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Previous editions are obsoleteform HUD-52515 (04/15) <br />Page 1 of 4 ref. Handbook 7420.8 <br />Funding Application <br />Section 8 Tenant-Based Assistance <br />Rental Certificate Program <br />Rental Voucher Program <br />U.S. Department of Housing <br />and Urban Development <br />Office of Public and Indian Housing <br />OMB Approval No. 2577-0169 <br />(exp.04/30/2018) <br />Send the original and two copies of this application form and attachments to the local HUD Field Office <br />Eligible applicants (HAs) must submit this information when applying for grant funding for tenant-based housing assistance programs under Section 8 of the <br />U.S. Housing Act of l937 (42 U.S.C. 1437f). HUD will use the information to evaluate an application based on selection crit eria stated in the Notice of <br />Funding Availability (NOFA). HUD will notify the HA of its approval/disapproval of the funding application. Responses are required to obtain a benefit from <br />the Federal Govenment. The information requested does not lend itself to con fidentiality. <br />Name and Mailing Address of the Housing Agency (HA) requesting housing assistance payments <br />Do you have an ACC with HUD No Yes Date of Application Legal Area of Operation <br />(area in which the HA has authority under State and local law to administer the program) <br />for Section 8 Certificates? <br />for Section 8 Vouchers? <br />A. Area(s) From Which Families To Be Assisted Will Be Drawn. <br />Locality (city, town, etc.)County Congressional <br />District <br />Units <br />B. Proposed Assisted Dwelling Units. <br />(Complete this section based on the unit sizes <br />of the applicants at the top of the w aiting list <br />) 0-BR 1-BR <br />Number <br />ofDwelling <br />2-BR <br />UnitsbyBedroom <br />3-BR <br />Size <br />4-BR 5-BR 6+BR <br />TotalDwelling Units <br />Certificates <br />Vouchers <br />C. Average Monthly Adjusted Income.Complete this section based on actual incomes of current participants by unit size. Enter average monthly adjusted <br />income for each program separately and only for the unit sizes requested in Section B. <br />0-BR 1-BR 2-BR 3-BR 4-BR 5-BR 6+BR <br />Certificates $$$$$$$ <br />Vouchers $$$$$$$ <br />D. Need for Housing Assistance.Demonstrate that the project requested in this application is responsive to the condition of the housing stock in the community <br />and the housing assistance needs of low-income families residing in or expected to reside in the community. (If additional space is needed, add separate pages <br />7-13