OPG 4.2 Checklist of Related Party Agreements

OMB No. 2502-0533
(Exp, 12/31/2017)

Sample
Mark-to-Market
Checklist of Related Party Agreements

Form 4.2

Project Name:
Project Address:
FHA Number:
Section 8 Expiration Date:
REMS I.D. #:
The owner must identify any related party transactions and relationships affecting the subject
property. This covers all contractual relationships involving owner-related parties concerning
the operation, maintenance or other regular business of the subject property. Owner-related
parties include all organizations and individuals who are related through kinship, marriage, or
financial interest to any controlling person or controlling entity. A controlling person or
controlling entity is one that controls an owner or purchaser, is controlled by an owner or
purchaser, or is under common control with the owner general partner. Controlling persons /
entities include, but are not limited to, a general partner of a partnership, a managing member of
an LLC, or an officer of either.
Accordingly, the project owner is requested to attach any identity of interest or related contract
and provide a brief narrative of each such contract or agreement summarizing the following
information:

•
•
•
•
•
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Type of Contract or Agreement
Name of Parties
Annual Payment
Length of Contract
Type of Relationship
Non-Monetary Compensation

I certify this information to be true and correct.
___________________________________
SIGNATURE
___________________________________
NAME & TITLE
___________________________________
NAME OF OWNER/ENTITY

September 2004

Form 4.2

________________
DATE

Public reporting burden for this collection of information is estimated to average 0.5 hour per
response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of
information. This information is required to obtain benefits. The Office of Multifamily Housing,
Office of Recapitalization 451 7th Street SW, Room 6230 Washington, DC 20410. HUD may
not collect this information, and you are not required to complete this form, unless it displays a
currently valid OMB control number. Title V of the Departments of Veterans Affairs and
Housing and Urban Development and Independent Agencies Appropriations Act of 1988
(P.L.105-65, 111 Stat. 1384) authorizes the FHA Multifamily Housing Mortgage and Housing
Assistance Restructuring Program. HUD implemented a statutory permanent program directed
at FHA-insured multifamily projects that have project- based Section 8contracts with abovemarket rents. The information collection is used to determine criteria eligibility of FHA-insured
multifamily properties for participation in the Mark to Market program and the terms on which
participation should occur. The purpose of the program is to preserve low-income rental housing
affordability while reducing the long-term costs of Federal rental assistance. While no
assurances of confidentiality are pledged to respondents, HUD generally discloses this data only
in response to a Freedom of Information request.