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Form HUD 424-B (1/27/2023) <br />Applicant and Recipient <br />Assurances and Certifications <br />U.S. Department of Housing <br />and Urban Development <br />OMB Number: 2501-0044 <br />Expiration Date: 2/28/2027 <br />Instructions for the HUD 424-B Assurances and Certifications <br />As part of your application for HUD funding, you, as the official authorized to sign on behalf of your organization or as an individual, <br />must provide the following assurances and certifications. The Responsible Civil Rights Official has specified this form for use for <br />purposes of general compliance with 24 CFR §§ 1.5, 3.115, 8.50, and 146.25, as applicable. The Responsible Civil Rights Official <br />may require specific civil rights assurances to be furnished consistent with those authorities and will specify the form on which such <br />assurances must be made. A failure to furnish or comply with the civil rights assurances contained in this form may result in the <br />procedures to effect compliance at 24 CFR §§ 1.8, 3.115, 8.57, or 146.39. <br />By submitting this form, you are stating that all assertions made in this form are true, accurate, and correct. <br />As the duly representative of the applicant, I certify that the <br />applicant: [Insert below the Name and title of the Authorized <br />Representative, name of Organization and the date of <br />signature]: <br />*Authorized Representative Name: <br />*Title: <br />*Applicant/Recipient Organization: <br />1. Has the legal authority to apply for Federal assistance, <br />has the institutional, managerial and financial capability <br />(including funds to pay the non-Federal share of program <br />costs) to plan, manage and complete the program as <br />described in the application and the governing body has duly <br />authorized the submission of the application, including these <br />assurances and certifications, and authorized me as the <br />official representative of the application to act in connection <br />with the application and to provide any additional information <br />as may be required. <br />2. Will administer the grant in compliance with Title VI of <br />the Civil Rights Act of 1964 (42 U.S.C 2000(d)) and <br />implementing regulations (24 CFR part 1), which provide that <br />no person in the United States shall, on the grounds of race, <br />color or national origin, be excluded from participation in, be <br />denied the benefits of, or otherwise be subject to <br />discrimination under any program or activity that receives <br />Federal financial assistance OR if the applicant is a <br />Federally recognized Indian tribe or its tribally designated <br />housing entity, is subject to the Indian Civil Rights Act (25 <br />U.S.C. 1301-1303). <br />3. Will administer the grant in compliance with Section 504 <br />of the Rehabilitation Act of 1973 (29 U.S.C. 794), as <br />amended, and implementing regulations at 24 CFR part 8, <br />the American Disabilities Act (42 U.S.C. §§ 12101 et.seq.), <br />and implementing regulations at 28 CFR part 35 or 36, as <br />applicable, and the Age Discrimination Act of 1975 (42 <br />U.S.C. 6101-07) as amended, and implementing regulations <br />at 24 CFR part 146 which together provide that no person in <br />the United States shall, on the grounds of disability or age, <br />be excluded from participation in, be denied the benefits of, <br />or otherwise be subjected to discrimination under any <br />program or activity that receives Federal financial <br />assistance; except if the grant program authorizes or limits <br />participation to designated populations, then the applicant <br />will comply with the nondiscrimination requirements within <br />the designated population. <br />4. Will comply with the Fair Housing Act (42 U.S.C. 3601- <br />19), as amended, and the implementing regulations at 24 <br />CFR part 100, which prohibit discrimination in housing on the <br />basis of race, color, religion sex (including gender identity <br />and sexual orientation), disability, familial status, or national <br />origin and will affirmatively further fair housing; except an <br />applicant which is an Indian tribe or its instrumentality which <br />is excluded by statute from coverage does not make this <br />certification; and further except if the grant program <br />authorizes or limits participation to designated populations, <br />then the applicant will comply with the nondiscrimination <br />requirements within the designated population. <br />5. Will comply with all applicable Federal nondiscrimination <br />requirements, including those listed at 24 CFR §§ 5.105(a) <br />and 5.106 as applicable. <br />6. Will comply with the acquisition and relocation <br />requirements of the Uniform Relocation Assistance and Real <br />Property Acquisition Policies Act of 1970, as amended (42 <br />U.S.C. 4601) and implementing regulations at 49 CFR part <br />24 and, as applicable, Section 104(d) of the Housing and <br />Community Development Act of 1974 (42 U.S.C. 5304(d)) <br />and implementing regulations at 24 CFR part 42, subpart A. <br />7. Will comply with the environmental requirements of the <br />National Environmental Policy Act (42 U.S.C. 4321 et.seq.) <br />and related Federal authorities prior to the commitment or <br />expenditure of funds for property. <br />8. That no Federal appropriated funds have been paid, or <br />will be paid, by or on behalf of the applicant, to any person <br />for influencing or attempting to influence an officer or <br />employee of any agency, a Member of Congress, and officer <br />or employee of Congress, or an employee of a Member of <br />Congress, in connection with the awarding of this Federal <br />grant or its extension, renewal, amendment or modification. <br />If funds other than Federal appropriated funds have or will <br />be paid for influencing or attempting to influence the persons <br />listed above, I shall complete and submit Standard Form- <br />LLL, Disclosure Form to Report Lobbying. I certify that I shall <br />require all subawards at all tiers (including sub-grants and <br />contracts) to similarly certify and disclose accordingly. <br />Federally recognized Indian Tribes and tribally designated <br />housing entities (TDHEs) established by Federally- <br />recognized Indian tribes as a result of the exercise of the <br />Byrd Amendment, but State-recognized Indian tribes and <br />TDHs established under State law are not excluded from the <br />I/We, the undersigned, certify under penalty of perjury <br />that the information provided above is true and correct. <br />WARNING: Anyone who knowingly submits a false claim <br />or makes a false statement is subject to criminal and/or <br />civil penalties, including confinement for up to 5 years, <br />fines, and civil and administrative penalties. (18 U.S.C. <br />§§287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802; 24 <br />CFR §28.10(b)(iii)). <br />* Signature: <br />* Date: (mm/dd/yyyy): <br />06/03/2025