Form 201701 Certification of Material Events Form

CERTIFICATION OF MATERIAL EVENTS FORM
For All CDFI Fund Programs
What is a “Material Event”:
A “Material Event” is an occurrence specified in any applicable assistance, allocation, or
bond loan agreement between the Community Development Financial Institutions Fund
(CDFI Fund) and an award recipient/allocate/borrower. Certified organizations and award
recipients and Borrowers should consult each applicable agreement to determine which
events must be reported. At a minimum, a Material Event includes any change in
organizational condition that may lead to or the actual violation of any terms and conditions
of an assistance, allocation, or bond loan agreement, regulation, or law. Certified
Community Development Financial Institutions (CDFI) and Certified Community
Development Entities (CDE) must report any event or condition that may cause the entity
to no longer meet one or more certification criteria.
When should a Material Event be filed?
A Material Events report must typically be filed by CDFI Fund award recipients
(Recipients, Allocatees, and Borrowers) within 20 days of a condition or event occurrence
in the case of the New Markets Tax Credits Program (NMTC) Program and 30 days in the
case of the CDFI Program, CDFI Bond Guarantee Program, Bank Enterprise Award (BEA)
Program, or Capital Magnet Fund (CMF) Program. The failure to file a timely report is
considered noncompliance with the terms and conditions of agreements, and may be
deemed a default or noncompliance under the applicable agreement.
Instructions:
This form is to be used by CDFI Fund award recipients to report a Material Event. A
separate Material Events form must be filed for each award as follows:
1. Indicate the name of the organization EIN, Certification Control Number, Award
Control Number. Provide a contact person and associated contact information.
2. Select the applicable Material Event(s). Note that this form is used for all CDFI
Fund programs. Not all Material Events will be applicable. Recipients, Borrowers,
and Allocatees should consult their assistance/allocation/bond loan agreement for
more information on the specific material events which apply. These agreements
requirements provide controlling authority, in the event of any conflict regarding
reporting requirements. To assist the user in identifying applicable material events,
each material event includes a notation:
BEA = Bank Enterprise Award Program;
BGP = Bond Guarantee Program;
CDFI = CDFI Program;
CMF = Capital Magnet Fund Program;
NMTC = New Markets Tax Credit Program;

Certification of Material Event Form: Revised October 2016

3. Provide a narrative explanation of the Material Event(s).
4. Provide a narrative statement indicating how the organization intends to correct or
address the Material Event.
5. Complete the Authorized Representative Signature information.
6. The completed form should be addressed to the attention of the Certification,
Compliance Monitoring and Evaluation Manager and submitted via a Service
Request through the Organization’s Awards Management Information System
account (AMIS). Please note that this form cannot be used to request an
amendment to any assistance agreement.
A. Award and Contact Information
Organization Name
EIN #:
Certification Control
number (if available):
Award #
Future Advance
Promissory Bond #
Name and title of person
to contact regarding this
report
Contact e-mail address
Contact Telephone #
Contract Street Address

2

Certification of Material Event Form: Revised October 2016

B. Material Events
Check next to all applicable Material Events:
Multiple Programs
1. Any proceeding instituted against the Recipient/Borrower (or in the case of
_____
the NMTC Program, the Allocatee, its Affiliates, including the Controlling
Entity) in, by or before any court, governmental or administrative body or
agency (including any Federal bank regulatory agency), which proceeding or
its outcome could reasonably be expected to have a material adverse effect
upon the financial condition or business operations, assets or properties of
the Recipient (or in the case of the NMTC Program, the Allocatee, its
Affiliates, including the Controlling Entity) and in the case of the Bond
Guarantee program Properties of the Borrower (BEA, BGP, CDFI, CMF,
NMTC)
2. Any material adverse change in the condition, financial or otherwise, or
_____
operations of the Recipient/Borrower (or for NMTC program, the Allocatee
or Controlling Entity) that would impair the Recipient, Borrower, or
Allocatee’s ability to carry out the terms and conditions and authorized uses
under the Agreement; (BEA, BGP, CDFI, CMF, NMTC)

_____

3. The occurrence of any Event of Noncompliance or Default, as that term is
defined in an Assistance, Allocation Agreement, or Bond Loan Agreement,
or any event which upon notice or lapse of time, or both, would constitute an
Event of Noncompliance or Default. (BEA, BGP, CDFI, CMF, NMTC)

_____ 4. The merger, consolidation or acquisition of the Recipient/Borrower, or in
the case of the NMTC Program the Allocatee or Allocatee’s Controlling
Entity by or with another entity; (BEA, BGP, CDFI, CMF, NMTC)
_____ 5. The replacement of any key management officials (e.g., the Executive
Director, the Chief Financial Officer, the Board Chairperson or their
equivalents) that had been named in the Assistance or Allocation Application
or Guarantee Application. In the case of the CMF Program only changes in
the executive director (or equivalent) are required to be reported. (BEA, BGP,
CDFI, CMF, NMTC)
_____ 6. Any substantial change in the business of the Recipient/Borrower (BEA,
BGP, CDFI, CMF)
_____ 7. Any event or change that would result in the Recipient no longer being
certified as a CDFI or CDE (if applicable); (BEA, BGP, CDFI, CMF, NMTC)
_____ 8. All violations of Federal criminal law involving fraud, bribery, or gratuity
violations potentially affecting the Federal award. Failure to make required
disclosures can result in any of the remedies described in 2 CFR §200.338 of
the Uniform Requirements. (BEA, CDFI, CMF)

3

Certification of Material Event Form: Revised October 2016

_____ 9. The loss of the Recipient’s Insured Credit Union status as defined in 12
U.S.C. § 1752(7) (if applicable); (BGP, CDFI, CMF)
_____ 10. loss of the Recipient’s Insured Depository Institution status under 12 USC §
1813(c)(2) and in the case of the CDFI, Capital Magnet Fund, and Bond
Guarantee programs - Depository Institution Holding Company status under
12 USC § 1813(w)(1) (BEA, CDFI, CMF)
_____ 11. the existence of any non-compliance with the terms and conditions of any
loan or other credit agreement with a creditor other than the CDFI Fund
(CDFI, CMF)
_____ 12. Any proceeding instituted against the Recipient/Borrower in, by or before
any court, governmental or administrative body or agency (including any
Federal bank regulatory agency), which proceeding involves allegations of
discrimination by the Recipient/Borrower on the basis of race, color, national
origin, disability, age, marital status, receipt of income from public
assistance, religion, or sex; (BEA, BGP, CDFI, CMF, NMTC)
13. Such other events that may be determined by the CDFI Fund, in its sole
discretion, to be material events, and for which the CDFI Fund issues related
guidance (BEA, CDFI, CMF, NMTC)
CDFI Program Only
14. A change in the Recipient’s shareholders or organization that results in (i) the
CDFI Fund’s ownership of equity in the Recipient exceeding 50 percent
and/or (ii) the CDFI Fund controlling the Recipient’s operations.
BEA Program Only
15. Prepayment, redemption, repurchase, or withdrawal of any Qualified
Activities reported to the CDFI Fund in the Recipient’s Application,
specifically if: i. Any borrower of the Recipient prepays, in whole or in part,
the principal amount of any loan carried out during the Assessment Period
that the Recipient reported to the CDFI Fund in its Application; ii. Any
investee of the Recipient redeems or repurchases, in whole or in part, any
Equity Investment or Project Investment which the Recipient reported to the
CDFI Fund in its Application; or iii. The Recipient withdraws, in whole or in
part, any deposit that the Recipient reported to the CDFI Fund in its
Application as a CDFI Support Activity; provided, however, the Recipient is
not required to notify the CDFI Fund of any prepayment, redemption, or
repurchase occurring more than two calendar years after the Federal Award
Date of the Agreement; and provided, further, that the Recipient is not
required to notify the CDFI Fund of any withdrawal which occurs more than
three years after the date of the deposit. Such notice shall, at a minimum,
identify each prepayment, redemption, repurchase or withdrawal and the
dollar amount, the date of and the specific facts and circumstances
surrounding each prepayment, redemption, repurchase, or withdrawal.

4

Certification of Material Event Form: Revised October 2016

NMTC Program Only
16. The occurrence of any event that may be a recapture event pursuant to IRC §
45D(g) and 26 C.F.R. §1.45D-1(e)(2);
17. The Allocatee’s Controlling Entity (as identified in the Allocation
Application) shall no longer have any ownership or management interest in
the Allocatee and/or shall no longer have Control over the day-to-day
management and operations (including investment decisions) of the
Allocatee;
18. The occurrence of any event described in 31 C.F.R. §19.350
19. The filing of any bankruptcy proceeding or the appointment of a conservator
for the Allocatee or its Affiliates, including the Controlling Entity;
CMF Program Only
20. Any event or change that would result in the Recipient losing its status as a
Nonprofit Organization (if applicable)
_____ 21. Failure by the Recipient to have Committed all of its Capital Magnet Fund
Award by the date set forth in Schedule 1 of the applicable Agreement;
Bond Guarantee Program Only
_____ 22. Any significant revisions in credit, risk management, or financial reporting
policies and procedures of the Borrower;
_____ 23. Any direct financial obligation that is material to the Borrower under an offbalance sheet arrangement;
_____ 24. Any acquisition or disposition of a significant amount of assets by the
Borrower;
_____ 25. Any assessment (other than assessments provided by an Appropriate Federal
or State Banking Agency that are prohibited by applicable law or regulation
from disclosure to the Department of the Treasury) of significant or material
weaknesses in the design or operation of internal controls that are reasonably
likely to adversely affect the Borrower’s abilities to record, process,
summarize, and report financial information;
_____ 26. Any fraud, whether or not material, that involves management or other
employees of the Borrower who have a significant role in internal controls
over financial reporting;
_____ 27. Any adverse audit opinions received by the Borrower or pronouncements of
non-reliance on previously issued financial statements by the Borrower’s
board of directors or a committee of the board of directors;
_____ 28. Any changes in corporate governance, senior management, or leadership of
the Borrower, including any Key Personnel. “Key Personnel” means any
officer or senior staff person of the Borrower responsible for the day-to-day

5

Certification of Material Event Form: Revised October 2016

administration of the duties, responsibilities, and obligations of the Borrower
under the Bond Loan Agreement;
_____ 29. Any organizational updates such as changes in Bylaws or Articles of
Incorporation of the Borrower;
30. Any fact, circumstance, event, change, occurrence, condition, or
development of which the Borrower is aware and which, individually, or in
the aggregate, has had or would reasonably be expected to have a material
adverse effect on an organization’s strategic direction, mission, or business
operation

C. Provide a narrative explanation of the material event(s). Be sure to include
the date the event(s) occurred. Additional pages may be added if necessary.

6

Certification of Material Event Form: Revised October 2016

D. Provide a narrative statement indicating how the organization intends to
correct or address the Material Event.

E. The Certification of Material Events form must be signed by the
organization’s Authorized Representative.
To the best of my knowledge and belief, all information contained in the Certification of
Material Events statement is true and correct. My signature indicates authorization on
behalf of the organization’s governing body.

Name: ________________________________________________________

Title: _________________________________________________________

Signature: _____________________________________________________

Date: ___________________________

7

Certification of Material Event Form: Revised October 2016

-----------------------------------------------------------------------------------------------------------PAPERWORK REDUCTION ACT NOTICE
CDFI - 0036
OMB Control Number 1559-0037
Paperwork Reduction Act Notice
This submission requirement is provided to CDFI Fund Awardees, applicants, and certified CDEs
and CDFIs, to report potential Material Events to the CDFI Fund. CDFI Fund Awardees, applicants,
and certified CDEs and CDFIs, are not required to respond to this collection of information unless
it displays a currently valid OMB number. The estimated average burden associated with this
collection of information is 0.25 hours. Comments concerning the accuracy of this burden estimate
and suggestions for reducing this burden should be directed to the Department of the Treasury,
Community Development Financial Institutions Fund, 1500 Pennsylvania Ave., N.W., Washington,
DC 20220.
The CDFI Fund is an equal opportunity provider.

------------------------------------------------------------------------------------------------------------

8