Form Hud-52483-A - Proposal For A Public Housing Project (Page 3 of 3) in pdf

Section C. Professional Assistant to PHA

The following

(

) professional service contracts are attached:

enter the number

___________

1. Service

2. Name and Address of Firm or Individual

Section D. Annual Contributions Contract

Three original, signature copies of the following are attached:

Form HUD-53010. Part One of the ACC (Form HUD-53010) signed and dated by the authorized PHA official. (Part Two should not be returned.)

Forms HUD-274 and HUD-51999. The Designation of Depository for Direct Deposit of Loan or Grant Funds (Form HUD-274) and the General

Depository Agreement (Form HUD-51999) signed and dated by the authorized PHA official and bank representative.

Forms HUD-9204, HUD-52250 and HUD-5412. The Project Loan Note (Form HUD-9204), the Permanent Note (Form HUD-52250), and the Note

Signature Certificate (Form HUD-5412) signed and dated by the authorized PHA official.

Section E. Request for Advances

1. A PHA request for advances (a)

is attached (b)

is not attached.

2. Funds required are for: (a)

planning expenses required for the first calendar quarter following Field Office execution of the ACC ($ __________________

and/or (b)

site acquisition and related costs ($ ____________________ ).

A detailed explanation of the nature and the amount of each obligation or proposed obligation and the extent that the obligation is necessary for the

proposed project is attached.

The PHA certifies that required blanket fidelity bond and any other required insurance coverage is in force.

Section F. Signature

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)

Typed Name and Title of Authorized PHA Official:

Signature:

Date:

Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions,

searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may

not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

This collection of information is required for developing a public housing project pursuant to HUD regulations 24 CFR 94l. The information will be used

to provide HUDwith sufficient information to enable a determination that funds should or should not be reserved or a contractual commitment made. This

information collection is mandated pursuant to the U.S. Housing Act of l937. The information requested does not lend itself to confidentiality.

form HUD-52483-A (5/94)

ref Handbook 7417.1

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