HUD-52860-G Retention Addendum

This information is required as a supplement to the form HUD-52860 for all SAC applications that involve requests from PHAs to retain Public Housing Property free from HUD’s interest in the property under the Annual Contribution Contracts (ACC) and Declarations of Trust (DOT) in accordance with 2 CFR 200.311(c)(1) and PIH Notice 2016-20 (or any successor or substitute notice or other guidance that HUD may issue). All capitalized terms in this form shall have the meaning of the terms in that notice. Public reporting burden for this collection of information is estimated to average 2 hours 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. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. This information is required when PHAs propose to retain public housing property free from ACC and DOT restrictions. HUD will use this information to determine whether, to permit retention, as well as to track removals for other record keeping requirements. Responses to this collection of information are regulatory required to obtain a benefit. The information requested does not lend itself to confidentiality. PHAs are required to submit this information electronically to HUD through this Inventory Removals Submodule of the Inventory Management System/PIH Information Center (IMS/PIC) system (or a later electronic system prescribed by HUD).

Section 1. Why Property Is No Longer Needed for Public Housing.

*Attach a statement describing why the public housing real property is no longer needed for public housing purposes.

Section 2. Estimate of HUD’s Percentage of Participation

Estimate of HUD’s percentage of participation in the cost of the original purchase (plus costs of any improvements, include subsequent modernization) *Attach explanation of how amount was determined, specifically explaining any differences between this amount and the fair market value (FMV) of the property

$     

Section 3. Intent to Compensate HUD

1. Is the PHA planning on compensating HUD for HUD’s percentage of participation?	Yes No
2. Is the PHA requesting that HUD grant an exception to the compensation requirement? *If yes, attach a statement of the proposed future use that justifies an exception in accordance with PIH Notice 2016-20	Yes No

Section 4. PHA Certification of Compliance

Acting on behalf of the Board of Commissioners of the PHA, as its Chairman, Executive Director, or other authorized PHA official, I approve the submission of this SAC Application known as DDA      for removing public housing property from public housing use restriction, of which this document is a part, and make the following certifications, agreements with, and assurances to the Department of Housing and Urban Development (HUD) in connection with the submission of this SAC application and the implementation thereof:

1. The PHA specifically authorized this removal action in its annual PHA Plan or in a Significant Amendment to that Plan) and HUD approved that Plan or Significant Amendment. The description of action in the PHA Plan is substantially identical to that in this application. If my PHA is a Qualified PHAs under the Housing and Economic Recovery Act of 2008 (HERA), my PHA described the proposed retention at its required annual public hearing (or a second public hearing if it is submitting this Application between its annual public hearings). If my PHA is a Moving to Work (MTW) entity, it has authorized and described this action in its MTW Plan; and

2. The public housing property proposed for retention in this SAC application is no longer needed for public housing purposes in accordance with the PHA’s ACC and Section 9 of the 1937 Act.

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	     

Form HUD-52860-G Instructions

This form supplements the HUD-52860 and is required when PHAs propose removal actions of public real housing property in the form of retentions in accordance with PIH Notice 2016-20 PHAs must complete this form and upload it as (along with the required supporting documentation) as part of their SAC applications submitting electronically through IMS/PIC (or a replacement system). PHAs refer PIH Notice 2016-20 for additional guidance on completing this form.

Section 1: Why Property Is No Longer Needed for Public Housing.

Refer to PIH Notice 2016-20.

Section 2. Estimate of HUD’s Percentage of Participation

Refer to PIH Notice 2016-20. The amount a PHA must pay to HUD is calculated by applying HUD’s percentage of participation in the cost of the original purchase (and costs of any improvements, including subsequent modernization) of the public housing real property to the fair market value (FMV) of the project or other real property. Because generally public housing real property has been funded exclusively with public housing funds, the percentage of participation costs are generally 100% of the FMV of the public housing real property.

Section 3. Intent to Compensate HUD

Refer to PIH Notice 2016-20. If a PHA is requesting an exception to the compensation requirement and its plans include the demolition of existing structures (e.g. non-dwelling property or property that once comprised public housing dwelling units where the assistance was converted under RAD), the PHA must specifically indicate the demolition and describe how such demolition is part of its planned future use for the property.

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