Home Contract Amendment Request Form (Page 2 of 2) in pdf

Home Contract Amendment Request Form Page 2

Budget Amendment – request for DED approval

Original Contract Budget Approved

Activity Name

Activity Number

HOME Funds

Other Funds

Total Funds

Total

Proposed Budget After Amendment

Activity Name

Activity Number

HOME Funds

Other Funds

Total Funds

Total

Attachment 1: Letter from the Authorized Official including:

Certification that the governing body has approved the budget amendment;

Identification and reasons for the proposed budget amendment; including

Changes to the nature of the project requiring the amendment;

Steps being taken to avoid any future amendment requests for the same reasons.

If additional local matching funds are required as a result of this amendment, certification that such

funds are available.

If the amendment includes a new activity, certification that the activity meets the national objective.

Attachment 2: Minutes from the public hearing (for local governments) or board meeting (for non-profits and local

housing authorities) held on the proposed amendment.

Attachment 3: If the budget amendment will affect major milestones, a revised implementation schedule showing

when major milestones will be completed for each activity.

Attachment 4: Certification of re-evaluation of the environmental assessment (this form is included in the HOME

Administration Manual Chapter 7: Environmental Review) if necessary.

DED Use Only

Date amendment request received

Date amendment approved/denied

NE HOME Contract Amendment Request Form

Page 2 of 2

August 20, 2009

Home Contract Amendment Request Form Page 2