HOME Grant 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.
Financial Management
- FM-1 Supplier Direct Deposit Authorization Form
- W-9 (fillable)
- FM-1A Grantee Remittance Advice Form
- 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
- FM-8 HR Homeowner Rehabilitation Completion Report
- FM-8 HB Homebuyer Completion Report
- FM-9 Rental Housing Project Completion Report
- FM-10 Standard Form of Agreement for Professional Services
- FM-11 Contract for Professional Services - Part II
- THDA Payoff Request Form
Environmental Review
- ER-1 Sample Floodplains and Wetlands Notice
- ER-2 Sample Notice of Explanation
- ER-3 Environmental Review Requirement Checklist
- ER-4 Statutory Checklist for Categorically Excluded Projects
- ER-6A NOI/RROF for Cities and Counties – Site Specific
- ER-6B NOI/RROF for Cities and Counties – Tiered or Unspecified Site
- ER-7A NOI/RROF for CHDOs and Non-profits – Site Specific
- ER-7B NOI/RROF for CHDOs and Non-profits – Tiered or Unspecified Site
- ER-8 Public Comment Period for a Categorically Excluded Project
- ER-9 Environmental Assessment Worksheet
- ER-10
- ER-11 Combined RROF and FONSI for Cities and Counties
- ER-12 Combined RROF and FONSI 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
- ER-17 Environmental Review Procedures for Entities Assuming HUD Environmental Responsibilities
Relocation & Displacement
- RL-1 Guide form General Information Notice--Residential Tenant that Will Not be Displaced
- RL-2 Guide form General Information Notice--Residential Tenant to be Displaced
- RL-3 Guide form Notice of Non-displacement to Residential Tenant
- RL-4 Guide form Notice of Eligibility for Relocation Assistance--Residential Tenant
- RL-5 Schedule for Fixed Moving Expense and Dislocation
- RL-7 Record of Advisory Assistance and Other Contacts
- RL-8 Site Occupant Record - Residential
- RL-9 HUD Form 40054 - Residential Claim for Moving and Related Expenses
- RL-10 HUD Form 40058 - Claim for Rental Assistance or Down Payment Assistance
- RL-11 Residential Relocation Management Report
- RL-12 Sample Grievance Procedure
- RL-13 Guide form Notice to Prospective Tenant
Acquisition
- AQ-1 Sample Voluntary Acquisition Notice
- AQ-1A Addendum to Contract
- AQ-3 Preliminary Involuntary 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 (HUD 1)
- AQ-10 Notice of Intent Not to Acquire
- AQ-11 Report on Real Property Acquisition
- AQ-12 Site Acquisition Report
Fair Housing & Equal Opportunity
- EO-1 Policy and Procedures For Outreach to Minority and Women Business Enterprises
- EO-2 Diversity or Disadvantaged Business Enterprise Directory
- EO-3 Affirmative Marketing Policy and Procedures
- EO-4 Contract and Subcontract Activity Report
- EO-5 Section 3 Questionnaire
- EO-5A Section 3 Summary Report (HUD 60002)
- EO-6 Policy of Nondiscrimination
- EO-7 Minority Employment Goals
- EO-8 Fair Housing, Equal Opportunity for All
- EO-9 Housing Discrimination Complaint Form (HUD 903.1)
Lead-Based Paint
- LBP-1 Protect Your Family from Lead in Your Home
- LBP-2 Homeowner Receipt of Lead-Based Paint Risk Assessment
- LBP-4 Status of Compliance with Lead-Based Paint Regulations
- LBP-5 Homeowner Receipt of Lead-Based Paint Clearance Report
- LBP-6 Statement of Completion and Clearance
- LBP-7 Elderly Relocation Waiver
- LBP-8 Disclosure of Information of Lead-Based Paint and/or Lead-Based Paint Hazards
Homebuyer Programs
- HB-1 Sample Policies and Procedures for Downpayment Assistance Programs
- HB-2 Sample Policies and Procedures for Housing Development for Homeownership
- HB-3 Sample Homebuyer Application
- HB-4 Sample Voluntary Acquisition Notice
- HB-5 Homeownership Disclosure
- HB-6 Lead-Based Paint Disclosure
- HB-7 Lead-Based Paint Visual Assessment
- HB-8 Certification of Inspection
- HB-9 Homeownership Occupancy Report for Long Term Compliance
- Single Family Underwriting Tool
Homeowner Rehabilitation
- HO-1 Sample Policies and Procedures
- HO-2 Program and Individual File Checklists
- HO-3 HOME Rehabilitation Application
- HO-4 Ineligible for Assistance
- HO-4A Conflict of Interest Questionnaire
- HO-5 Approval for Rehabilitation Assistance
- HO-6A Rehabilitation Work Write-Up
- HO-7 Determination for Reconstruction
- HO-8 Justification to Reconstruct - Structural or System Failure
- HO-9 Request for Abatement of Lead-Based Paint Hazards
- HO-10 Rehabilitation Bid Tabulation
- HO-11 Contract for Rehabilitation
- 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 Recession
- 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
- HO-22 Calculation of After Rehabilitation Property Values for Homeowner Rehabilitation Projects
- HO Rehab Note
- HO Reconstruct Note
- HO Rehab Deed of Trust
- HO Reconstruct Deed of Trust
- Beneficiary Insurance Acknowledgment
- HO Beneficiary Agreement Reconstruction (Recon)
- HO Beneficiary Agreement Rehabilitation
- HO Beneficiary Agreement Rehabilitation w/External Funding (With Funding)
- HO Beneficiary Agreement Amendment
Rental Housing
- 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 Unit Summary Data
Property Standards
- UPCS Checklist
- UPCS Definitions
- UPCS Work Write Up
- UPCS Work Write Up Estimate
- THDA Design Standards