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<br /> <br /> <br />INSTRUCTIONS FOR COMPLETION OF DISCLOSURE REPORT <br /> <br />All applicants for HUD assistance must complete and submit, with their application, Parts I, II and VI of the <br />Disclosure Report. At the completion of Part II of the report, some applicants will find that they must complete <br />Parts III, IV, and V of the Report. <br /> <br />Part I requires the applicant's name, address, phone and Federal Employer Identification number; indication as to <br />whether this is an initial report or an update (all applicants will check the initial report box ); name of the project <br />to be assisted; the Federal fiscal year (Oct. 1 through Sept. 30) that funds are subject to the disclosure; and the aggregate amount of all assistance from HUD, State, and unit of general local government for this specific project <br />or activity that you have received and can reasonably expect to receive during the Federal fiscal year the <br />application is submitted. <br /> <br />Part II asks three questions. If the answer to all the questions is "No", the applicant must provide the certification <br />at the end of Part VI, but is not required to complete the remainder of the report. If the answer to any question is <br />"Yes" then the applicant must complete the remainder of the Report. <br /> <br />Part III requires information on any other Federal, State and/or local assistance that is to be used in conjunction <br />with the HUD project. <br />Part IV requires the identification of interested parties. Interested parties are persons and entities with a reportable <br />financial interest in the project. If an entity is being disclosed, the disclosure in Part IV must include an identification of each officer, director, principal stockholder or other official of the entity. All consultants, <br />developers or contractors involved in the application for HUD assistance, or in the planning, development or <br />implementation of the project, must be identified as an interested party. Also, any other person or entity that has a <br />pecuniary interest in the project that exceeds $50,000 or 10 percent of the HUD assistance, whichever is lower, <br />must be listed as an interested party. Pecuniary interest means any financial involvement in the project, including <br />(but not limited to) situations in which a persons or entity has an equity interest in the project, shares in any profit or resale or any distribution of surplus cash or other assets of the project or receives compensation for any goods <br />or services provided in connection with the project. (The following are not considered interested parties: local <br />administrative staff, recipients of housing rehab assistance, and rehab contractors as long as the rehab agreement <br />is between the property owner and the contractor.) <br /> <br />It is realized that at the time of application, applicants may not be aware of all interested parties since con-tracts <br />and agreements for goods and services are not awarded until after the Release of Funds. Subsequent to the Release <br />of Funds, as projects are being implemented, funds will be committed to interested parties which will necessitate the submission of an updated Disclosure Report. However, if an applicant for HUD funds identifies, under Part III <br />of the Disclosure Report, other governmental assistance that is to be used in con-junction with projects funded <br />with HUD funds and, if these other funds have been committed to interested parties, then these interested parties <br />must be identified in Part IV of the initial report. <br /> <br />Part V requires applicants to identify the sources and uses of all funds to be used in conjunction with the funded <br />project. The sources and uses must include all the other assistance identified in Part III as well as the HUD funds <br />identified in Part I). <br />Part VI requires the certification of the Chief Elected Official. <br />