Annual Report

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STATE OF CALIFORNIA
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
ANNUAL REPORT
DIVISION OF FINANCIAL ASSISTANCE
SPONSOR CERTIFICATION
AMC 183 (REV 8/2/06)
Project Name:
Contract #:
Sponsor’s Name:
Project Fiscal Year:
The sponsor must send one copy of this Annual Report Sponsor Certification along with the annual Audited
Financial Statements to the Department of Housing and Community Development within ninety (90) days (or
within the period of time specified in the Regulatory Agreement, if different) after the end of the project fiscal
year. The Annual Report Sponsor Certification must have original signatures. Please note that if additional
information is required for a specific program’s annual reporting requirement, that information must
accompany the Annual Audited Financial Statements as a separate attachment. The Annual Report includes
the Sponsor Certification, the Audited Financial Statements and all other annual reporting documents.
Sponsor Certification
It is hereby certified that all of the representations made by the sponsor in the Regulatory Agreement and the
financial disclosures contained in the Annual Report are true and correct, and that there is not any condition,
event, or act which would constitute an event of default there under, or which with notice, passage of time, or
both, would constitute such an event of default.
Authorized Signature
Printed Name
Title
Date

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