HUD-50077-SL Certification by State or Local Official of PHA Plans Co

Certification by State or Local U. S Department of Housing and Urban Development

Official of PHA Plans Consistency Office of Public and Indian Housing

with the Consolidated Plan or OMB No. 2577-0226

State Consolidated Plan Expires xx/xx29/20196

(All PHAs)

Certification by State or Local Official of PHA Plans

Consistency with the Consolidated Plan or State Consolidated Plan

I, _________________________________, the _____________________________________

Official’s Name Official’s Title

certify that the 5-Year PHA Plan and/or Annual PHA Plan of the

_________________________________________________________________________________

PHA Name

is consistent with the Consolidated Plan or State Consolidated Plan including the Analysis of Impediments (AI) to Fair Housing Choice or Assessment of Fair Housing (AFH) when applicable to the

______________________________________________________________________________

Local Jurisdiction Name

pursuant to 24 CFR Part 91 and 24 CFR §903.15.

Provide a description of how the PHA Plan is consistent with the Consolidated Plan or State Consolidated Plan.

I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

Name of Authorized Official Title

__________________________________________________________________________________________________________________________________

Signature Date

Page 1 of 1 form HUD-50077-SL (62/2016)