2991

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

2991

OMB: 2539-0015

Document [pdf]
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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

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