Certification By State Or Local Official Of Pha Plans Hud 50077sl printable pdf download

Certification By State Or Local Official Of Pha Plans Hud 50077sl

Certification by State or Local

U. S Department of Housing and Urban Development

Official of PHA Plans Consistency

Office of Public and Indian Housing

with the Consolidated Plan or

OMB No. 2577-0226

State Consolidated Plan

Expires 2/29/2016

(All PHAs)

Certification by State or Local Official of PHA Plans

Consistency with the Consolidated Plan or State Consolidated Plan

I, _________________________________, the _____________________________________

Official’s Name

Official’s Title

certify that the 5-Year PHA Plan and/or Annual PHA Plan of the

_________________________________________________________________________________

PHA Name

is consistent with the Consolidated Plan or State Consolidated Plan and the Analysis of

Impediments (AI) to Fair Housing Choice of the

______________________________________________________________________________

Local Jurisdiction Name

pursuant to 24 CFR Part 91.

Provide a description of how the PHA Plan is consistent with the Consolidated Plan or State

Consolidated Plan and the AI.

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

Page 1 of 1 form HUD‐50077‐SL (12/2014)

Certification By State Or Local Official Of Pha Plans Hud 50077sl

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