Application for Healthy Homes and Lead Hazard Control Program Grants

Application for Healthy Homes and Lead Hazard Control Grant Programs and Quality Assurance Plans

2991

Application for Healthy Homes and Lead Hazard Control Program Grants

OMB: 2539-0015

Document [pdf]
Download: pdf | pdf
OMB Approval No. 2506-0112 (Exp. 3/31/2010)

U.S. Department of Housing
and Urban Development

Certification of Consistency
with the Consolidated Plan

I certify that the proposed activities/projects in the application are consistent with the jurisdiction’s current, approved Consolidated Plan.
(Type or clearly print the following information:)
Applicant Name: ___________________________________________________________________

Project Name: ___________________________________________________________________

Location of the Project:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Name of the Federal
Program to which the
applicant is applying: ___________________________________________________________________

Name of
Certifying Jurisdiction: ___________________________________________________________________
Certifying Official
of the Jurisdiction
Name:

___________________________________________________________________

Title: ___________________________________________________________________

Signature: ___________________________________________________________________

Date: _____________________________________

Page 1 of 1

form HUD-2991 (3/98)


File Typeapplication/pdf
File Title2991
Subject2991
AuthorRSV
File Modified2007-05-14
File Created1999-02-22

© 2024 OMB.report | Privacy Policy