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HOPE 3

U.S. Department of Housing

OMB Approval No. 2506-0128 (exp. 8/31/2003)

/ Single Family Homes Program

and Urban Development

Property Completion Form

Office of Community Planning

and Development

This information is required by 24 CFR Part 572, to obtain benefits under the HOPE 3 Program authorized by the National Affordable Housing Act of 1990,

as amended. Information collected pursuant to the requirements will be reviewed and analyzed by HUD staff at the Field Office and Headquarters level to

determine compliance with statutory requirements for eligibility, and compliance with national objectives.

Public Reporting Burden for this collection of information is estimated to average 0.25 hours per response, including the time for reviewing instructions,

searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments

regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management

Officer, Paperwork Reduction Project (2506-0128), Office of Information Technology, U.S. Department of Housing and Urban Development, Washington,

D.C. 20410-3600. Do not send this completed form to either of these addressees.

HUD may not conduct or sponsor, and a person is not required to respond to, a collection information unless that collecton displays a valid OMB control

number.

Information on activities and expenditure of grant funds is public information and is generally available for disclosure. Recipients are responsible for ensuring

confidentiality when public disclosure is not required. Recipients may assure additional confidentiality where doing so would not be inconsistent with the

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requirements of the Freedom of Information Act and the Privacy Act.

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to:

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Submit this form within 30 days

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HOPE 3 Program,

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of the final disbursement of

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U.S. Department of Housing and Urban Development,

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HOPE 3 funds for this property

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L'Enfant Plaza Station, PO Box 23997

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Washington, DC 20026

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Part A. Recipient Information

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1. LOCCS Pgrm. Area:

= Original Submission

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HOP3

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= Revision

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3. Recipient Organization's Name :

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4. Grant No:

5. Property No: (12 digits)

3a. Recipient Organization's TIN :

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Part B. Property Information

Fill in all information.

1. Name of Homebuyer(s):

First Name:

Initial: Last Name:

Mr.

Mrs.

Ms.

First Name:

Initial: Last Name:

Mr.

Mrs.

Ms.

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2a. Property Street Address:

2b. Unit No:

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2c. City:

2d. State:

2e. Zip Code:

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Was lead base paint

Does the property meet the higher of local housing code

5. For Lease-Purchase Only

removed from this property?

or Section 8 Housing Quality Standards (HQS)?

Actual Date of Sale to Homebuyer:

(mm/dd/yy)

Yes

Part C. Grantee's Costs to Acquire and Prepare the Property for Sale

Do not include financial assistance to the Homebuyer.

(A)

(B)

(C)

(D)

Type of Cost

HOPE 3

Match

Other

Total Costs

Acquisition

Rehabilitation

Other Property Costs

(See form HUD-40102-B)

Recipient's Property Transfer Costs

Total

Page 1 of 3

form HUD-40105 (7/94)

Form Hud-40105 - Property Completion Form - U.s. Department Of Housing And Urban Development

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