HUD 2993 form

U.S. Department of Housing
and Urban Development

Acknowledgment of
Application Receipt

OMB Approval No. 2577-0259
Exp. 06/30/2017

OMB Approval No. 2577-0259 Exp. 0430/201 ❑

Public reporting burden. Public reporting burden for this collection of information is estimated to average 0.25 hours per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed,
and completing
and reviewing
the collection
of information.
Comments
the accuracy
this space
burden estimate
and any suggestions for reducing this burden can be sent to: U.S.
Type
or clearly
print the
Applicant's
name
and regarding
full address
in ofthe
below.
Department of Housing and Urban Development, Office of the Chief Data Officer, R, 451 7th St SW, Room 8210, Washington, DC 20410-5000. Do not send completed forms to this address. This agency may not collect
this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. HUD is authorized to collect this information under the authority cited in the Notice of Funding
Opportunity for this grant program. The information collected will provide proposed budget data for multiple programs. HUD will use this information in the selection of applicants. This information is required to obtain
the benefit sought in the grant program. This information will not be held confidential and may be made available to the public in accordance with the Freedom of Information Act (5 U.S.C. §552).

Type or clearly print the Applicant's name and full address in the space below.

(fold line)

or clearly
clearly print
print the
thefollowing
followinginformation:
information:
Type or
Name of the
the Federal
Federal
Name
Program to
which the
the
Program
to which
applicant is applying:

To Be Completed by HUD
HUD received your application
application by
by the deadline
deadline and
and will
will consider
consider itit for funding.
funding. In
In accordance
accordance
with Section 103 of the Department of Housing and Urban
Urban Development
Development Reform
Reform Act
Act of
of 1989,
1989,
information will
HUD regarding
regarding the
the relative
relative standing
standing of any
any applicant
applicant until
until
no information
will be released by HUD
funding
funding announcements
announcementsare
aremade.
made.However,
However,you
youmay
maybebecontacted
contactedbybyHUD
HUDafter
afterinitial
initial
screening to permit
permit you
you to
tocorrect
correctcertain
certainapplication
applicationdeficiencies.
deficiencies.
will
HUD did not receive
receive your
your application
applicationby
bythe
thedeadline;
deadline;therefore,
therefore,your
yourapplication
application
willnot
not
receive further consideration.
consideration. Your
Yourapplication
applicationis:
is:
Enclosed
Being

sent under separate
separate cover
cover

Processor's Name
Date of Receipt
Receipt

(❑®md)
(12/2011)

form HUD-2993