National Housing Trust Fund Operating Subsidy Funding Application Certification	

Instructions: If applying for a National Housing Trust Fund Operating Subsidy (NHTF OS) funds, the owner/developer must complete and return this form with their Multifamily Consolidated Request for Proposals (RFP) application via the Multifamily Portal. By signing this form, the owner/developer is willing to accept NHTF OS funds, if awarded, which trigger federal cross-cutting requirements. 

NOTE: Violating cross-cutting requirements could cause the withdrawal of the NHTF OS funds from the project. If you have any questions about these requirements, contact Aaron Keniski at aaron.keniski@state.mn.us or 651.296.4452. 
Property Information	
Development Name	     	
Development Address 
(Street, City, State, Zip Code)	     	

Certifications Related to Other Government Assistance (sign one of the two statements)
I/We, the applicant(s) for NHTF OS funds, hereby certify that other form(s) of government assistance are or will be provided to the referenced project and that Minnesota Housing will be kept apprised as to any change in status or amount of other form(s) of government assistance.

     											     
Owner/Applicant Printed Name		Owner/Applicant Signature		Date

     											     
If LLC, Printed LLC Name and 			Authorized Signer Signature		Date
Authorized Signer Name
OR

I/We, the applicant(s) for NHTF OS funds, hereby certify that no other form(s) of government assistance are or will be provided to the referenced project and that if other government assistance should be sought in the future, I/we will promptly notify Minnesota Housing as to the source(s), amount(s), and other required information.

     												     
Owner/Applicant Printed Name		Owner/Applicant Signature			Date

     												     
If LLC, Printed LLC Name and			Authorized Signer Signature			Date
Authorized Signer Name
Certifications Related to NHTF Program Requirements
NOTE: If an applicant is unable to certify any of the following statements, indicate on this form which statement(s), and attach to this certification an explanation as to the reasons why statement(s) cannot be certified.

I/we, the applicant(s) hereby certify the following:
•	I/We have received, read, and understand the conditions and restrictions associated with the receipt and use of NHTF OS funds, as outlined in 24 CFR Part 93 and in the HOME Investment Partnerships (HOME) and National Housing Trust Fund (NHTF) Combined Program Guide and agree to comply with all applicable terms and requirements.
•	This property has not already received assistance that would make it ineligible for NHTF OS, as outlined in 24 CFR Part 93 and identified in the HOME and NHTF Combined Program Guide. The information provided on this application form is true and correct to the best of my/our knowledge, and I/we understand that providing false information may jeopardize the receipt and use of federal funds for this property.
•	I/We will comply with the environmental provisions in §93.301. If it is determined that the project cannot meet these environmental provisions, I/we understand that the project will not be able to receive NHTF OS.
•	I/We will comply with §93.351 and all requirements as outlined in the Lead-Based Paint Poisoning Prevention Act, and the Residential Lead-Based Paint Hazard Reduction Act of 1992, and will implement regulations as outlined in 24 CFR Part 35, subparts A, B, J, K, M and R of this title, Minnesota Housing’s Rental Housing Design/Construction Standards, and Minnesota Housing’s Lead-Based Paint Policy.
•	I/We will comply with §93.352 and all of the Uniform Relocation Act requirements, including but not limited to hiring an experienced relocation specialist company.
•	I/We will comply with §93.350 and §93.407 affirmative marketing requirements.
•	I/We will comply with the applicable site and neighborhood standards in §93.150 and property standards in §93.301.
•	I/We will comply with all applicable Section 3 requirements.
•	I/We will comply with all applicable Black, Indigenous, and People of Color-owned/Women-owned Business Enterprise requirements.
•	I/We will comply with Minnesota Housing’s fair housing policy to affirmatively further fair housing in all programs so that individuals of similar income levels have equal access to its programs regardless of race, color, creed, religion, national origin, sex, age, marital status, status with regard to public assistance, disability, familiar status or sexual orientation and will comply with all applicable laws and regulations prohibiting housing discrimination, including the Fair Housing Act, 24 CFR Part 5.105 and the Minnesota Human Rights Act. 
•	I/We will comply with all existing laws and regulations prohibiting discrimination in all aspects of employment due to race, color, creed, sex, age, religion, national origin, marital status, sexual orientation, familial status, receipt of public assistance or disability. This shall be accomplished substantially by nondiscrimination in recruiting, hiring, training, promoting, contracting, demotion, layoff, and/or termination.
•	I/We certify that neither ownership entity nor its principals are excluded from participation in this transaction by any federal department or agency and the applicant agrees to verify that its contractors and any subcontractors, along with any related principals, are not excluded from participation in this project.
•	I/We will comply with §93.353 conflict of interest requirements. 
•	I/We will comply with the Violence Against Women Act requirements, if applicable.
•	I/We will comply with the Minnesota Government Data Practices Act, and Minnesota Statutes chapter 13, Section 13.04(2) requirements.
•	I/We certify that we will use only lead-free pipes, solder, and flux in this project. 
•	I/We certify that if archaeological resources or human remains are discovered on the project site during construction or rehabilitation, I/we will consult with affected Tribes and/or descendant communities and comply with the Native American Graves Protection and Repatriation Act, state law, and/or local ordinance. 

This certification is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the applicant knowingly rendered an erroneous certification, the federal government and/or the department or agency with which this transaction originated may pursue any available remedies, including but not limited to suspension and/or debarment. The applicant must provide immediate written notice to Minnesota Housing if at any time the applicant learns that its certification was erroneous when submitted or becomes erroneous by reason of changed circumstances. 

     												     
Owner/Applicant Printed Name		Owner/Applicant Signature			Date

OR

     												     
If LLC, Printed LLC Name and			Authorized Signer Signature			Date
Authorized Signer Name