Looking for a Hud Forms And Templates? Download it for free!

Form Hud-40110-C - Annual Progress Report (Apr) - Housing Opportunities For Persons With Aids (Hopwa) Program Page 24

Part 5: Summary of Project Sponsor Information

E. Certification of Continued Usage for HOPWA Facility-Based Stewardship Units

(ONLY)

Grantees that use HOPWA funding for new construction, acquisition, or substantial rehabilitation are required to operate

their facilities for HOPWA eligible individuals for at least ten years. If non-substantial rehabilitation funds were used

they are required to operate for at least three years. Stewardship begins once the facility is put into operation. This

Annual Certification of Continued HOPWA Project Operations is to be used in place of other sections of the APR, in the

case that no additional HOPWA funds were expended in this operating year at this facility that had been acquired,

rehabilitated or constructed and developed in part with HOPWA funds.

1. General information

HUD Grant Number(s)

Operating Year for this report

From (mm/dd/yy) to (mm/dd/yy)

Final Yr

Yr 1;

Yr 2;

Yr 3;

Yr 4;

Yr 5;

Yr 6;

Yr 7;

Yr 8;

Yr 9;

Yr 10;

Grantee Name

Date Facility Began Operations

2. Number of Units and Leveraging

Housing Assistance

Number of Units Receiving Housing

Amount of Leveraging from Other Sources

Assistance with HOPWA funds

Used during the Operating Year

Stewardship units (developed with HOPWA funds but

no current operations or other HOPWA costs) subject

to 3- or 10- year use periods

3. Details of Project Site

Project Sites: Name of HOPWA-funded project

Site Information: Project Zip Code(s) and

Congressional District(s)

Is the address of the project site confidential?

Yes, protect information; do not list.

Not confidential; information can be made available to the public.

If the site is available to the public, please provide the

contact information, phone, email address/location, if

business address is different from facility address.

I certify that the facility that received assistance for acquisition, rehabilitation, or new construction from the Housing Opportunities

for Persons with AIDS Program has operated as a facility to assist HOPWA-eligible persons from the date shown. I also certify that

the grant is still serving the planned number of HOPWA-eligible households at this facility through other resources and all the

requirements of the grant agreement are being satisfied.

I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.

Name & Title of Authorized Official

Signature & Date (mm/dd/yy)

Name & Title of Contact at Grantee Agency

Contact Phone (include area code)

(person who can answer questions about the report and program)

Previous editions are obsolete

Page

form HUD-40110-C (Expiration Date: 12/31/2010)

Form Hud-40110-C - Annual Progress Report (Apr) - Housing Opportunities For Persons With Aids (Hopwa) Program Page 24

Related Articles

Related forms

Related Categories