Form Hud-40093-A - Attachment A To The Funding Approval And Home Investment Partnerships Agreement 2000
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1U.S. Department of Housing
Attachment A to the Funding
and Urban Development
Approval and HOME Investment
Office of Community Planning
and Development
Partnerships Agreement
Title II of the National Affordable Housing Act
This form must be used if 1) the State is transferring HOME funds to a new Jurisdiction, or 2) if the City/Urban County is declin-
ing HOME funds. Send the form to Headquarters, OAHP, Attn: Director, Financial and Information Services Division via fax
(202-708-1744) or pouch mail (Room 7164).
Check one box only.
1. The State is transferring HOME funds to a new Jurisdiction to enable a new Jurisdiction to meet its minimum
participation threshold amount.
The State of _______________________________________________
(Enter the name of the State that the HOME funds are being transferred from)
Grant Number ____________________
___________
(Enter the State Grant Number)
(and the FY(yyyy))
is transferring $______________________________________to ______________________________
(enter the amount of HOME funds being transferred)
Enter the name of the PJ receiving the HOME funds)
Grant Number ____________________
___________
(Enter the PJ Grant Number)
(and the FY(yyyy))
Revised obligation for the State
$ _______________________________
(original obligation minus the amount transferred
Revised obligation for the new PJ $ _______________________________
(original obligation plus the amount transferred
If the State and new Participating Jurisdiction are overseen by different Field Offices:
_________________________________________
_______________________________________
State's Field Office
New Jurisdiction's Field Office
2. The City/Urban County is declining HOME funds.
The City/County of ___________________________________is declining the FY (yyyy) ___________
(Enter the name of the PJ that declined)
allocation of $ ________________________________.
Revised obligation for the State $ __________________________________________
If the declining Jurisdiction and the State are overseen by different Field Offices:
_________________________________________
_______________________________________
State's Field Office
Declining Jurisdiction's Field Office
Prepared by _______________________at________________________in_____________________________
(Name)
(Phone/email)
(Field Office)
form HUD-40093-A (10/2000)
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