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17-1 <br />Public reporting burden for this collection of information is estimated to average 2.0 hours per response, including the Gine for revievAng Instructions, <br />searching existing data sources, gathering and maintaining the data needed, and completing and revievnng the Wacuon of Information. This agency rn <br />not conduct or sponsor, and a person is not required to respond to, a colleclion information unless that collection displays a valid OMB control number. <br />Privacy Act Statement. Except for Social Security Numbers (SSNs) and Employer Identificahon Numbers (EiNs), the Departme ilof Housing and Urba <br />Development (HUD) is authonzed to tcnllect an the information required by this form under section 102 of the Department of Housing and Urban <br />Development Reform Act of 1989. 42 U.S.C. 3531. Disclosure of SSNs and EINs is optional. The SSN or EIN is used as a unique identifier. The <br />information you provide will enable HUD to carry out its responsibilities under Sections 102(b), (c). and (d) of the Department of Housing and Urban <br />Development Reform Act of 1989, Pub. L. 101.235, approved December 15, 1989. These provisions will help ensure greater accountability and integrity <br />the provision of certain types of assistance administered by HUD. They will also help ensure that HUD assistance for a spedfie housing project under <br />Section 102ld) is not more than is necessary to make the project feasible after laking account of olher government assistance. HUD will make available <br />the public all applicant disclosure reports for five years in the rase of applications for competitive assistance, and for generally three years In the case of <br />other applications. Update reports will be made available along with the disclosure reports, but in no case for a period generally less than three years. - <br />reports, both Initial reports and update reports, will be made avaliable to accordance with the Freedom of Information Act (5 U.S.C. §552) and HUD's <br />Implemeriling regulations at 24 CFR Pah 15. HUD will use the Information In evaluating individual assistance applications and in performing internal <br />administrative analyses to assist in the management of specific HUD programs. The informabon will also be used in making the datenminabon under <br />Section 102(dy whether HUD assistance for a specific housing project is more than is necessary to make the project feaslble cher taking account of othe <br />government assistance. You must provide all the required information. Failure to provide any required information may delay the processing of your <br />application, and may result in sanctions and penalties, including imposl8on of the administrative and civil money penalties specified under 24 CFR §4.38 <br />Note: This form only covers assistance made available by the Department. States and units of general focal government fhal Cary out responsibilities <br />under Sections 102(b) and (c) of the Reform Act must develop their own procedures for complying with the Act. <br />Instructions <br />Overview. <br />A. Coverage. You must complete this report if: <br />(1) You are applying for assistance from HUD for a specific project or <br />activity and you have received, or expect to receive. assistance <br />from HUD in excess of $200.000 during the during the fiscal year; <br />(21 You are updating a prior report as discussed below; or <br />(3) You are submitting an application for assistance to an entity other <br />than HUD, a State or local government if the application is required <br />by statute or regulabon to be submitted to HUD for approval or for <br />any other purpose. <br />IB. Update reports (filed by "Recipients" of HUD Assistance): <br />General. All recipients of covered assistance must submit update <br />reports to the Department to reflect substantial changes to the initial <br />applicant disclosure reports <br />Line -by -Line Instructions. <br />ApplicantlRecl plant Information, <br />All applicants for HUD competitive assistance, must complete the <br />information required in blocks 1-5 of form HUD -2880: <br />1 Enter the full name, address, city. State, zip code, and telephone <br />numb -or (including area code) of the applicanllrecipient. Where the <br />applicant/recipient is an individual, the last name, first name, and <br />middle initial must be entered, <br />2. Entry of the applicant/recipient's SSN or EIN, as appropriate, is <br />optional. <br />3. Applicants enter the HUD program name underwhich the assistance <br />is being requested. <br />4. Applicants enter the amount of HUD assistance that is being <br />requested. Recipients enter the amount of HUD assistance that has <br />been provided and to which the update report relates. The amounts <br />are those stated in the application or award documentation. NDTE: In <br />the case of assistance that is piovided pursuant to contract over a <br />period of lime (such as projecbbased assistance under section B of <br />the United Stales Housing Act of 1937), the amount of assistance to <br />be reported includes all amounts that. are 10 be provided over the term <br />of the contract, irrespective of when they are to be received. <br />S. Applicants enter the name and full address of the project or activity for <br />which the HUD assistance is sought. Recipients enter the name and <br />full address of the HUD•assisled project or activity to which the update <br />report relates. The most appropriate government identifying number <br />must be used (e.g.. RFP No.: IFB No.; grant announcement No.; or <br />contract, grant, or loan No.) Include prefixes. <br />Part 1. Threshold Determinations - Applicants Only <br />Pail I contains information to help the applicant determino whether the <br />remainder of the form must be completed. Recipients filing Update <br />Reports should not complete this Part. <br />If the answer to effhor questions 1 or 2 Is No, the applicant meed not <br />complete Parts II and III of the report, but must sign the carlificallon at <br />the and of the form. <br />Part It, Other Government Assistance and Expected Sources and <br />Uses of Funds, <br />Other Government Assistance. This Part is to be completed by both <br />applicants and recipients for assistance and recipients riling update <br />reports, Applicants and recipients must report any other government <br />assistance involved in the project or activity for which assistance is <br />sought. Applicants and recipients must report any other government <br />assistance involved in the project or activity. Other government <br />assistance is darned in note 4 on the last page. For purposes of this <br />definition, other government assistance is expected to he made <br />available 11, based on an assessment of all the circumst—ces <br />involved, there are reasonable grounds to anticipate that the <br />assistance will be forthcoming. <br />Both applicant and recipient disclosures must include all other <br />government assistance involved with the HUD assistance, as well as <br />any other government assistance that was made available bolore the <br />request, but that has continuing vitality at the time of the request. <br />Examples of this latter category include tax credits that provide for a <br />number of years of tax, henefits, and grant assistance that continues tc <br />benefit the project at the time of the assistance request. <br />The following information must be provided: <br />1. Enter the name and address, city, State, and tip code of the <br />government agency making the assistance available. <br />2. Slate the typ . of other government assistance (e.g., loan, grant, <br />loan insurance). <br />3. Enter the dollar amount of the other government assistance that is, <br />or is expected to be, made available with respect to the project or <br />acl vilies for which the HUD assistance is sought (applicants) or <br />has been provided (recipients). <br />4. Uses of funds. Each reportable use of funds must clearly identity <br />the purpose to which they are to be put. Reasonable aggregaSione <br />may be used, such as'tutal structure' to include a number of <br />structural costs, sucil as roof, elevators, exlanor masonry, ale. <br />D. Non -Government Assislance. Note that tiro applicant and recipient <br />disclosure report must specify all expected sources and uses of funds <br />both from HUD and Any other source - that have baert of ere to be. <br />made available for tho proJecl or activity. Non-government sources of <br />- - - - -- Form HUD -7890 (3198 <br />