Previous Participation U.S. Department of Housing U.S. Department of Agriculture OMB Approval No. 2502-0118 Certification And Urban Development Farmers Home Administration (exp 11/30/2012) Office of Housing /Federal Housing Commissioner

Part I To be completed by Principals of Multifamily Projects. See Instructions For HUD HQ/FmHA use only Reason for Submitting Certification insured project of HUD, USDA FmHA and State and complaint or indictment charging a felony. (A felony is 5. I am not a principal participant in an assisted or local government housing finance agencies in which I defined as any offense punishable by imprisonment for insured project as of this date on which 1.have Agency been orNam am nowe and a principal.City where the application is fileda term exceeding one year, but does not include any 2. Projectconstruction Name, has Project stopped Number. for a period City in and excess Zip Code contained in the application 2. For the period beginning 10 years prior to the date of offense classified as a misdemeanor under the laws of a of_20 days or which has been substantially this certification, and except as shown by me on the State and punishable by imprisonment of two years or completed for more than 90 days and documents certification. less); for closing, including final cost certification 3. Loan or Contract Amount 4. Number of Units or Beds 5. Section of Act 6. Type of Project (check one a. No mortgage on a project listed by me has ever f. I have not been suspended, debarred or otherwise have not been filed with HUD or FmHA ) been in default, assigned to the Government or restricted by any Department or Agency of the Federal 6. To my knowledge IExisting have not been foundRehabilitation by Proposed (New) List offoreclosed, all proposed nor Principalhas mortgage Participants relief by andthe attach organizationGovernment chart foror ofall a organizations. State Government from doing HUD8. orRole FmHA of Each to be in noncompliance9. Expected with % Owner 10. Social Security or IRS Employer 7. mortgageeNames and been addresses given; of All Known Principals and Affiliatesbusiness (people, with business such Department& organizations) or Agency. proposing to any applicablePrincipal fair in housingShip and Interest civil rights in Project Number participate in the project described above. (list names alphabetically; last, first, middle initial) Project b. I have not experienced defaults or noncompliancesg. I have not defaulted on an obligation covered by a requirements in 24 CFR 5.10_(a). under any Conventional Contract or Turnkey surety or performance bond and have not been the 7. I am not a Member of Congress or a Resident Contract of Sale in connection with a public subject of a claim under an employee fidelity bond. Commissioner nor otherwise prohibited or housing project; 3. All the names of the parties, known to me to be limited by law from contracting with the c. To the best of my knowledge, there are no principals in this project(s) in which I propose to Government of the United States of America. unresolved findings raised as a result of HUD participate, are listed above. 8. Statements above (if any) to which I cannot Certifications:audits, I (meaning management the individual reviews or who other signs Governmental as well 4. I am not a HUD/FmHA employee or a member of a certify have been deleted by striking through the as the corporations,investigations partnerships concerning or other me orparties my projects; listed above HUD/FmHA employee's immediate household as words with a pen. I have initialed each deletion who certify)d. There hereby has apply not been to HUD a suspension or USDA or FmHA, termination as the of defined in Standards of Ethical Conduct_Ior Employees (if any) and have attached a true and accurate payments under any HUD assistance contract in signed statement (if applicable) to explain the case maybe, for approval to participate as a principal in the of the Executive Branch in 5C.F.R. Part 2635 (57 FR which I have had a legal or beneficial interest; facts and circumstances which I think helps to role and project listed above based upon my following 35006) and HUD's Standard of Conduct in 24 C.F.R. previouse. participationI have not beenrecord convicted and this ofCertification. a felony and Verify am not qualify me as a responsible principal for presently, to my knowledge, the subject of a Part _ and USDA's Standard of Conduct in 7 C.F.R. participation in this project. that neither you nor any of your principals or affiliates have Part _ Subpart B. ever been found to be in noncompliance with any applicable fair housing and civil rights requirements in 24 CFR 5.105 (a). If you or any of your principals or affiliates have been found to be in noncompliance with any such requirements, attach a signed statement explaining the relevant facts, circumstances, and resolution, if any. I certify that all the statements made by me are true, complete and correct to the best of my knowledge and belief and are made in good faith, including the data contained in Schedule A and Exhibits signed by me and attached to this form. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. I further certify that:

Schedule A contains a listing of every assisted or

Typed or Printed Name of Principal Signature of Principal Certification Date (mm/dd/yyyy) Area Code and Telephone No.

This form was prepared by (Please print name) Area Code and Telephone No.

Previous editions are obsolete Page 1 of 3 ref Handbook 4065.1 form HUD-2530 (7/2009) Part II – For HUD Internal Processing Only Received and checked by me for accuracy and completeness; recommend approval or transferral to Headquarters as checked below: Date (mm/dd/yyyy) Telephone Number and Area Code A. No adverse information C. Disclosure or Certification problem

Staff Processing and Control B. Name match in System D. Other, our memorandum is attached

Supervisor Director of Housing/Director, Mulitfamily Division Approved Date (mm/dd/yyyy) Yes No

Previous editions are obsolete Page 2 of 3 ref Handbook 4065.1 form HUD-2530 (7/2009) InstructionsBlock 9: Fill in for the Completing percentage of the ownership Previous in ColumnWho Must 3 ListSign the and role(s) File Form of your HUD-2530: participation, andExemptions provide a telephone – The names number of where the followingyou can IfHUD-2530"). you do requestBeside each re considerationsignature, fill in by the the Participationthe proposed Certificate, project that form each HUD-2530 principal is datesForm HUD-2530 participated, must and be ifcompleted fee or identityand signed of beparties reached do not during need the to day. be Nolisted determina on formtions HUD - Reviewrole of each Committee party (the andsame the as shown reconsideration in block expected to have. Also specify if the participant interestby all with parties owners. applying to become principal Carefully read these instructions and the ap- will2530: be Publicmade Housingon these Agencies,certificates. tenants, owners results8). In addition, in an adverseeach person determination, who signs the you form may is a general or limited partner. Beside the name participants in HUD multifamily housing projects, plicable regulations. A copy of those regulations Column 4 Indicate the current status of the of less than five condominium or cooperative thenshould request fill in the a hearing date that before he or a she Hearing signs, Of asficer. of those parties who will not be owners, write including those who have no previous File one copy of the Master List with each HUD published at 24 C.F.R. 200.210 to 200.245 can loan. Except for current loans, the date asso- units and all others whose interests were Thewell asHearing providing Officer a telephone will issue number a report where to hethe "None." participation. The form must be signed and filed Office where you do business and mail one be obtained from the Multifamily Housing ciated with the status is required. Loans under a acquired by inheritance or court order. Reviewor she can Committee. be reached You during will businessbe notified hours. of the by all principals and their affiliates who propose copy to the following address: RepresentativeBlock 10: Fill in at the any Social HUD SecurityOffice. Type Number or print or workout arrangement are considered assigned. Where and When Form HUD-2530 Must Be finalBy providing ruling by a certified telephone mail. number where you can participating in the HUD project. Use a separate HUD-2530 Master List neatlyIRS employer in ink when number filling of out every this party form. listed, Mark An explanation of the circumstances Filed: The original of this form must be be reached, you will help to prevent any form for each role in the project unless there is Participation and Compliance Specific Line Instructions: answersincluding inaffiliates. all blocks of the form. If the form is surrounding the status is required for all non- submitted to the HUD Office where your project possible delay caused by mailing and an identity of interest. Division – Housing Reason for submitting this Certification: e.g., notInstructions filled completely, for Completing it will delaySchedule approval A: of current loans. application will be processed at the same time processing time in the event HUD has any U.S. Department of Housing and refinance, management, change in ownership, your application. ColumnPrincipals 5 include Explain all any individuals, project defaults joint ven duringtures, you file your initial project application. This form questions. Be sure that Schedule A is filled-in completely, partnerships, corporations, trusts, nonprofit Urban Development 451 Seventh transfer of physical assets, etc. Attach extra sheets as you need them. Be sure your participation. must be filed with applications for projects, or If you cannot certify and sign the certification as accurately and the certification is properly dated organizations, any other public or private entity, Street, S.W. Washington, D.C. 20410 to indicate "Continued on Attachments" when otherwise required in the situations listed itBlock is printed 1: Fill becausein the name some of the statements agency to do which not and signed, because it will serve as a legal thatColumn will participate 6 Enter the in latest the proposed Management project and/ as ora wherever appropriate. Sign each additional below: correctlyyou are describe applying. your For record, example: use HUD a pen Office, and record of your previous experience. All sponsor,Physical Inspection owner, prime Review contractor, rating. If either turnkey of page that you attach if it refers to you or your • Projects to be financed with mortgages strikeFarmers through Home those Administration parts that District differ withoffice, your or Multifamily Housing projects involving HUD/ developer,the ratings are managing below average, agent, the nursing report issued home record. If you have many projects to list (20 or inOncesured you under have the filed National a Master Housing List, Act you (FHA). do not record,the name then of signa State and orcertify local to housing that remaining finance FmHA, and State and local Housing Finance administratorby HUD is required or to operator, be submitted packager, along with or more) and expect to be applying frequently for •need to completeProjects Scheduleto be financed A when according you sub tomit partagency. which Below does that,describe fill in you the or name your record.of the city Agencies in which you have previously partici- consultant.the applicant's Architects explanation and ofattorneys the circumstances who have participation in HUD projects, you should con- Sectionform HUD-2530. 202 of the Instead, Housing write Act ofthe 1959 name (Elderly of the where the office is located. pated must be listed. Applicants are reminded anysurrounding interest thein therating. project other than an arms sider filing a Master List. See Master List andparticipant Handicapped). in column 1 of Schedule A and Block 2: Fill in the name of the project, such as that previous participation pertains to the lengthNo Previous fee arrangement Record: Even for if professional you have never ser- Attach a signed letter, note or an explanation of instructions below under "Instructions for Com- •beside thatProjects write "See in which Master 20 percentList on file."or more Also of "Greenwood Apts." If the name has not yet been individual principal within an entity as well as the vicesparticipated are also in considered a HUD project principals before, by youHUD. must give the date that appears on the Master List the items you have struck out on the certification pletingentity itself. Schedule A newly A." formed company may not the units are to receive a subsidy as described in andselected, report writethe facts "Name of your unknown." correct record. Below Item that, Incomplete the case form of partnerships,HUD-2530. If allyou general have no partners record that you submitted. Below that, report all Carefullyhave previous read participation, the certification but the before principals you 24 C.F.R. 200.213. A(2)(e)enter the relates HUD tocontract felony or convictions project identi withinfication the regardlessof previous ofprojects their to percentage list, fill in your inter nameest and in changes and additions that have occurred since signwithin it. the Any company questions may regarding have had the extensive form or • Purchase of a project subject to a pastnumber, 10 years. the If Farmers you have Home been convicted Administration of a limitedcolumn partners1 of Schedule having A, a and 25 percentwrite across or more the that date. Be sure to include any mortgage howparticipation to complete and it disclosure can be answered of that activity by your is mortgage insured or held by the Secretary of felonyproject within number, 10 years, or the strike State out or all local of A(2)(e) housing on interestform by your in thename partnership – "No previous are participation, considered defaults, assignments or foreclosures not listed HUDrequired. Office To Multifamily avoid duplication Housing of Representative. disclosure, list HUD. thefinance certificate agency and project attach your or contract statement number. giving principals.first experience." In the case of public or private previously. Purpose:the project Thisand then form the provides entities HUDor individuals with a Purchase• of a Secretary-owned project. yourInclude expla allnation. project A felonyor contract conviction identi willfication not corporationsMaster List orSystem: governmental If you expectentities, to princi file palsthis If you have withdrawn from a project since certifiedinvolved in report that project. of all previous You may participation use the name in Proposed substitution or addition of a princi- necessarilynumbers that cause are relevant your participation to the project.Also to be includeform frequently the president, and youvice havepresident, a long secretary, list of the date the Master List was filed, be sure to HUDor a numbermultifamily code housing to denote projects the by entity those or pal, or principal participation in a different disapprovedenter the name unless of the there city isin awhich criminal the recordproject oris treasurerprevious projects and all to other report executive on Schedule officers A, whoyou name the project. Give the project identification partiesindividual making that participated. application. The The number information code capacity from that previously approved for otherlocated, evidence and the ZIP that Code your of previous the site location. conduct or areshould directly consider responsible filing a Masterto the board List. By of doingdirectors, so, number, the month and year your participation requestedcan then be inused this in formcolumn is 3 usedto denote by role. HUD to the same project. method of doing business has been such that oryou any will equivalent avoid having govern toing list body, all your as well previous as all began and/or ended. determine if you meet the standards established Proposed acquisition by an existing limited yourBlock participation 3: Fill in the in thedollar project amount would requested make it anin directorsprojects each and time each you stockholder file a new application. having a 10 toColumn ensure 2 that List all the principal project participantsor contract inidentifi HUD- partnerCertification: of an additional interest in a project unacceptablethe proposed mortgage,risk from the or theunderwriting annual amount stand- percent or more interest in the corporation. projectscation of will each honor previous their project. legal, All financial previous and To make a Master List, use form HUD2530. On Afterresulting you inhave a total completed interest allof 25other percent parts orof form pointof rental of assistance an insurer, requested. lender or governmental contractualprojects must obligations be included and are or accept your certificaable risks- page 1, in block 1, enter (in capital letters) the HUD-2530,more, or proposed including acquisition Schedule by A, a read corpo the- agency.Block 4: Fill in the number of apartment units Affiliates are defined as any person or business fromtion cannotthe underwriting be processed. standpoint Include of an the insurer, name words "Master List." In blocks 2 through 6 Certificationrate stockholder carefully. of an Inadditional the box interestbelow the in proposed, such as "40 units." For hospital concern that directly or indirectly controls the lenderof all projects,or governmental the cities agency. in which HUD they requires are enter in "N.A." meaning Not Applicable. statementa project resulting of certification, in a total fill interest in the name of 10 of all projects or nursing homes, fill in the number of policy of a principal or has the power to do so. A thatlocated you and certify the government your record agency of previous (HUD, Complete blocks 7 through 10. principalspercent or and more. affiliates (type or print neatly). beds proposed, such as "100 beds." holding or parent corporation would be an participationUSDA-FmHA inor HUD/USDA-FmHA,State or local housing State finance and In the box below the statement of certification, BesideProjects the with name U.S.D.A., of each Farmers principal Home and affiliate,Ad- example of an affiliate if one of its subsidiaries is Block 5: Fill in the section of the Housing Act Localagency) Housing that was Finance involved. Agency At the end projects of your by fill in the names of all parties who wish to file a eachministration, party must or with sign state the form,or local with govern the - a principal. under which the application is filed. completinglist of projects, and draw signing a straight this form, line beforeacross yourthe Master List together (type or print neatly). exceptionment housing in some finance cases agencies of individuals that include Block 7: Definitions of all those who are projectpage to applicationseparate your or record participation of projects can from be BesideException each forname, Corporations every party must– All sign principals the associatedrental assistance with a undercorporation Section (see 8 of "Exception the considered principals and affiliates are given approved.that of others signing this form who have a form.and affiliates In the box must titled personally "Proposed sign Role," the certifi fill in cate forHousing Corporations" Act of 1937. in the For section projects of theof this instruc - above in the section titled "Who Must Sign and HUDdifferent approval record to report. of your certification is a "N.A."except Also, in fill the in the following date you situation. sign the form When a tionstype, titledform HUD-2530"Who Must shouldSign and be Filefiled form with File...." necessaryThe Department precondition of Housing for yourand Urbanparticipation Development in (HUD)corporation is authorized is a principal, to collect this all ofinformation its officers, by law (42the U.S.C. appropriate 3535(d) applications and 24 C.F.R. directly 200.217) to those and by regulation at 24 CFR 200.210. This information is theneeded project so andthat inprincipals the capacity applying that toyou participate propose. in multifamilydirectors, programs trustees can and become stockholders HUD-approved with 10participants.agencies. The information you provide will enable HUD to evaluateBlock 8: your Beside record the with name respect of each to established principal, fill Ifstandards you do not of performance,file this certification, responsibility do not and furnish eligibility.percent Without orprior more approval, of the acommon principal (voting)may not stockparticipate in a proposed or existing multifamily project. HUD usesin this the informationrole that each to evaluate will perform. whether The or following not theprincipals information pose anrequested unsatisfactory accurately, underwriting or do not risk. Theneed information not sign is used personally to evaluate if they the all potential have theprincipalsReview and approve of Adverse only individuals Determination: and organizations If approval who willare honor possible their legal, roles financial that the and principals contractual may meetobligations. established standards, HUD will not same record to report. The officer who is of your participation in a HUD project is denied, perform: Sponsor, Owner, Prime Contractor, Privacyapprove Actyour Statement certification.: The Housing and Community authorizedDevelopment to signAct of for 1987, the corporation 42 U.S.C. 3543 or agency requires personswithheld, applying or conditionally for a Federally-insured granted on the or basisguaranteed of loanTurnkey to furnish Developer, his/her Managing Social Security Agent, Number Packager, (SSN).Note that HUD approval must have of your your certification SSN for identification does not of yourwill records.list the namesHUD may and use title your of thoseSSN for who automated elect processingyour record of yourof previous records participa and to maketion, yourequests will be for informationConsultant, about General you and Partner,your previous Limited records Partner withobligate other HUDpublic toagencies approve and yourprivate project sector apsources.- HUDnot to may sign. disclose However, certain any information person who to Federal, has a Statenotified and local by agencies the HUD when Office. relevant You tomay civil, request criminal, or (includeregulatory investigations percentage), and Executive prosecutions. Officer, It willplication, not be andotherwise it does disclosed not satisfy or releasedall other outsideHUD of HUD,record except of participation as required inand HUD permitted projects by law.that Youis mustreconsideration provide all of theby theinformation HUD Review requested Committee. in this application,Director, including Trustee, your Major SSN. Stockholder, or Nursing separate from that of his or her organization Home Administrator. Beside the name of each Publicprogram reporting requirements burden relative for this tocollection your qualifi of information- is estimated to average 1 hour per response, includingAlternatively, the time for you reviewing may request instructions, a hearing searching before existing data sources, gathering and maintaining must report that activity on this form and sign affiliate, write the name of the person or firm of thecations. data needed, and completing and reviewing the collection of information. This agency may not collect this ainformation, Hearing Officer. and you Either are notrequest required must to be complete made this form, unless it displays a currently valid his or her name. The objective is full disclosure. affiliation, such as "Affiliate of Smith OMB control number. in writing within 30 days from your receipt of the Construction Co." A response is mandatory. Failure to provide any of the information will result in your disapproval for participationnotice in this of determination.HUD program.

Previous editions are obsolete Page 3 of 3 ref Handbook 4065.1 form HUD-2530 (7/2009)