Version 2
January 2026
Certification that Recipient is not Disqualified Business
[This form should be used by Recipients who are not natural persons]
The following certification is given to induce Minnesota Housing to make a loan under the SHTC Contribution Program. Except as otherwise defined herein, all capitalized terms shall have the meanings assigned to them in the SHTC Contribution Program Guide. Minnesota Housing has provided the list of contributors set forth on Exhibit A, which is attached to and made a part of this certification (“Exhibit A”).
As a duly authorized representative of  Insert Entity Legal Name(the “Recipient”), the undersigned hereby certifies as follows: 
1.	The Recipient did not make a contribution to the SHTC Contribution Program in tax year 2025 or tax year 2026 and receive a tax credit certificate in connection with such contribution;
2.	No individual or entity listed on Exhibit A is an officer or principal of the Recipient;
3.	No spouse of any of the individuals listed on Exhibit A, to the extent such individual and spouse are a married couple filing a joint tax return, is an officer or principal of the Recipient;
4.	None of the individuals or entities listed on Exhibit A owns 20 percent or more of the Recipient; 
5.	No individual listed on Exhibit A together with the spouse of such individual, to the extent such individual and their spouse are a married couple filing a joint tax return, collectively owns 20 percent or more of the Recipient;
6.	No individual or entity listed on Exhibit A is a general partner, manager, or managing member of Recipient or otherwise has 20 percent or more of the power or authority to control the Recipient;
7.	No individual listed on Exhibit A together with the spouse of such individual, to the extent such individual and spouse are a married couple filing a joint tax return, has 20 percent or more of the power or authority to control the Recipient;
8.	No individual or entity listed on Exhibit A has the power to vote 20 percent or more of the outstanding securities of the Recipient; 
9.	No individual listed on Exhibit A together with such individual’s spouse, to the extent such individual and spouse are a married couple filing a joint tax return, has the power to vote 20 percent or more of the outstanding securities of the Recipient.  

These certifications are given as of the date indicated in the signature block below. By signing below, the Recipient agrees to promptly notify Minnesota Housing if these certifications become inaccurate or misleading. 

    Signature  __________________
Print Name:         
            Title:      
           Date:       

Exhibit A
[Minnesota Housing will provide, upon the Recipient’s request, a list of all entities that made a contribution in the current or prior taxable year, and received a tax credit certificate, whose contributions, in whole or in part, are intended to fund the loan to the Recipient].