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Previous editions are obsoleteform HUD-52515 (04/15)
<br />Page 2 of 4 ref. Handbook 7420.8
<br />E. Housing Quality Standards (HQS).(Check applicable box) HUD’s HQS will be used with no modifications Attached for
<br />HUD approval are HQS acceptability criteria variations
<br />F. New HA Information.Complete this section if HA currently does not administer a tenant-based certificate or voucher program.
<br />Financial and Administrative Capability. Describe the experience of the HA in administering housing or other programs and prov ide any
<br />other relevant information which evidences present or potential management capability for the proposed rental assistance program. Submit
<br />this narrative on a separate page.
<br />Qualification as an HA. Demonstrate that the applicant qualifies as an HA and is legally qualified and authorized to administer the funds
<br />applied for in this application. Submit the relevant enabling legislation and a supporting legal opinion.
<br />Note: If this application is approved, the HA must submit for HUD approval a utility allowance schedule and budget documents.
<br />G. Certifications.The following certifications are incorporated as a part of this application form. The signature on the last page of this ap plication of the HA
<br />representative authorized to sign the application signifies compliance with the terms of these certifications.
<br />Equal Opportunity Certification
<br />The Housing Agency (HA) certifies that:
<br />(1) The HA will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d) and regulations issued pursuant thereto (24 CFR
<br />Part 1) which state that no person in the United States shall, on the ground of race, color, or national origin, be excluded fr om participation
<br />in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant receives
<br />financial assistance; and will take any measures necessary to effectuate this agreement.
<br />(2) The HA will comply with the Fair Housing Act (42 U.S.C. 3601-19) and regulations issued pursuant thereto (24 CFR Part 100) which
<br />prohibit discrimination in housing on the basis of race, color, religion, sex, handicap, familial status, or national origin, and administer its
<br />programs and activities relating to housing in a manner to affirmatively further fair housing.
<br />(3) The HA will comply with Executive Order 11063 on Equal Opportunity in Housing which prohibits discrimination because of race,
<br />color, creed, or national origin in housing and related facilities provided with Federal financial assistance and HUD regulations (24 CFR
<br />Part 107).
<br />(4) The HA will comply with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794) and regulations issued pursuant ther eto (24
<br />CFR Part 8) which state that no otherwise qualified individual with handicaps in the United States shall solely by reason of th e handicap
<br />be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity r eceiving
<br />Federal financial assistance.
<br />(5) The HA will comply with the provisions of the Age Discrimination Act of 1975 (42 U.S.C. 6101-07) and regulations issued pursuant
<br />thereto (24 CFR Part 146) which state that no person in the United States shall on the basis of age be excluded from participation in,
<br />be denied the benefits of, or be subjected to discrimination under a program or activity receiving Federal financial assistance .
<br />(6) The Housing Agency will comply with the provisions of Title II of the Americans with Disabilities Act (42 U.S.C. 12131)and regulations
<br />issued pursuant thereto (28 CFR Part 35) which state that subject to the provisions of Title II, no qualified individual with a disability shall,
<br />by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs or activiti es of a public
<br />entity, or be subjected to discrimination by any such entity.
<br />The following provisions apply only to housing assisted with Project-Based Certificates:
<br />(7) The HA will comply with Executive Order 11246 and all regulations pursuant thereto (41 CFR Chapter 60-1) which state that no person
<br />shall be discriminated against on the basis of race, color, religion, sex or national origin in all phases of employment during the
<br />performance of Federal contracts and shall take affirmative action to ensure equal employment opportunity.
<br />(8) The HA will comply with Section 3 of the Housing and Urban Development Act of 1968, as amended (12 U.S.C. 1701u) and regul ations
<br />issued pursuant thereto (24 CFR Part 135), which require that, to the greatest extent feasible, opportunities for training and employment be
<br />given to low-income persons residing within the unit of local government for metropolitan area (or non-metropolitan county) in which the
<br />project is located.
<br />Certification Regarding Lobbying
<br />The undersigned certifies, to the best of his or her knowledge and belief, that:
<br />(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influen cing or
<br />attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an em ployee
<br />of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any
<br />Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modificat ion of
<br />any Federal contract, grant, loan, or cooperative agreement.
<br />(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempt ing to
<br />influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a M ember
<br />of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
<br />Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
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