Fair Housing Project Summary & Certification

Fair Housing Project Summary & Certification

Fair and Equitable Housing Office (FEHO)

****To be returned to HCR PRIOR to Mortgage Closing****

****Please complete all sections****

This form allows HCR to conduct a preliminary fair housing review prior to closing. Please note that, in order to proceed to occupancy and lease-up of HCR-funded units, you are also required to obtain HCR approval of a full Affirmative Fair Housing Marketing Plan prior to occupancy and lease-up.Please review HCR Guidelines to filling out this and the full AFHMP at the following address:

Section 1 – Project Identification

1a. Project Name: Click here to enter text.

1b. Owner and/or Developer (with contact info): Click here to enter text.

1c. Project Address (include City, County, State & Zip Code):Click here to enter text.

1d. Project ID Number, if applicable:Click here to enter text.

1e. Number of HCR-funded Units: Click here to enter text.

Number of Market Rate Units, if applicable: Click here to enter text.

Number of Other Units, if applicable: Click here to enter text.

Total Number of Units in Project:Click here to enter text.

Total Number of Buildings in Project:Click here to enter text.

1f. Project Type (check all that apply):

☐Small Rental Development Initiative (SRDI)

☐Remarketing of Existing Project

☐Acquisition of existing occupied property

☐New Construction

☐Preservation/Rehabilitation.Click here to list no. of units & Identify if there will be vacancies to market

☐Site Improvement

☐Family

☐Mitchell Lama

☐80/20

☐Seniors 55 and older: Click here to list no. of units

☐Seniors 62 and older: Click here to list no. of units

☐Special Needs. List.:Click here to enter text.

1g. Project Funding Sources (List Sources and Amounts):

☐HCR. List: Click here to enter text.

☐NYS (non-HCR). List: Click here to enter text.

☐Federal. List: Click here to enter text.

☐Local government. List: Click here to enter text.

☐Private (non-government). List: Click here to enter text.

☐Other. List:Click here to enter text.

Section 2 – Set Aside Units for Special Populations

2a.Will this project give preference in the selection of tenants to households with at least one person with Special Needs? Choose an item. (If NO, skip to next section)

2b.If YES, to how many total units will the preference(s) apply? Click here to enter text.

Check all that apply:

☐Families who are Homeless.List No. of Units

☐Persons & Families who are in Long Term Recovery from Alcohol Abuse.No. of Units

☐Persons & Families who are in Long Term Recovery from Substance Abuse.No. of Units

☐Persons who are Frail Elderly.List No. of Units

☐Persons who are Homeless.List No. of Units

☐Persons with Intellectual/Developmental Disabilities.List No. of Units

☐Persons who are Victims of Domestic Violence.No. of Units

☐Persons with AIDS/HIV Related Illness. List No. of Units

☐Persons with Physical Disability/Traumatic Brain Injury.No. of Units

☐Persons with Psychiatric Disabilities.List No. of Units

☐Veterans who are Homeless.List No. of Units

☐Veterans in Long Term Recovery from Alcohol AbuseList No. of Units

☐Veterans in Long Term Recovery from Substance Abuse.List No. of Units

☐Veterans with Intellectual/Developmental Disabilities.List No. of Units

☐Veterans who are Victims of Domestic Violence.List No. of Units

☐Veterans with AIDS/HIV Related Illness.List No. of Units

☐Veterans with Physical Disabilities/Traumatic Brain Injury.List No. of Units

☐Veterans with Psychiatric Disabilities.List No. of Units

☐Veterans who are Frail Elderly.List No. of Units

☐Other Special Needs Preference. List No. of Units

Section 3– Occupancy Preference

3a. Other than Special Needs Set Aside Units listed above, will there be an occupancy preference for a specific type of applicant? (If the occupancy preference is limited to the Special Needs Set Asides selected in Section 2, select “No”) Choose an item.

3b. If YES, please specify the type of preference, the number of units set aside for the preference, and the duration of the requested preference?

Choose an item.

If “Other,” please specify:Enter Text

Number of units set aside for the occupancy preference: Enter Text

Duration of the requested preference: Enter Text

3c. What is the reason for the preference (e.g., requirements of funding source, etc.)?Enter Text

Section 4– Disclosure of Fair Housing Complaints

4a. Have any fair housing complaints been filed with HUD, a state agency (for example, the NYS Division of Human Rights) or a local municipal governmentin the last 10 years against the owner, sponsor or managing agent?Choose an item.

If yes, in each instance, when was the complaint filed, what was the outcome and what action was taken to provide a resolution: Enter Text

FAIR HOUSING CERTIFICATION

1. Recipient hereby agrees to comply with the policies and procedures promulgated by HCR as to marketing and tenant selection requirements, and to comply with all federal, New York State and local fair housing and non-discrimination laws, as applicable.

2.Consistent with such requirements, Recipient has submitted its Fair Housing Project Summary, listing any special needs and occupancy preferences that it will apply toward the selection of tenants in the project, and will not deviate from it without express written approval from HCR.

3.Also consistent with such requirements, Recipient may not market or lease units or proceed to occupancy until it has submitted to and obtained approval from HCR of an Affirmative Fair Housing Marketing Plan and marketing materials that are consistent with HCR’s Affirmative Fair Marketing Plan Guide for Managing Agents, Owners, and Developers, HCR’s policies and regulations, and all federal, New York State and local fair housing and non-discrimination laws, as applicable.

4.Recipient must submit its Affirmative Fair Housing Marketing Plan and all marketing materials and ads, as well as proof of registration on NYHousingSearch.gov, to HCR upon 70 percent completion of construction, but in no case later than 180 days prior to date assigned for substantial completion and/or Certificate of Occupancy.

5.I hereby certify that I have read and am familiar with the requirements and provisions of the New York State Homes and Community Renewal Affirmative Fair Housing Marketing Plan Guidelines, and all information stated herein and attached Exhibits, are true and accurate.

6.The Recipient understands that failure to comply with HCR’s marketing plan and tenant selection requirements shall subject the Owner, Developer and/or Marketing Agent to the fullest extent of the law including, but not limited to, HCR limiting or prohibiting the future participation of the undersigned, any subsidiaries or related entities in NYSHCR programs.

7.I, the signatory of this Fair Housing Certification, am duly authorized and have legal capacity to execute and this Certification on behalf of the Recipient.

Signature:______☐Check if signing electronically by

typing name

Print Name:______

Job Title:______

Employer:______

Date:______

Project Name:______

SHARS ID/

Contract Number:______

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