HUD Form xxxx Urban Abstract Form

SUBMIT

Urban Communities 2013 Promise Zone Abstract Form

OMB Control
#: 2577-xxxx
Number:
(expires
xx/xx/2014)

Posting Application Information. After the selection process, HUD may post on-line certain summary and contact
information from Promise Zone applications (e.g., the Executive Summary, neighborhood map, Lead Applicant
contact information, etc.) in order to provide information to interested non-federal organizations and members of
the public.

Part A:
Urban Target Neighborhood/Community Name
Urban Community Name:
Urban Organizational Information
Organization Serving as Lead Applicant:
Street Address:

City:

State:

Zip Code:

Website:

Type of Organization: ...

Designated Official from Lead Applicant Organization

Please provide contact information for the person designated to execute documents on behalf of the lead
applicant organization, generally the Mayor, Executive Director, President, CEO or similar position.

Name:

Title:

Phone:

Email:

Street Address:

City:

State:

Zip Code:

Staff Point of Contact

Please provide contact information for an individual within the organization that Federal staff may contact with
any questions about the Promise Zones application.

Name:

Title:

Phone:

Email:

Street Address:

City:

State:

Zip Code:

Urban Communities 2013 Promise Zone Abstract Form
Part B:

Leadership Support: Local Official

As noted in Section II of the Application Guide, please list the local officials that are submitting letters of
support. For applications across jurisdictional lines, a clear lead applicant must be identified, and
commitment must be demonstrated by leadership of all jurisdictions involved. For additional officials,
please list their information in the “Additional Local Official” box at the end of the form.

Authorized Representative
Name:
Title:
Jurisdiction:
Check Box if Letter of
Commitment Attached:

Congressional District(s)

Please list any Congressional District(s) your Promise Zone would encompass.

Implementation Partners

In the space below, please list partnering organizations that will be collaborating in the implementation
1
of the Promise Zone .

Part C:
Qualifying Program Whose Boundaries are Included in the Proposed Promise Zone
Please list one or more qualifying programs. The complete list of qualifying programs is
at www.hud.gov/promisezones.

Select Qualifying Program:

Eligible Community Name:

Year of Original Award:

...

...
...

1

Refer to the last page of the Application Guide for the definition of Implementation Partners.

2

Urban Communities 2013 Promise Zone Abstract Form
Part D: Boundaries of Zone
a.

Check Box if Maps and optional Mapping Tool data sheet are attached:

b. Narrative Description of Proposed Promise Zone and its Boundaries (1,500 Character Limit):

County/counties:

City/cities:

State(s):

Part E: Qualifying Criteria and Need Criteria Data

Please provide information pertaining to Section II and III of the Application Guide. The optional mapping tool
provides this information except the crime statistics. In Section III of the Applicant Guide, applicants can provide a
narrative more fully describing the need-related data points.

Overall Poverty Rate
Highest Poverty Census Tract Rate 2
Population 3
Vacancy Rate
Employment Rate
Rate of Part 1, serious and violent
crimes for 2010-2012 within the
proposed target area. 4

2

Proposed Urban Promise Zones must have an overall poverty rate above 20%, and must have one census tract with a poverty
rate above 30%.
3
Proposed Urban Promise Zones must encompass a population of at least 10,000 but no more than 200,000 residents.
4
Use 2009-2011 if 2012 is unavailable.

3

Urban Communities 2013 Promise Zone Abstract Form
Part F: Promise Zone Evidence Base (500 Characters Each):

Please provide a brief statement of the community’s goals and strategies related to each of the Promise Zone goals.

Creating Jobs

Increasing Economic Activity

Improving Educational Opportunities

Reducing (or Maintaining a Low
Rate of) Serious and Violent Crime

Leveraging Private Capital

Other Key Outcomes (If Applicable)
Including reduction of Promise Zone
poverty rate.

4

Urban Communities 2013 Promise Zone Abstract Form
Executive Summary (5,000 Character Limit) :

The Executive Summary should include a statement of local priorities and describe how the Promise Zones
designation would accelerate and strengthen efforts at comprehensive neighborhood revitalization.

Additional Local Officials (Optional) :

Please list any additional officials in the space below by name, title, jurisdiction, and if a letter of commitment is
attached.

Note: Public reporting burden for the entire collection of information is estimated to average 48 hours. This
includes the time for collecting, reviewing, and reporting the data. The information is being collected for OMB
#2577-xxx and will be used for xxx. Response to this request for information is required in order to receive the
benefits to be derived. This agency may not collect this information, and you are not required to complete this
form unless it displays a currently valid OMB control number. No confidentiality is assured.

5