Certification forms
The
PHA must complete, sign and mail certification forms with original
signatures to its local HUD office as a part of the PHA Plan submission
process. The certification forms validate the plan before submission
to a local HUD office, and validate the Plan's consistency with
the Consolidated Plan. In addition, a PHA submitting a request for
the Capital Fund Program/Capital Fund Program Replacement Housing
Factor is required to complete certifications related to the receipt
of Federal funds.
Overview of required forms
Form
HUD-50077: PHA Certifications of Compliance with PHA Plans and Related
Regulations
(Adobe PDF, 2 pages)
This certification is the standard certification PHAs submit
indicating their compliance with PHA Plan, Civil Rights Certification,
and related regulations. Additional certifications are required
for PHAs applying for funds under the Capital Fund program (see
below).
Form
HUD-50070: Certification for a Drug-Free Workplace (Adobe PDF,
1 page)
Must be completed by all PHAs requesting funding under the Capital
Fund Program (CFP).
Form
SF-LLL: Disclosure of Lobbying Activities (Adobe PDF, 2 pages)
All PHAs requesting funding under the Public Housing Drug Elimination
Program (PHDEP) and/or Capital Fund Program (CFP) must complete this
form. A PHA requesting funding under both programs is required to
submit only one Disclosure of Lobbying Activities form. See
also the Disclosure
of Lobbying Activities Continuation Sheet.
Form
HUD-50071: Certification of Payments to Influence Federal Transactions
(Adobe PDF, 1 page)
Must be completed by all PHAs requesting funding under the Public
Housing Drug Elimination Program (PHDEP) and/or Capital Fund Program
(CFP). A PHA requesting funding under both programs is required
to submit only one Certification of Payments to Influence Federal
Transactions form.
Form
HUD-50077-CR, Civil Rights Certifications (Adobe PDF, 1 page)
Annually, qualified public housing agencies are required
to make a Civil Rights certification of the public housing program
in accordance with 5A of the Act, as amended by HERA, on form HUD-0077-CR,
Civil Rights Certification. The HUD-50077-CR, may be signed by the
PHA Board of Commissioners or other authorized PHA official if there
is no Board of Commissioners, and submitted with signature by mail
or electronically with scanned signatures, however electronic submission
to the appropriate HUD Field Office is preferred.
Form
HUD-50077-SL,Certification by State or Local Office of PHA Consistency
with the Consolidated Plan (Adobe PDF, 1 page)
HUD-50077-SL, Certification by State or Local Office of PHA Plans
Consistency with the Consolidated Plan. The State or Local certification
of consistency must be made by the appropriate state or local officials
that the PHA Plan is consistent with the Consolidate Plan(s). If
the PHA is located in more than one jurisdiction, it must include
a certification from each appropriate official. All PHAs must use
the form provided for this statement and maintain the signed certification
in their office.
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