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EXHIBIT 2 <br />51 <br />CY2021HousingChoiceVoucherProgramandMainstreamVouchersAppendix G <br />Applicationfor$110Million Set-AsideforCategory2aUnforeseenCircumstances <br />NameofPHA: <br />PHANumber: <br />ExecutiveDirector: <br />CHECK ALL BOXES THAT APPLY in Sections 1 & 2. Complete the table(s) that applies to this <br />request. PHAs applying under both programs must ensure they complete each table with the data that <br />applies to that program. Ensure completion of the month of your request. Ensure that you check the <br />appropriatebox inSection 2ontheapplicable circumstancefortheapplication. <br />SECTION1: <br />Category2a:UnforeseenCircumstancesforMainstreamVouchers. <br />TotalHAP ExpensesandUMLsforthemonthof,2021 <br />Most recent month of TotalUMLs for the most recentHAP Expenses divided by <br />HAPExpensesmonthofHAPExpensesUMLs= PUC <br />$$ <br />Category2a:UnforeseenCircumstancesfortheHCVProgram. <br />TotalHAP ExpensesandUMLsforthemonthof,2021 <br />Most recent month of TotalUMLs for the most recentHAP Expenses divided by <br />HAPExpensesmonthofHAPExpensesUMLs= PUC <br />$$ <br />SECTION2: <br />UnforeseenCircumstanceisduetoCOVID-19;or, <br />Unforeseen Circumstance is due to a circumstance unrelated to COVID-19, <br />whichisdescribed withinattached narrative. <br />Documentation requirements and Deadlines for each of the above categories are contained in Section <br />13 ofthisnotice. <br />ThiscertificationmustbesignedbytheappropriatePHAofficialandreturned. <br />Certification:I,, hereby certify that the HCV Program and/or Mainstream Vouchers <br />experienced increased renewal costs in CY 2021 due to the unforeseen circumstances of COVID-19 or those <br />described intheattachednarrative,as applicable. <br />Iadditionallyherebycertifythatalltheinformationstatedherein,aswellasanyinformationprovidedinthe <br />accompaniment herewith, is true and accurate. Warning: Anyone who knowingly submits a false claim or <br />makesafalsestatementissubjecttocriminaland/orcivilpenalties,includingconfinementforupto5years, <br />fines,andcivilandadministrativepenalties(18U.S.C.§§287,1001,1010,1012;31U.S.C.§3729,3802). <br />Signature of Executive Director and Date <br />ContactNameandPhoneNumber <br /> <br />