2995 Certification of Consistency with Sustainable Communitie

OMB Approval Number: 2535-0121 (Exp. 02/28/2015)

U.S. Department of Housing
and Urban Development

Certification of Consistency with Sustainable Communities Planning and Implementation
I certify that the proposed activities/projects in this application are consistent with the Livability
Principles advanced by communities in the FY2010 Sustainable Communities Regional Planning
and HUD-DOT Challenge Grants.
(Type or clearly print the following information)

Applicant Name: _______________________________________________________________

Name of the Federal Program to
which the applicant is applying:____________________________________________________
_____________________________________________________________________________

Name of the Preferred Sustainable
Communities Status Community:___________________________________________________
_____________________________________________________________________________
I further certify that:
(1) The applicant is engaged in activities, that in consultation with the designated Point of Contact of
the HUD designated Preferred Sustainability Status Communities, further the purposes of the
regional planning grant program;
(2) The applicant’s proposed activities either directly reflect the Livability Principles cited and
contained in HUD’s General Section to the FY2011 NOFAs or will result in the delivery of
services that are consistent with the goals of the Livability Principles;
(3) The applicant has committed to maintain an on-going relationship with the HUD Preferred
Sustainability Status Communities for the purposes of being part of the planning and
implementation processes in the designated area.

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form HUD-2995 (01/2011)

Name of the Official Authorized to Certify the Preferred
Sustainable Communities Status meets
the above criteria to receive bonus points: ____________________________________________
Title: _________________________________________________________________________
Organization: __________________________________________________________________
Signature: _____________________________________________________________________
Date _________________________________
(mm/dd/yyyy)

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form HUD-2995 (01/2011)