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THDA Home Page A brief description of the various housing programs that THDA administers Contact staff at THDA via email or phone

HOME Program Forms

Not all forms are available at this time in the fill-in format. This page will be updated with the fill-in forms as they become available. If you identify any problems with a form, please let us know at jtate@thda.org

Financial Management

  • FM-1 Authorization Agreement for Automatic Deposits
  • FM-2 Signature Form
  • FM-3 Project Set-up Form
  • FM-4 Request for Payment Form
  • FM-5 Interim Payment Application
  • FM-6 Detail of Administrative Cost
  • FM-7 Certification of Completion and Final Inspection - 2010
  • FM-8 HR Homeowner Rehabilitation Completion Report - 2010
  • FM-8 HB Homebuyer Completion Report - 2010
  • FM-9 Rental Housing Project Completion Report - 2010
  • FM-10 Standard Form of Agreement for Professional Services
  • FM-11 Contract for Professional Services - Part II


    • Environmental Review

  • ER-1 Sample Floodplains and Wetlands Notice (Early Public Notice)
  • ER-2 Sample Notice of Explanation
  • ER-3 Environmental Review Checklist
  • ER-4 Statutory Checklist - 2010
  • ER-6A NOI/RROF for Cities and Counties – Site Specific - 2010
  • ER-6B NOI/RROF for Cities and Counties – Tiered or Unspecified Site - 2010
  • ER-7A NOI/RROF for CHDOs and Non-profits – Site Specific - 2010
  • ER-7B NOI/RROF for CHDOs and Non-profits – Tiered or Unspecified Site - 2010
  • ER-8 Public Comment Period for a Categorically Excluded Project
  • ER-9 Environmental Assessment Worksheet - 2010
  • ER-10 NEPA Environmental Assessment Checklist - 2010
  • ER-11 Combined Notice for Cities and Counties
  • ER-12 Combined Notice for CHDOs and Non-profits
  • ER-13 Public Comment Period for a Project Requiring an Environmental Assessment
  • ER-14 Request for Release of Funds and Certification
  • ER-15 Authority to Use Grant Funds
  • ER-16 Determination of Categorical Exclusion Not Subject to 24 CFR 58.5 - 2010



    • Relocation and Displacement

  • RL-1 Guideform General Information Notice--Residential Tenant that Will Not be Displaced
  • RL-2 Guideform General Information Notice--Residential Tenant to be Displaced
  • RL-3 Guideform Notice of Nondisplacement to Residential Tenant
  • RL-4 Guideform Notice of Eligibility for Relocation Assistance--Residential Tenant
  • RL-5 Guideform Waiver of Relocation Assistance Under URA
  • RL-6 Schedule for Fixed Moving Expense and Dislocation
  • RL-7 Site Occupant Record-Residential
  • RL-8 Record of Advisory Assistance and Other Contacts
  • RL-9 Claim for Moving and Related Expenses
  • RL-10 Claim for Rental Assistance or Down payment Assistance
  • RL-11 Residential Relocation Management Report
  • RL-12 Sample Grievance Procedure
  • RL-13 Guideform Notice to Prospective Tenant


    • Acquisition

  • AQ-1 Addendum to Contract - 2010
  • AQ-2 Waiver of Rights and Benefits
  • AQ-3 Preliminary Acquisition Notice
  • AQ-4 "When a Public Agency Acquires Your Property"
  • AQ-5 Invitation to Accompany an Appraiser
  • AQ-6 Offer to Purchase
  • AQ-7 Statement of Basis for Determination of Just Compensation
  • AQ-8 Offer of Sale of Land
  • AQ-9 Statement of Settlement Costs
  • AQ-10 Notice of Intent Not to Acquire
  • AQ-11 Report on Real Property Acquisition
  • AQ-12 Site Acquisition Report


    • Fair Housing and Equal Opportunity

  • EO-1 Policy and Procedures - Outreach to Minority and Women Business Enterprises
  • EO-2 Directory of Minority and Female Contractors and Suppliers
  • EO-3 Affirmative Marketing Policy and Procedures
  • EO-4 Contract and Subcontract Activity
  • EO-5 Section 3 Questionnaire
  • EO-6 Policy of Nondiscrimination
  • EO-7 Minority Employment Goals
  • EO-8 "Fair Housing - It's Your Right"
  • EO-9 Housing Discrimination Complaint


    • Labor Standards

  • LB-1 Request for Determination and Response to Request
  • LB-2 Sample Advertisement and Invitation for Bids
  • LB-3 Federal Labor Standards Provisions
  • LB-4 Ten Day Call Confirmation
  • LB-5 Sample Pre-Construction Conference Report
  • LB-6 Payroll
  • LB-7 Record of Employee Interview
  • LB-8 Final Wage Compliance Report
  • LB-9 Federal Labor Standards Intake Form
  • LB-10 Final Wage Compliance Report


    • Lead-Based Paint

  • LBP-1 Protect Your Family from Lead in Your Home - 2010
  • LBP-2 Homeowner Receipt of Lead-Based Paint Risk Assessment – 2010
  • LBP-4 Status of Compliance with Lead-Based Paint Regulations – 2010
  • LBP-5 Homeowner Receipt of Lead-Based Paint Clearance Report – 2010
  • LBP-6 Statement of Completion and Clearance – 2010
  • LBP-7 Elderly Relocation Waiver – 2010


    • Homebuyer Programs

  • HB-1 Sample Policies and Procedures for Downpayment Assistance Programs - 2010
  • HB-2 Sample Policies and Procedures for Housing Development for Homeownership - 2010
  • HB-3 Sample Homebuyer Application - 2010
  • HB-4 Eminent Domain Disclosure and Vacant Unit Certification - 2010


    • Homeowner Rehabilitation

  • HO-1 Sample Policies and Procedures - 2010
  • HO-2 Program and Individual File Checklists - 2010
  • HO-3 HOME Rehabilitation Application - 2010
  • HO-4 Ineligible for Assistance
  • HO-4 A Conflict of Interest Questionnaire
  • HO-5 Approval for Rehabilitation Assistance
  • HO-6A Preliminary Inspection Report
  • HO-6B Work Write-up and Cost Estimate
  • HO-7 Determination for Reconstruction - 2010
  • HO-9 Request for Abatement of Lead-Based Paint Hazards - 2010
  • HO-9A Request for Preseumption of Lead-Based Paint or Lead-Based Paint Hazards - 2010
  • HO-10 Rehabilitation Bid Tabulation
  • HO-11 Contract for Rehabilitation - 2010
  • HO-12 Contract Addendum for Reduction of Lead Paint Hazards
  • HO-13 Contractor's Certification of Eligibility to Participate
  • HO-14 - Notice of Right of Recission
  • HO-15 Notice to Proceed
  • HO-16 Change Order
  • HO-17 Inspection or Punchlist Report
  • HO-18 Punch List Letter
  • HO-19 Final Invoice, Release of Liens, and Warranty
  • HO-20 Receipt of Final Payment
  • HO-21 Contractor's Non-Kickback Certification - 2010
  • HO-22 Calculation of After Rehabilitation Property Values for Homeowner Rehabilitation Projects – 2010


    • Rental Rehabilitation

  • RH-1 Sample Policies and Procedures
  • RH-2 Rental Housing Feasibility Worksheet
  • RH-3 Sample Rental Housing Application
  • RH-4 Sample Security Deposit Installment Payment Agreement
  • RH-5 Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards
  • RH-6 Sample HOME Lease
  • RH-7 Initial Occupancy Profile
  • RH-8 Subrecipient Working Agreement

    • For more information, you may contact Coralee Holloway, Director of Community Programs at (615) 815-2030.


    404 James Robertson Parkway, Suite 1200, Nashville TN 37243-0900
    General Information 615-815-2200 -- Toll Free Number 800-228-THDA -- TTY Line 615-532-2894