This certification and any attachments are made under penalty of perjury. Failure to complete this form in its entirety will result in noncompliance
with program regulations. In addition, any individual other than an owner or general partner of the project is not permitted to sign this form, unless
permitted by the state agency.
Owner’s Certificate (2019)
OWNER’S CERTIFICATE OF CONTINUING PROGRAM COMPLIANCE
Property Name: Project#:
Property Address:
GP Name and Email Address:
Tax ID# of Ownership Entity:
Certification Dates:
(From MM/DD/YYYY) (To MM/DD/YYYY)
The Owner hereby certifies that:
1. The project meets the minimum requirement of (check one)
The 20-50 test under Section 42(g)(1)(A)
The 40-60 test under Section 42 (g)(1)(B)
The Average Income test under Section 42(g)(1)(C)
The 15-40 test for “deep rent skewed” projects under 42(g)(4) and 142(d)(4)(B)
2. There has been no change in the applicable fraction as defined in Section 42(c)(1)(B) for any building in the project.
True False If “False,” attach documentation of the applicable fraction to be reported
to the IRS for each building in the project for the certification year.
3. At initial occupancy, the owner has received a Tenant Income Certification from each low-income resident and
documentation to support that certification, and if applicable, at annual recertification, the owner has received a
Tenant Income Certification and documentation to support that certification.
True False If “False,” attach an explanation and the supporting documentation.
4. The owner has received an annual Student Self Certification for each low-income household.
True False If “False,” attach an explanation and the supporting documentation.
5. Each qualified low-income unit is rent-restricted under Section 42(g)(2) of the Code.
True False If “False,” attach an explanation and the supporting documentation.
6. All low-income units in the project are for use by the general public and are used on a non-transient basis, except as
otherwise permitted by Section 42 of the Code.
True False If “False,” attach an explanation and the supporting documentation.
7. The property is in compliance with all Fair Housing Act regulations and there have been no violations of the Fair
Housing regulations, including accessibility guidelines, filed against the project within the reporting period.
True False If “False,” attach an explanation and the supporting documentation.
No buildings have been placed in service.
At least one building has been placed in service, but the owner elects to begin credit period in the following year.
If either of the above applies, please check the appropriate box, and proceed to page 3 to sign and date this form.
Resyndication Properties Only:
No buildings have been placed in service under the most recent allocation.
At least one building has been placed in service under the most recent allocation, but the owner elects to begin credit period in the
following year.
If either of the above applies, please check the appropriate box, and complete the certification for the original allocation.
This certification and any attachments are made under penalty of perjury. Failure to complete this form in its entirety will result in noncompliance
with program regulations. In addition, any individual other than an owner or general partner of the project is not permitted to sign this form, unless
permitted by the state agency.
Owner’s Certificate (2019)
8. Each building in the project is suitable for occupancy taking into account local health, safety, building codes, and
Uniform Physical Condition Standards (UPCS) as defined by HUD, and the state or local government unit responsible
for building code inspections did not issue a report of a violation for any building or low-income unit in the project.
True False If “False,” attach an explanation and the supporting documentation, including a copy of
the violation report and any documentation of correction.
9. There have there been no changes in the eligible basis under Section 42(d) for any building in the project.
True False If “False,” attach an explanation and the supporting documentation.
10. All resident facilities included in the eligible basis of any building in the project are provided on a comparable basis
without a separate fee to all residents in the building.
True False If “False,” attach an explanation and the supporting documentation.
11. If a low-income unit in the project has been vacant during the year, reasonable attempts were or are being made to
rent that unit or the next available unit of comparable or smaller size to tenants having a qualifying income before any
units were or will be rented to tenants not having a qualifying income.
True False If “False,” attach an explanation and the supporting documentation.
12. If the income of a low-income household increased above the limit allowed in Section 42(g)(2)(D), all next available
units of comparable or smaller size in that building were rented to an income qualified household.
True False If “False,” attach an explanation and the supporting documentation.
13. An extended low-income housing commitment as described in section 42(h)(6) is in effect, including the requirement
under Section 42(h)(6)(B)(iv) that an owner cannot refuse to lease a unit in the project to an applicant because the
applicant holds a voucher of eligibility under Section 8 of the United States Housing Act of 1937, and all warranties,
covenants, and representations contained in the Regulatory Agreement (Extended Use Agreement) and the
Reservation Contract remain in force.
True False If “False,” attach an explanation and the supporting documentation.
14. If the owner received a Credit allocation from the portion of the state ceiling set-aside for a project involving
“qualified non-profit organizations” under Section 42(h)(5) of the code, the non-profit entity materially participated in
the operation of the development within the meaning of Section 469(h).
True False N/A If “False,” attach an explanation and the supporting documentation.
15. There has been no change in the ownership or management of the property since the completion of the last
Certification of Continuing Program Compliance.
True False If “False,” attach an explanation and the supporting documentation.
16. The property is in compliance with the Violence Against Women Act requirements and all related implementing
regulations providing protections for residents and applicants who are victims of domestic violence, dating violence,
sexual assault, and/or stalking.
True False If “False,” attach an explanation and the supporting documentation.
17. Pursuant to IRS Revenue Ruling 2004-82, the owner has not evicted any resident, or refused to renew any lease,
except for good cause.
True False If “False,” attach an explanation and the supporting documentation.
18. The owner continues to comply with all terms it agreed to in its application for Credit authority, including all federal
and state-level program requirements and any commitments for which it received points or other preferential
treatment in its application.
True False If “False,” attach an explanation and the supporting documentation.
This certification and any attachments are made under penalty of perjury. Failure to complete this form in its entirety will result in noncompliance
with program regulations. In addition, any individual other than an owner or general partner of the project is not permitted to sign this form, unless
permitted by the state agency.
Owner’s Certificate (2019)
19. The property has not suffered a casualty loss resulting in the current displacement of residents.
True False If “False,” attach an explanation and the supporting documentation outlining the
circumstances and date of the casualty loss and date on which the tenant(s) were able to
return to their unit(s).
20. The owner has not refused to lease a unit to an applicant based solely on their status as a holder of a Section 8
voucher.
True False If “False,” attach an explanation and the supporting documentation.
I,
(Print Name of Owner/Authorized Signer)
the undersigned Owner, being duly sworn, hereby represent and certify under penalty of perjury that the project is
otherwise in compliance with the U.S. Tax Code, any Treasury/IRS Regulations, the applicable state Qualified Allocation
Plan, and all other applicable laws, rules, and regulations. The information contained in this statement and answers to the
above questions, including any attachments hereto, are true, correct and complete to the best of my knowledge. I further
certify that I have the requisite authority to execute this Owners Annual Certification.
(If there has been a change in signing authority, please attach a copy of the corporate resolutions or minutes from the
partnership meeting, showing the undersigned has the authority to execute these documents for the ownership entity.)
Printed Name Title Owner Entity
Signature Date
click to sign
signature
click to edit
This certification and any attachments are made under penalty of perjury. Failure to complete this form in its entirety will result in noncompliance
with program regulations. In addition, any individual other than an owner or general partner of the project is not permitted to sign this form, unless
permitted by the state agency.
Owner’s Certificate (2019)
NA This form is required only for LIHTC projects that received an allocation of credits in 2016 or later. If the project
named above received a credit allocation prior to 2016, check “N/A” and disregard this form.
ANNUAL CERTIFICATION OF SERVICE COORDINATION
Property Name: Reporting Period:
Service Coordinator:
Phone: Email:
The number of hours per week that service coordination is provided for this property:
Service coordination is provided: Onsite Remotely Both
During this reporting period did the service coordinator:
1. Collect rent, inspect units, make determinations on requests for reasonable
accommodation, investigate lease violations, or issue eviction notices?
Yes No
2. Have a private space to meet with residents or meet with residents in their
homes?
Yes No
3. Have access to a telephone and internet when meeting with residents?
Yes No
4. Assess resident’s service needs within 60 days of move-in?
Yes No
5. Follow up with residents to address needs identified in their service plans?
Yes No
6. Maintain documentation of resident service needs assessments and follow-up
in a secure location?
Yes No
Coordinated Service #1
Service provider contact person:
Phone: Email:
The dates the service was provided during this reporting period:
The number of residents served:
Provide a brief description of the service:
Coordinated Service #2
Service provider contact person:
Phone: Email:
The dates the service was provided during this reporting period:
The number of residents served:
Provide a brief description of the service:
This certification and any attachments are made under penalty of perjury. Failure to complete this form in its entirety will result in noncompliance
with program regulations. In addition, any individual other than an owner or general partner of the project is not permitted to sign this form, unless
permitted by the state agency.
Owner’s Certificate (2019)
Are agreements for services on file (if any) and evidence that the services are being
provided (e.g. sign-in sheets, letters/memos to tenants advertising the event/service,
service log book and/or activity reports) maintained at the property?
Yes No
Was an annual survey conducted of all residents regarding their need for and
satisfaction with the service coordination, including coordinated services (not
required for first year of occupancy)?
Yes No
Are any changes to Service Coordination or Coordinated Services being proposed
for the next reporting period? (If yes, prior approval is required. Submit change
request to the Asset Manager for the property.)
Yes No
Who conducted the survey?
Phone: Email:
The project is otherwise in compliance with the Code, including any Treasury Regulations, the applicable
State Allocation Plan, and all other applicable laws, rules and regulations. This Certification and any
attachments are made UNDER PENALTY OF PERJURY.
I hereby certify that the above information is complete and true. I further certify that I have the requisite
authority to execute this Annual Certification of Service Coordination.
Name Title
Company
Signature Date
click to sign
signature
click to edit