41901 Assurance of Compliance

OMB No. 2502­0602 (Exp. 05/31/2015)

HUD-41901­OHF (5-66)
(Formerly CFA-1901)

U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

ASSURANCE OF COMPLIANCE
WITH DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
REGULATIONS UNDER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
__________________________________________________________________ (hereinafter called the
(Name)

"Applicant") HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act of 1964 (P.L
88-352 and all requirements imposed by or pursuant to the Regulations of the Department of Housing and
Urban Development (24 CFR, Subtitle A, Part 1) issued pursuant to that Title, to the end that, in
accordance with Title V1 of the Act and the Regulations, no person in the United States shall, on the
ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be
otherwise subjected to discrimination under any program or activity for which the Applicant receives
Federal financial assistance from the Department of Housing and Urban Development, and HEREBY
GIVES ASSURANCE THAT it will immediately take any measures necessary to effectuate this
agreement.
If any real property or structure thereon is provided or improved with the aid of Federal financial
assistance extended to the Applicant by the Department of Housing and Urban Development, this
assurance shall obligate the Applicant, or in the case of' any transfer of such property, any transferee, for
the period during which the real property or structure is used for a purpose for which the Federal financial
assistance is extended or for another purpose involving the provision or similar services or benefits. If any
personal property is so provided, this assurance shall obligate the Applicant for the period during which it
retains ownership or possession of the property. In all other cases, this assurance shall obligate the
Applicant for the period during which the Federal financial assistance is extended to it by the Department
of Housing and Urban Development.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all Federal
loans, advances, grants, properties, contracts or other Federal financial assistance extended after the date
hereof to the Applicant by the Department of Housing and Urban Development, including installment
payments after such date on account of applications for Federal financial assistance which were approved
before such date. The Applicant recognizes and agrees that such Federal financial assistance will he
extended in reliance on the representations and agreements made in this assurance, and that the United
States shall have the right to seek judicial enforcement of this assurance. This assurance is binding on the
Applicant, its successors, transferees, and assignees, and the person or persons whose signatures appear
below are authorized to sign this assurance on behalf of the Applicant.

Public reporting burden for this collection of information is estimated to average hours. This includes the time for collecting, reviewing, and reporting the data.
Response to this request for information is required in order to receive the benefits to be derived. Section 232 of the National Housing Act authorizes mortgage
insurance for the development of nursing homes and intermediate care facilities. 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. While no assurance of confidentiality is pledged to respondents, HUD generally
discloses this data only in response to a Freedom of Information Act request.