Form HUD-424B Applicant and Recipient Assurances and Certifications -

Applicant and Recipient
Assurances and Certifications

U.S. Department of Housing
and Urban Development

OMB Number: 2501-0044
Expiration Date: 2/28/2027

Instructions for the HUD 424-B Assurances and Certifications
As part of your application for HUD funding, you, as the official authorized to sign on behalf of your organization or as an individual, must
provide the following assurances and certifications. The Responsible Civil Rights Official has specified this form for use for purposes of
general compliance with 24 CFR §§ 1.5, 3.115, 8.50, and 146.25, as applicable. The Responsible Civil Rights Official may require specific
civil rights assurances to be furnished consistent with those authorities and will specify the form on which such assurances must be made. A
failure to furnish or comply with the civil rights assurances contained in this form may result in the procedures to effect compliance at 24
CFR §§ 1.8, 3.115, 8.57, or 146.39.
By submitting this form, you are stating that all assertions made in this form are true, accurate, and correct.
As the duly representative of the applicant, I certify that the
applicant: [Insert below the Name and title of the Authorized
Representative, name of Organization and the date of signature]:
*Authorized Representative Name:
*Title:
*Applicant/Recipient Organization:
1. Has the legal authority to apply for Federal assistance, has
the institutional, managerial and financial capability (including
funds to pay the non-Federal share of program costs) to plan,
manage and complete the program as described in the
application and the governing body has duly authorized the
submission of the application, including these assurances and
certifications, and authorized me as the official representative of
the application to act in connection with the application and to
provide any additional information as may be required.
2. Will administer the grant in compliance with Title VI of the
Civil Rights Act of 1964 (42 U.S.C 2000(d)) and implementing
regulations (24 CFR part 1), which provide that no person in the
United States shall, on the grounds of race, color or national
origin, be excluded from participation in, be denied the benefits
of, or otherwise be subject to discrimination under any program
or activity that receives Federal financial assistance OR if the
applicant is a Federally recognized Indian tribe or its tribally
designated housing entity, is subject to the Indian Civil Rights
Act (25 U.S.C. 1301-1303).
3. Will administer the grant in compliance with Section 504 of
the Rehabilitation Act of 1973 (29 U.S.C. 794), as amended, and
implementing regulations at 24 CFR part 8, the American
Disabilities Act (42 U.S.C. §§ 12101 et.seq.), and implementing
regulations at 28 CFR part 35 or 36, as applicable, and the Age
Discrimination Act of 1975 (42 U.S.C. 6101-07) as amended,
and implementing regulations at 24 CFR part 146 which together
provide that no person in the United States shall, on the grounds
of disability or age, be excluded from participation in, be denied
the benefits of, or otherwise be subjected to discrimination under
any program or activity that receives Federal financial
assistance; except if the grant program authorizes or limits
participation to designated populations, then the applicant will
comply with the nondiscrimination requirements within the
designated population.
4. Will comply with the Fair Housing Act (42 U.S.C. 3601-19),
as amended, and the implementing regulations at 24 CFR part
100, which prohibit discrimination in housing on the basis of
race, color, religion, sex, disability, familial status, or national
origin and will affirmatively further fair housing; except an
applicant which is an Indian tribe or its instrumentality which is
excluded by statute from coverage does not make this
certification; and further except if the grant program authorizes or
limits participation to designated populations, then the applicant

will comply with the nondiscrimination requirements within the
designated population.
5. Will comply with all applicable Federal nondiscrimination
requirements, including those listed at 24 CFR §§ 5.105(a) and
5.106 as applicable.
6. Will not use Federal funding to promote diversity, equity, and
inclusion (DEI) mandates, policies, programs, or activities that
violate any applicable Federal anti-discrimination laws.
7. Will comply with the acquisition and relocation requirements
of the Uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970, as amended (42 U.S.C. 4601)
and implementing regulations at 49 CFR part 24 and, as
applicable, Section 104(d) of the Housing and Community
Development Act of 1974 (42 U.S.C. 5304(d)) and implementing
regulations at 24 CFR part 42, subpart A.
8. Will comply with the environmental requirements of the
National Environmental Policy Act (42 U.S.C. 4321 et.seq.) and
related Federal authorities prior to the commitment or
expenditure of funds for property.
9. That no Federal appropriated funds have been paid, or will
be paid, by or on behalf of the applicant, to any person for
influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, and officer or employee of
Congress, or an employee of a Member of Congress, in
connection with the awarding of this Federal grant or its
extension, renewal, amendment or modification. If funds other
than Federal appropriated funds have or will be paid for
influencing or attempting to influence the persons listed above, I
shall complete and submit Standard Form-LLL, Disclosure Form
to Report Lobbying. I certify that I shall require all subawards at
all tiers (including sub-grants and contracts) to similarly certify
and disclose accordingly. Federally recognized Indian Tribes and
tribally designated housing entities (TDHEs) established by
Federally-recognized Indian tribes as a result of the exercise of
the tribe’s sovereign power are excluded from coverage by the
Byrd Amendment, but State-recognized Indian tribes and TDHEs
established under State law are not excluded from the statute’s
coverage.
I/We, the undersigned, certify under penalty of perjury that
the information provided above is true, accurate, and
correct. WARNING: Anyone who knowingly submits a false
claim or makes a false statement is subject to criminal
and/or civil penalties, including confinement for up to 5
years, fines, and civil and administrative penalties. (18
U.S.C. §§287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802;
24 CFR §28.10(b)(1)(iii)).
* Signature:

* Date: (mm/dd/yyyy):

Form HUD 424-B (1/27/2023)

Public Reporting Burden Statement: The public reporting burden for this collection of information is estimated to average 0.5 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 regarding the accuracy of this burden estimate and any suggestions for
reducing this burden can be sent to: U.S. Department of Housing and Urban Development, Office of the Chief Data Officer, R, 451 7th St
SW, Room 4176, Washington, DC 20410-5000. Do not send completed HUD 424-B forms to this address. This agency may not conduct
or sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid OMB control number.
The Department of Housing and Urban Development is authorized to collect this information under the authority cited in the Notice of
Funding Opportunity for this grant program. The information collected provides assurances and certifications for legal requirements related
to the administration of this grant program. HUD will use this information to ensure compliance of its grantees. 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).

Form HUD 424-B (1/27/2023)