Fillable Management Entity Profile - Hud (Page 4 of 4) in pdf

19a. List all HUD Field Offices that have jurisdiction over the projects included in 6a. For companies that operate in more than five Field Office jurisdictions,

identify the five jurisdictions where the greatest number of your HUD-related projects are located.

19b. List all State Agencies in whose jurisdiction you have managed or are managing State Agency-financed projects. For companies that operate in more

than five States, identify the five where the greatest number of your State Agency projects are located.

19c.

List all FmHA offices in whose jurisdiction you have managed or are managing FmHA projects. For companies that operate in more than five FmHA

jurisdictions, identify the five where the greatest number of your FmHA projects are located.

Certification: The undersigned hereby certifies that the statements and information contained in this profile are true and correct.

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010 , 1012; 31 U.S.C. 3729, 3802)

Signed by Management Entity Representative

Signature

Date (mm/dd/yyyy)

Print Name

Title

Public reporting burden for this collection of information is estimated to average 2 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 info rmation. This agency

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

Owners of insured and assisted multifamily housing projects are required by HUD administrative guidelines as found in HUD Handb ook 4381.5 REV-2, The

Management Agent Handbook, to submit certain data for review by the local HUD office of approval of a new management agent. These requirements

apply to insured multifamily projects or HUD-held mortgages and subsidized, non-insured projects that are not financed by State Agencies or the Rural

Housing Service Agency.

Privacy Act Statement: The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S. Housing Act

of 1937, as amended, and the Social Security Numbers (SSN) by the Housing and Community Development Act of 1987, 42 U.S.C. 3543

. . The information

concerning management documents for Multifamily Housing projects is being collected by HUD to: (1) determine the acceptability of proposed

management agents, (2) ensure compliance with program requirements, (3) provide leverage for removing poor managers, and (4) recover excessive

management fees. The information is being used as a management tool to avoid the misuse of HUD subsides and defaults against the FHA insurance

fund by management agents. Specifically, the information will provide for improved project management by ensuring: that subsidy funds are administered

in accordance with HUD rules, project expenses are reasonable, maintenance of documented records, and use of project funds only in accordance with

HUD requirements. The SSN is used as a unique identifier. HUD may disclose this information to Federal, State and local agencies when relevant to civil,

criminal, or regulatory investigations and prosecutions. It will not be otherwise disclosed or released outside of HUD, except as permitted or required by

law. Failure to provide the information could result in HUD's denial of proposed management or fees or cancellation of management contracts for

noncompliance with HUD procedures. Providing the SSN is mandatory, and failure to provide it could affect your participation in HUD programs.

form HUD-9832 (8/91)

Previous editions are obsolete

Page 4 of 4

ref. Handbook 4381.5