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Certification Period
January 1, 2018 – December 31, 2018
Agency Name
IDIS #’s
Project Address
City, Zip Code
Project Phone:
Project Email:
1. The owner/management agent has received an annual certification from each HOME-assisted
unit and documentation to support that certification.
Yes No
2. All units in the project were available for use by the general public.
Yes No
3. All rents for HOME-assisted units were approved by RIHousing before institution and no rents
exceed the approved amount.
Yes No
4. On December 31, 2018, each building and all HOME-assisted units in the project were suitable
for occupancy, taking into account State and local health, safety, and other applicable codes, ordi-
nances and requirements, and on-going property standards established by the participating jurisdic-
tion (PJ) to meet the requirements of Section 92.251.
Yes No
If “No”, please attach information on all units that are not suitable for occupancy including unit
numbers, date unit went “off-line”, and detailed explanation of the events/circumstances that led
to the current condition.
Unit inspections by Management are done at least: Quarterly Semi-Annually Annually
Date of last full property inspection by owner or managing agent:
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Note: Failure to complete this form in its entirety will result in noncompliance with
HOME program requirements.
The undersigned, having entered into a loan or grant agreement pursuant to the applicable provi-
sions of the “HOME Investment Partnership Act” (“HOME”), does hereby certify that the hous-
ing project is in continuing compliance with the HOME Regulatory Agreement (or similar docu-
ment) and any other applicable compliance requirements. This Certification and any attachments
are made under penalty of perjury.
Ownership Entity:
Printed Name:
(Authorized Representative of Ownership Entity)
Title: Date:
Signature By:
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