this state agency issued an 8823 for any violations in the last three years in the following categories? <br />❑ Major violations of health, safety, and building codes. Such finding is ❑ Corrected ❑ Uncorrected <br />❑ Refusal to lease to persons with Section 8 vouchers. Such finding is El Corrected ❑ Uncorrected <br />❑ Determination of a violation under the Fair Housing Act. Such finding is Corrected E] Uncorrected <br />❑ Development is out of compliance and is never expected to comply as reported to the IRS via an 8823. <br />2. Are all the developments under control or ownership by the Applicant named above in compliance? ❑ Yes ❑ No <br />If "No," what formal or informal action has been taken by your agency?, <br />3. Is there other information you wish to share regarding compliance status? <br />This response represents this agency's evaluation of the ApplicanYs compliance status as of February 28, 2005. <br />Prepared By: <br />Title / Phone Number <br />Date <br />Please return "Exhibit 1, Part E, Section 3" to TDHCA within 30 days of receipt. This documentation can be transmitted by mail to: <br />TDHCA Compliance Monitoring Division, P.O. Box 13941, Austin, Texas 78711-3941, or via fax at 512.475.3359. If you have any <br />questions, contact Jo En Taylor at (512) 475-4972. Your prompt response and any information that you are able to share is greatly <br />appreciated. <br />Part II, Page 11 of 15 <br />