The following documents are required for the Moderate Rehabilitation and Single Room Occupancy programs. Please submit one original and one copy. Please ensure documents are reviewed for accuracy and completeness prior to submission to your Financial Analyst at the Financial Management Center (FMC).

• Form HUD-52673, Estimate of Total Required Annual Contributions, pages 1 & 2
• Form HUD-52672, Supporting Data for Annual Contributions Estimates
• Form HUD-52663, Requisition for Partial Payment of Annual Contributions

• Form HUD-50070, Drug Free Workplace Certification
• Form HUD-50071, Certification of Payments to Influence Federal Transactions
• Form SF-LLL, Disclosure of Lobbying Activities (if applicable)
• 100% of Official Time Certification: "No employee is serving in a variety of positions, which will exceed 100% of his/her official time".

Helpful Tips

1. Indicate if the amounts shown on the 52672 for Monthly Gross Rent/Payment are based on averages, since we compare these numbers to the Fair Market Rents for compliance with the basic range as stated in the Federal Register, Section 982.503.
2. Be sure to provide an approved copy of the Budget to your accountant.
3. To avoid delays in processing, please double check your submission package for completeness and accuracy prior to submission to the Financial Management Center.