RENEWAL WORKSHEET FOR OPTION FIVE
Request Renewal of Contract for Portfolio Reengineering Demonstration or
Preservation Projects
My project is a Portfolio Reengineering Demonstration Project. I hereby request a RENEWAL
of my contract under Option Five.
The project has a recorded Mortgage Restructuring Demo Program Use Agreement
with rents adjusted annually by the OCAF.
The project has a recorded Budget Based Without Mortgage Restructuring Demo
Program Use Agreement with rents adjusted annually by the OCAF. A RCS maybe
required at the end of each 5-year period; at which time rents will be adjusted to
comparable market rents.
I understand that the contract may be renewed as a multiyear contract with the term not to
exceed the number of years under the Demo Program Use Agreement.
My project is a Preservation Project (LIPHRA or ELIPHRA). I hereby request a RENEWAL of
my contract under Option Five in accordance with the approved Plan of Action. I understand that
the contract may be renewed as a multiyear contract with the term not to exceed 20 years or the
remaining term of the recorded Use Agreement.
I hereby certify that:
Neither I, nor any of my affiliates, are suspended or debarred OR
I, or my affiliates, are suspended or debarred and are requesting a contract renewal subject to HUD
approval: AND
This information is true and complete.
Project Name ___________________________________________________________
Owner’s Name___________________________________________________________
Owner’s Signature_________________________________________Date________________
Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within
the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil
liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§
287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative
sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.
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form HUD-9624 (7/2008)