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2004 SuperNOFA Forms

The following standard forms, certifications, and assurances are used by the majority if not all of the programs that are part of the SuperNOFA. Also included on this page is Form HUD-52515, Funding Application, required for the Section 8 voucher assistance funding announcement. In addition to these standard forms, you should see the individual program information for the forms that are specific to that program. All forms are .pdf except where noted.

Standard Forms

SF-LLL Disclosure of Lobbying Activities
SF-424 Application for Federal Assistance
SF-424-sup Survey on Ensuring Equal Opportunity For Applicants
HUD-424B Applicant Assurances and Certifications
HUD-424CB Grant Application Detailed Budget
HUD-424CBW Grant Application Detailed Budget Worksheet
HUD-2880 Applicant/Recipient Disclosure/Update Report
HUD-2990 Certification of Consistency with the RC/EZ/EC Strategic Plan (if applicable)
HUD-2991 Certification of Consistency with the Consolidated Plan (if applicable)
HUD-2992 Certification Regarding Debarment and Suspension
HUD-2993 Acknowledgment of Application Receipt
HUD-2994 Client Comments and Suggestions (optional)
HUD-27061 Race and Ethnic Data Reporting Form
HUD-52515 Funding Application for the Housing Choice Voucher Program
HUD-96010 Program Outcome Logic Model
HUD-27300 America's Affordable Communities Initiative

Program Specific Forms

Office of Community Planning and Development (CPD)

HUD-40076-CoC Exhibit 1 A thru P (.doc)
HUD-40076-CoC Exhibit 2 Supportive Housing Program - New Project Instructions 2A thru 2I (.doc)
HUD-40076-CoC Exhibit 2R Supportive Housing Renewal Project Instructions, 2RA thru 2RD (.doc)
HUD-40076-CoC Exhibit 3 Shelter Plus Care Program - New Project Instructions, 3A thru 3H (.doc)
HUD-40076-CoC Exhibit 3R: Shelter Plus Care Program - Renewal Project Instructions, 3RA thru 3RE (.doc)
HUD-40076-CoC Exhibit 4: Section 8 Moderate Rehabilitation SRO - New Project Instructions, 4A thru 4E (.doc)
HUD-40076-CoC Attachment 7 - Questions and Answers (.doc)
HUD-40076-CoC Attachment 8 - Certifications (.doc)
HUD-40076 A EDI/BEDI Checklist and Submission of Table of Contents (.xls)
HUD-40076 B EDI/BEDI Rating Factor 2: Distressed/Extent of Problem (.xls)
HUD-40076 C EDI/BEDI Rating Factor 3: Soundness of Approach Project Timeline (.xls)
HUD-40076 D EDI/BEDI Rating Factor 4: Leveraging Resources/Financial Need Sources & Uses Statement (.xls)
HUD-40076 E EDI/BEDI/Section 108 CDBG Funding Eligibility Statement (Part 1 .xls) (Part 2 .xls)
HUD-40110-B HOPWA Renewal of Permanent Supportive Housing Grants (.doc)
HUD-40122 Section 108 Loan Guarantee State Certifications Related to Nonentitlement Public Entities

Office of Housing

HUD-2530 Previous Participation Certification
HUD-9902 Housing Counseling Agency Fiscal Year Activity Report
HUD-91186 Multifamily Housing Service Coordinator First Time Funding Request
HUD-92015-CA Supportive Housing for the Elderly Section 202 Application for Capital Advance Summary Information
HUD-92016-CA Supportive Housing for Persons with Disabilities Section 811 Application for Capital Advance Summary Information
HUD-92041 Sponsor's Conflict of Interest Resolution
HUD-92042 Sponsor's Resolution for Commitment to Project
HUD-92043 Certification for Provision of Supportive Services (Section 811 Only)
HUD-92045 Multifamily Housing Assisted Living Conversion Program Application Summary Sheet

Office of Policy Development and Research (PD&R)

HUD-30001 Community Outreach Partnership Centers Program Match Requirements
HUD-30002 Community Outreach Partnership Centers Program Breakout
HUD-30007 Community Development Work Study Program Student Data Sheet
HUD-30012 Verification of Match (New)
HUD-30013 CDWS Designation of Applicant Graduate Academic Degree Program
HUD-30014 CDWS State/Area-wide Planning Organization Budget Summary Sheet
HUD-30015 CDWS Study Program Student Budget Sheet

Office of Healthy Homes and Lead Hazard Control (HHLHC)

HUD-424-C Budget Summary for Competitive Grant Programs
HUD-96008 Work Plan Development Worksheet with Minimum Benchmark Performance Standards for 36-Month Period of Performance (.xls)
HUD-96009 Benchmark Standards for 42 Month Period of Performance (.xls)
HUD-7015.15 Request for Release of Funds and Certification

Office of Public and Indian Housing (PIH)

HUD-52651 Choice Voucher Family Self Sufficiency Program Coordinator Funding
HUD-52751 ROSS Funding Fact Sheet
HUD-52752 Certification of Consistency with the Indian Housing Plan
HUD-52753 ROSS Funding Certification of Election of Resident Council
HUD-52754 ROSS List of Resident Organizations Supporting Nonprofit Applicants
HUD-52755 Sample Contract Administrator Partnership Agreement
HUD-52756 ROSS Chart A: Program Staffing
HUD-52757 ROSS Chart B: Applicant/Contract Administrator Track Record
HUD-52764 Sample ROSS-RSDM Elderly/Persons with Disabilities
HUD-52766 Sample Business Plan for Applicants of the ROSS Neighborhood Networks Funding Category
HUD-52767 ROSS Public Housing Family Self-Sufficiency Funding Request


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Content Archived: December 6, 2010

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U.S. Department of Housing and Urban Development
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Telephone: (202) 708-1112 TTY: (202) 708-1455