Instructions
The information in this application for IRS Form 8609/Certification by Owner (application) will be used to complete the IRS Form 8609 (Form 8609), which will be filed with the Internal Revenue Service (IRS). All information provided by you in this application must be consistent with your Housing Tax Credit (HTC) application and with the Attorney's Opinion and the Final Certified Public Accountant (CPA) Cost Certification prepared in connection with this application. Only the Minnesota Housing Finance Agency (Minnesota Housing), or, as applicable, an authorized suballocator, may issue a Form 8609. No other entity may issue a Form 8609.  

You may not file a Form 8609 with the IRS in advance of you or your agent receiving Minnesota Housing’s signed version of the approved Form 8609. In addition, neither you nor your agent may electronically file a Form 8609 with the IRS that does not accurately reflect the information contained on Minnesota Housing’s signed version of the approved Form 8609. When Minnesota Housing becomes aware that a project’s owner/agent has filed a self-prepared Form 8609 with the IRS, Minnesota Housing reserves the right to ban all parties involved from future participation in Minnesota's HTC Program for a period of 10 years.

Certification
As the owner of the below-referenced project (project), I hereby apply for a final award or allocation of HTCs via the issuance of Form 8609 and certify the following:

1.	Project Information
Minnesota Housing HTC #(s):      
Name of Project:      
2.	Determination of Final HTC Amount 
a.	Total qualified basis for all buildings that are part of the project (from Exhibit A): $     
b.	Annual HTC amount – 9% HTC use the allocation from Reservation/Carryover Agreement:
Year			Source			Amount
     		     			$     
     		     			$     
				Total:	$     
c.	Maximum annual HTC amount allowed*:	$     

*Annual HTC amount, which is the lesser of the amount limited by the HTC Basis Calculation1, the HTC Equity Gap Calculation1, or the amount allocated to the 9% HTC project via issuance of a Reservation/Carryover Agreement. (1Refer to the Determination of Credit tab in the Workbook for this project)

I acknowledge that it is my sole responsibility to fully understand how Section 42 of the Internal Revenue Code of 1986, as amended (Section 42), and the regulations and rules promulgated thereunder, apply to the project. I understand that final determinations of how Section 42 applies to the project can only be made by the IRS.

I hereby state that the project is in compliance with all HTC program requirements and conditions of selection and any additional or special conditions described in the Minnesota Housing Reservation, Carryover Agreement, 42M Determination Letter, HTC Qualified Allocation Plan, or Section 42., 

I hereby certify that the full extent of all federal, state and local subsidies that apply (or are expected to apply) have been disclosed to Minnesota Housing.

Ownership Entity:      
Ownership Address:        	City, State, Zip:       
General Partner:      
Authorized Signatory for General Partner:     
Ownership Entity Federal Tax ID #:       
Email Address:                                   Phone Number:                              Fax Number:      

Nonprofit Corporation General Partner (if applicable):      
Authorized Signatory For Nonprofit Corporation General Partner:      
Email Address:                                  Phone Number:                              Fax Number:      

Acknowledged, agreed, and accepted:	OWNER

	     
	Typed or Printed Name of Entity
	     
	Typed or Printed Legal Description of Entity and State of Authorization

By:	___________________________________
	Signature
     __________________________________
Typed or Printed Name of Signer

Its:	     
Typed or Printed Title of Signer

Dated:	     

STATE OF 	)
	)	ss.
COUNTY OF	)

	Subscribed and sworn to before me, a notary public, this       day of      ,      , by      ,       of      on behalf of said      

________________________________________
Notary Public