HUD-1044 Assistance Award/Amendment

Family Self-Sufficiency Program (FSS)

1044

Family Self-Sufficiency Program (FSS)

OMB: 2577-0178

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U.S. Department of Housing
and Urban Development
Office of Administration

Assistance Award/Amendment
1. Assistance Instrument

Cooperative Agreement
3. Instrument Number

2. Type of Action

Grant

Award

4. Amendment Number

7. Name and Address of Recipient

Amendment

5. Effective Date of this Action

8. HUD Administering Office

8a. Name of Administrator

10. Recipient Project Manager

11. Assistance Arrangement

Cost Reimbursement
Cost Sharing
Fixed Price

6. Control Number

8b. Telephone Number

9. HUD Government Technical Representative

12. Payment Method

13. HUD Payment Office

Treasury Check Reimbursement
Advance Check
Automated Clearinghouse

14. Assistance Amount

15. HUD Accounting and Appropriation Data

Previous HUD Amount

$

15a. Appropriation Number

15b. Reservation Number

HUD Amount this action
Total HUD Amount
Recipient Amount
Total Instrument Amount

$
$
$
$

Amount Previously Obligated
Obligation by this action
Total Obligation

$
$
$

16. Description

17.

Recipient is required to sign and return three (3) copies
of this document to the HUD Administering Office

19. Recipient (By Name)

Signature & Title

Previous editions are obsolete.

18.

Recipient is not required to sign this document.

20. HUD (By Name)

Date (mm/dd/yyyy)

Signature & Title

Date (mm/dd/yyyy)

form HUD-1044 (8/90)
ref. Handbook 2210.17


File Typeapplication/pdf
File Modified2011-02-06
File Created2011-02-06

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