Form 201701 Certification of Material Events Form

CERTIFICATION OF MATERIAL EVENTS FORM
For All CDFI Fund Programs
What is a “Material Event”?
A “Material Event” is an occurrence specified in any applicable Assistance, Award,
Allocation, or Bond Loan Agreement, or Agreement to Guarantee between the Community
Development Financial Institutions Fund (CDFI Fund) and an Award
Recipient/Allocatee/Borrower. Certified organizations, award Recipients and Borrowers
should consult each applicable agreement to determine which events must be reported. At
a minimum, a Material Event includes any change in an organization’s condition that may
lead to or cause the actual violation of terms and conditions of an Assistance, Award,
Allocation, or Bond Loan Agreement, Agreement to Guarantee, regulation, or law.
Certified Community Development Entities (CDEs) and Community Development
Financial Institutions (CDFIs) must also report any event or condition that may cause the
entity to no longer meet one or more certification criteria.
When should a Material Event report be filed?
A Material Event must be reported within 30 days of the occurrence or as specified in the
agreement(s) for the specific CDFI Fund Program. The failure to timely report a Material
Event is considered a violation of the terms and conditions of the applicable agreement,
and may be deemed an event of Default or Noncompliance.
Upon receipt of the Material Event Form, the CDFI Fund will review the content and assess
its impact on the submitting organization.
Instructions:
This form is to be used by CDFI Fund award Recipients/Allocatee/Borrowers to report a
Material Event. A separate Material Events form must be filed for each subsequent
Material Event with the information outlined below:
1. Indicate the name of the organization, Employer Identification Number (EIN) or
Unique Entity Identifier (UEI), Certification Control Number and
Award/Allocation/Loan Agreement Control Number. Provide a contact person and
associated contact information.
2. Select the applicable Material Event(s). Note that this form is used for all CDFI
Fund programs. Not all Material Events will be applicable. Recipients, Borrowers,
and Allocatees should consult their particular CDFI Fund agreement(s) for more
information on the specific Material Events that apply. These agreements provide
controlling authority in the event of any conflict regarding Material Event reporting
requirements.
3. Provide a narrative explanation of the Material Event(s).

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4. Provide a narrative statement indicating how the organization intends to correct or
address the Material Event.
5. Complete the Authorized Representative Signature information.
6. The completed form should be addressed to the attention of the Compliance
Monitoring and Evaluation Manager and submitted via a Service Request through
the Organization’s Awards Management Information System (AMIS) account. Any
supporting documentation (i.e. certificate of merger, name change form, etc.) can
be attached to the Service Request. Please note that this form should not be used
to request an amendment to any applicable Assistance, Award, Allocation, or
Bond Loan Agreement, or Agreement to Guarantee between CDFI Fund and
an Award Recipient/Allocatee/Borrower.

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A.

Award and Contact Information

Organization Name
Employer Identification
Number (EIN) or Unique
Entity Identifier (UEI)
Certification Control Number
(if available)
Award/Allocation/Loan
Agreement Control
Number(s)
Future Advance Promissory
Bond Number
Name and title of person to
contact regarding this report
Contact E-mail Address

Contact Telephone Number

Contact Street Address

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B.

Material Events

Check all applicable Material Events:
All Programs
1. Any proceeding instituted against the Recipient/Borrower (or in the case of
the NMTC Program, the Allocatee, its Affiliates, including the Controlling
Entity) in, by or before any court, governmental or administrative body or
agency (including any Federal bank regulatory agency), which proceeding or
its outcome could reasonably be expected to have a material adverse effect
upon the financial condition or business operations, assets or properties of the
Recipient (or in the case of the NMTC Program, the Allocatee, its Affiliates,
including the Controlling Entity) and in the case of the Bond Guarantee
program Properties of the Borrower.
2. Any material adverse change in the condition, financial or otherwise, or
operations of the Recipient/Borrower (or for NMTC Program, the Allocatee
or Controlling Entity) that would impair the Recipient, Borrower, or
Allocatee’s ability to carry out the terms and conditions and authorized uses
under the Agreement.
3. The occurrence of any Event of Noncompliance or Default, as that term is
defined in an Assistance, Allocation Agreement, or Bond Loan Agreement,
or any event, which upon notice or lapse of time, or both, would constitute an
Event of Noncompliance or Default.
4. The merger, consolidation or acquisition of the Recipient/Borrower, or in the
case of the NMTC Program the Allocatee or Allocatee’s Controlling Entity
by or with another entity.
5. The replacement of any key management officials (e.g., the Executive
Director, the Chief Financial Officer, the Board Chairperson or their
equivalents) that had been named in the Assistance or Allocation Application
or Guarantee Application.
6. Any substantial change in the business of the Recipient/Borrower.
7. Any event or change that would result in the Recipient no longer being
certified as a CDFI or CDE (if applicable).
8. All violations of Federal criminal law involving fraud, bribery, or gratuity
violations potentially affecting the Federal award. Failure to make required
disclosures can result in any of the remedies described in 2 CFR §200.339 of
the Uniform Requirements.
9. The loss of the Recipient’s Insured Credit Union status as defined in 12
U.S.C. § 1752(7) (if applicable).
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10. The loss of the Recipient’s Depository Institution Holding Company status
under 12 USC § 1813(w)(1) or Subsidiary Insured Depository Institution
status under 12 USC § 1813(c)(2) (if applicable).
11. The existence of any non-compliance with the terms and conditions of any
loan or other credit agreement with a creditor other than the CDFI Fund.
12. Any proceeding instituted against the Recipient/Borrower in, by or before any
court, governmental or administrative body or agency (including any Federal
bank regulatory agency), which proceeding involves allegations of
discrimination by the Recipient/Borrower on the basis of race, color, national
origin, disability, age, marital status, receipt of income from public assistance,
religion, or sex.
13. Such other events that may be determined by the CDFI Fund, in its sole
discretion, to be Material Events, and for which the CDFI Fund issues related
guidance.
14. The debarment, suspension, exclusion or disqualification, by the Department
of the Treasury, or any other Federal department or agency, of any individual
or entity (or principal thereof) that received any portion of the Assistance in
a procurement or nonprocurement transaction, as defined in 31 C.F.R.
§19.970.
CDFI Progam, CDFI Rapid Response Program and Small Dollar Loan
Program Only
15. A change in the Recipient’s shareholders or organization that results in (i) the
CDFI Fund’s ownership of equity in the Recipient exceeding 50 percent
and/or (ii) the CDFI Fund controlling the Recipient’s operations.
16. Any adverse finding by the Appropriate Federal Banking Agency related to
the Recipient.
Bank Enterprise Award Program Only
17. Prepayment, redemption, repurchase, or withdrawal of any Qualified
Activities reported to the CDFI Fund in the Recipient’s Application,
specifically if: i.) Any Borrower of the Recipient prepays, in whole or in part,
the principal amount of any loan carried out during the Assessment Period
that the Recipient reported to the CDFI Fund in its Application; ii.) Any
investee of the Recipient redeems or repurchases, in whole or in part, any
Equity Investment or Project Investment which the Recipient reported to the
CDFI Fund in its Application; or iii.) The Recipient withdraws, in whole or
in part, any deposit that the Recipient reported to the CDFI Fund in its
Application as a CDFI Support Activity; provided, however, the Recipient is
not required to notify the CDFI Fund of any prepayment, redemption, or
repurchase occurring more than two calendar years after the Federal Award
Date of the Agreement; and provided, further, that the Recipient is not
required to notify the CDFI Fund of any withdrawal which occurs more than
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three years after the date of the deposit. Such notice shall, at a minimum,
identify each prepayment, redemption, repurchase or withdrawal and the
dollar amount, the date of and the specific facts and circumstances
surrounding each prepayment, redemption, repurchase, or withdrawal.
New Markets Tax Credit Program Only
18. The occurrence of any event that may be a recapture event pursuant to IRC §
45D(g) and 26 C.F.R. §1.45D-1(e)(2).
19. The Allocatee’s Controlling Entity (as identified in the relevant Allocation
Application) no longer meets the definition of a Controlling Entity as
stipulated in the relevant Allocation Application/Allocation Agreement.
20. The occurrence of any event described in 31 C.F.R. §19.350.
21. The filing of any bankruptcy proceeding or the appointment of a conservator
for the Allocatee or its Affiliates, including the Controlling Entity.
Capital Magnet Fund Program Only
22. Any event or change that would result in the Recipient losing its status as a
Nonprofit Organization (if applicable).
23. Failure by the Recipient to have Committed all of its Capital Magnet Fund
Award by the date set forth in Schedule 1 of the applicable Agreement.
Bond Guarantee Program Only
24. Any significant revisions in credit, risk management, or financial reporting
policies and procedures of the Borrower.
25. Any direct financial obligation that is material to the Borrower under an offbalance sheet arrangement.
26. Any acquisition or disposition of a significant amount of assets by the
Borrower.
27. Any assessment (other than assessments provided by an Appropriate Federal
or State Banking Agency that are prohibited by applicable law or regulation
from disclosure to the Department of the Treasury) of significant or material
weaknesses in the design or operation of internal controls that are reasonably
likely to adversely affect the Borrower’s abilities to record, process,
summarize, and report financial information.
28. Any fraud, whether or not material, that involves management or other
employees of the Borrower who have a significant role in internal controls
over financial reporting.

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29. Any adverse audit opinions received by the Borrower or pronouncements of
non-reliance on previously issued financial statements by the Borrower’s
board of directors or a committee of the board of directors.
30. Any changes in corporate governance, senior management, or leadership of
the Borrower, including any Key Personnel. “Key Personnel” means any
officer or senior staff person of the Borrower responsible for the day-to-day
administration of the duties, responsibilities, and obligations of the Borrower
under the Bond Loan Agreement.
31. Any organizational updates such as changes in Bylaws or Articles of
Incorporation of the Borrower.
32. Any fact, circumstance, event, change, occurrence, condition, or development
of which the Borrower is aware and which, individually, or in the aggregate,
has had or would reasonably be expected to have a material adverse effect on
an organization’s strategic direction, mission, or business operation.

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C.

Provide a narrative explanation of the material event(s). Be sure
to include the date the event(s) occurred. Additional pages may be
added if necessary.

D.

Provide a narrative statement indicating how the organization
intends to correct or address the Material Event.

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E.

The Certification of Material Events form must be signed by the
organization’s Authorized Representative or authorized designee.

To the best of my knowledge and belief, all information contained in the Certification of
Material Events statement is true and correct. My signature indicates authorization on
behalf of the organization’s governing body.

Name:
Title:
Signature:
Date:

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PAPERWORK REDUCTION ACT NOTICE
CDFI - 0036
OMB Control Number 1559-0037

Paperwork Reduction Act Notice
This submission requirement is provided to CDFI Fund Awardees, applicants, and certified CDEs
and CDFIs, to report potential Material Events to the CDFI Fund. CDFI Fund Awardees, applicants,
and certified CDEs and CDFIs, are not required to respond to this collection of information unless
it displays a currently valid OMB number. The estimated average burden associated with this
collection of information is 0.25 hours. Comments concerning the accuracy of this burden estimate
and suggestions for reducing this burden should be directed to the Department of the Treasury,
Community Development Financial Institutions Fund, 1500 Pennsylvania Avenue, NW,
Washington, DC 20220.
The CDFI Fund is an equal opportunity provider.

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