2530 Previous Participation Certification

Previous Participation Certification

OMB Approval No. 2502-0118
(Exp. 02/29/2016)

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Office of Housing/Federal Housing Commissioner

Farmers Home Administration

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Reason for submission:

 Agency name and City where the application is filed
. Loan or Contract amount $

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. Project Name, Project Number, City and Zip Code

. Number of Units or Beds

. Section of Act

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. Type of Project (check one)
Existing
Rehabilitation

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Name and address of Principals and Affiliates (Name: Last, First, Middle Initial) proposing to participate

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Proposed (New)

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Certifications: The principal(s) listed above hereby apply to HUD or USDA FmHA, as the case maybe, for approval to participate as principal(s) in the role(s) and project listed above. The principal(s) each certify that all the
statements made on this form are true, complete and correct to the best of their knowledge and belief and are made in good faith, including any Exhibits attached to this form. :DUQLQJ HUD will prosecute false claims and
statements. Conviction may result in criminal and/or civil penalties. The principal(s) further certify that to the best of their knowledge and belief:
1. Schedule A contains a listing, for the last ten years, of every project assisted or insured by HUD, USDA FmHA and/or State and local government housing finance agencies in which the principal(s) have participated or are
now participating.
2. For the period beginning 10 years prior to the date of this certification, and except as shown on the certification:
a. No mortgage on a project listed has ever been in default, assigned to the Government or foreclosed, nor has it received mortgage relief from the mortgagee;
b. The principals have no defaults or noncompliance under any Conventional Contract or Turnkey Contract of Sale in connection with a public housing project;
c. There are no known unresolved findings as a result of HUD audits, management reviews or other Governmental investigations concerning the principals or their projects;
d. There has not been a suspension or termination of payments under any HUD assistance contract due to the principal’s fault or negligence;
e. The principals have not been convicted of a felony and are not presently the subject of a complaint or indictment charging a felony. (A felony is defined as any offense punishable by imprisonment for a term exceeding one
year, but does not include any offense classified as a misdemeanor under the laws of a State and punishable by imprisonment of two years or less);
f. The principals have not been suspended, debarred or otherwise restricted by any Department or Agency of the Federal Government or of a State Government from doing business with such Department or Agency;
g. The principals have not defaulted on an obligation covered by a surety or performance bond and have not been the subject of a claim under an employee fidelity bond;
3. All the names of the principals who propose to participate in this project are listed above.
4. None of the principals is a HUD/FmHA employee or a member of a HUD/FmHA employee's immediate household as defined in Standards of Ethical Conduct for Employees of the Executive Branch in 5 C.F.R. Part 2635
(57 FR 35006) and HUD's Standard of Conduct in 24 C.F.R. Part 0 and USDA's Standard of Conduct in 7 C.F.R. Part 0 Subpart B.
5. None of the principals is a participant in an assisted or insured project as of this date on which construction has stopped for a period in excess of 20 days or which has been substantially completed for more than 90 days and
documents for closing, including final cost certification, have not been filed with HUD or FmHA.
6.None of the principals have been found by HUD or FmHA to be in noncompliance with any applicable fair housing and civil rights requirements in 24 CFR 5.105(a). (If any principals or affiliates have been found to be in
noncompliance with any requirements, attach a signed statement explaining the relevant facts, circumstances, and resolution, if any).
7. None of the principals is a Member of Congress or a Resident Commissioner nor otherwise prohibited or limited by law from contracting with the Government of the United States of America.
8.Statements above (if any) to which the principal(s) cannot certify have been deleted by striking through the words with a pen, and the relevant principal(s) have initialed each deletion (if any) and have attached a true and
accurate signed statement (if applicable) to explain the facts and circumstances.
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Page 1 of 2

Previous Participation Certification

OMB Approval No. 2502-0118
(Exp. 02/29/2016)

6FKHGXOH $ /LVW RI 3UHYLRXV 3URMHFWV DQG 6HFWLRQ  &RQWUDFWV Below is a complete list of the principals’ previous participation projects and participation history in multifamily
Housing programs of HUD/FmHA, State and local Housing Finance Agencies. 1RWH Read and follow the instruction sheet carefully. Make full disclosure. Add extra sheets if you
need more space. Double check for accuracy. If no previous projects, write by your name, “1R SUHYLRXV SDUWLFLSDWLRQ )LUVW ([SHULHQFH´.
1. Principals Name (Last, First)

2. List of previous projects (Project name,
project ID and, Govt. agency involved )

3.List Principals’ Role(s)
(indicate dates participated, and if
fee or identity of interest
participant)

4. Status of loan
(current, defaulted,
assigned, foreclosed)

5.Was the Project ever
in default during your
participation
File Typeapplication/pdfFile Modified2013-04-30File Created2013-03-26