Hud-424-b Hud 424-b

Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)

HUD-424-b (revised 2-23-04).xls

Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)

OMB: 2502-0542

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Applicant Assurances and

U.S. Department of Housing

OMB Approval No. 2501-0017

Certifications

and Urban Development

(exp. 03/31/2005)

Instructions for the HUD-424-B Assurances and Certifications







As part of your application for HUD funding, you, as the official authorized to sign on behalf of your organization







or an an individual must provide the following assurances and certifications. By submitting this form, you are stating that to the







best of your knowledge and belief, all assertions are true and correct.

























As the duly authorized representative of the applicant, I certify that the



5. Will comply with the acquisition and relocation


applicant [Insert below the Name and title of the Authorized Representative,



requirements of the Uniform Relocation Assistance


name of Organization and the date of signature]:



and Real Property Acquisition Policies Act of 1970,


Name: , Title: .



as amended (42 U.S.C. 4601) and implementing


Organization: , Date: .



regulations at 49 CFR Part 24 and 24 CFR 42,


1. Has the legal authority to apply for Federal assistance, has the



Subpart A.


institutional, managerial and financial capability (including funds to pay



6. Will comply with the environmental


the non-Federal share of program costs) to plan, manage and complete



requirements of the National Environmental


the program as described in the application and the governing body



Policy Act (42 U.S.C.4321 et seq.) and related


has duly authorized the submission of the application, including these



Federal authorities prior to the commitment or


assurances and certifications, and authorized me as the official



expenditure of funds for property acquisition and


representative of the applicant to act in connection with the application



physical development activities subject to


and to provide any additional information as may be required.



implementing regulations at 24 CFR parts 50 or 58.


2. Will administer the grant in compliance with Title VI of the Civil Rights



7. That no Federal appropriated funds have been


Act of 1964 (42 U.S.C. 2000(d)) and implementing regulations (24 CFR



paid, or will be paid, by or on behalf of the applicant,


Part 1), which provide that no person in the United States shall, on the



to any person for influencing or attempting to


grounds of race, color or national origin, be excluded from participation



influence an officer or employee of any agency, a


in, be denied the benefits of, or otherwise be subjected to discrimination



Member of Congress, and officer or employee of


under any program or activity that receives Federal financial assistance



Congress, or an employee of a Member of Congress,


OR if the applicant is a Federally recognized Indian tribe or its tribally



in connection with the awarding of this Federal grant


designated housing entity, is subject to the Indian Civil Rights Act



or its extension, renewal, amendment or modification.


(25 U.S.C. 1301-1303).



If funds other than Federal appropriated funds have


3. Will administer the grant in compliance with Section 504 of the



or will be paid for influencing or attempting to


Rehabilitation Act of 1973 (29 U.S.C. 794), as amended, and implement-



influence the persons listed above, I shall complete


ing regulations at 24 CFR Part 8, and the Age Discrimination Act of 1975



and submit Standard Form-LLL, Disclosure Form to


(42 U.S.C. 6101-07), as amended, and implementing regulations at 24



Report Lobbying. I certify that I shall require all sub


CFR Part 146 which together provide that no person in the United States



awards at all tiers (including sub-grants and contracts)


shall, on the grounds of disability or age, be excluded from participation



to similarly certify and disclose accordingly.


in, be denied the benefits of, or otherwise be subjected to discrimination



Federally recognized Indian Tribes and tribally


under any program or activity that receives Federal financial assistance;



designated housing entities (TDHEs) established by


except if the grant program authorizes or limits participation to designat-



Federally-recognized Indian tribes as a result of the


ed populations, then the applicant will comply with the nondiscrimination



exercise of the tribe's sovereign power are excluded


requirements within the designated population.



from coverage by the Byrd Amendment, but State-


4. Will comply with the Fair Housing Act (42 U.S.C. 3601-19), as



recognized Indian tribes and TDHEs established


amended, and the implementing regulations at 24 CFR Part 100, which



under State law are not excluded from the statute's


prohibit discrimination in housing on the basis of race, color, religion,



coverage.


sex, disability, familial status, or national origin; except an applicant



These certifications and assurances are material


which is an Indian tribe or its instrumentality which is excluded by



representations of the fact upon which HUD can rely


statute from coverage does not make this certification; and further



when awarding a grant. If it is later determined that,


except if the grant program authorizes or limits participation



I the applicant, knowingly made an erroneous


to designated populations, then the applicant will comply with the



certification or assurance, I may be subject to


nondiscrimination requirements within the designated population.



criminal prosecution. HUD may also terminate the







grant and take other available remedies.


File Typeapplication/vnd.ms-excel
AuthorEric C. Gauff
Last Modified ByHUD
File Modified2004-02-23
File Created2002-06-13

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