Certification Of Material Events Form (Page 4 of 4) in pdf

Certification Of Material Events Form Page 4

Certification of Material Event Form: Revised September 2010

6. If a prior awardee or allocatee, will the event(s) have any effect on the organization’s

ability to comply with the reporting requirements set forth in the organization’s award

Yes

agreement?

If yes, please describe:

_______________________________________________________________________

7. If a prior awardee or allocatee, will the event(s) cause the organization to be in non-

compliance with an existing award agreement and/or necessitate the organization to seek

Yes

an amendment to its existing award agreement?

If yes, please describe:

_______________________________________________________________________

8. Will the event(s) have any effect on a pending application with one or more of the CDFI

Yes

Fund’s Programs?

If yes, please describe:

_______________________________________________________________________

To the best of my knowledge and belief, all information contained in this

certification statement is true and correct. My signature indicates authorization on

behalf of the organization’s governing body.

Authorized Representative Signature:

Title:

Date:

Certification Of Material Events Form Page 4