9624 Form – Fill Out and Use This PDF

I hereby elect to renew the above-indicated contracts under the following option (Check the appropriate box(es) below and provide the corresponding worksheet(s)):

This is an

Initial

or

Subsequent

Renewal of a MAHRA contract.

OPTION ONE - Request Renewal Under Mark-Up-To-Market Procedures

Option One A Entitlement Mark-Up-To-Market

Option One B Discretionary Authority

I hereby request a contract renewal for a _____-year term. (A five-year minimum term)

OPTION TWO - Request Renewal With Rents At or Below Comparable Market Rents And Without Restructuring

I hereby request a contract renewal for a _____-year term. (A maximum 20-year term)

OPTION THREE - Request Referral to OAHP for: Choose One

OPTION THREE-A - Reduction of Section 8 Rents to Comparable Market Rents without Restructuring (Lite)

OPTION THREE-B - Restructure of the mortgage and reduction of Section 8 Rents to Comparable Market Rents (Full)

OPTION FOUR - Request Renewal of the Contract for Projects Exempted from OAHP

I hereby request a contract renewal for a _______-year term.

OPTION FIVE - Portfolio Reengineering Demonstration and Preservation Contract Renewals

I request a contract renewal of my Demonstration Program Contract. (Based on Use Agreement)

Mortgage Restructuring Demonstration Use Agreement

Budget Based Without Mortgage Restructuring Demonstration Use Agreement

I request a contract renewal of my Preservation Program Contract.

I hereby request a contract renewal for a _______-year term. (The term may not exceed

the remaining term of the recorded Use Agreement.)

OPTION SIX - Opt-Out of the Section 8 Contract

Owner’s signature: ___________________________________Date: _______

2	form HUD-9624 (7/2008)

RENEWAL WORKSHEET FOR OPTION ONE

Requesting a Contract Renewal Under the Mark-Up-To-Market Procedure

I hereby request a renewal of my contract under the Mark-Up-To-Market procedures. I have attached a Rent Comparability Study (RCS) and completed the “Initial Eligibility Worksheet” for the Section 8 Contract(s) eligible under this Option.

Please select one of the following:

Option One A

I request Option One A, based on the RCS and the Initial Eligibility Worksheet; the comparable Market Rent Potential is at or above 100% of the published Fair Market Rents (FMRs).

The property does not have any low or moderate-income use restrictions that I cannot unilaterally eliminate.

Option One B

I request Option One B of the Mark-Up-To-Market eligibility requirements because (Please select the following statements that apply)

The project has a high percentage (>50%) of units rented to elderly, disabled, or large families.

The project is located in a low-vacancy area (<3%) where tenant-based assistance is difficult to be used and there is a lack of comparable rental housing; and/or

The project is a high priority for the local community as the attached documentation of State or local funds demonstrates.

I hereby certify that:

The property’s most recent REAC score is 60 or above and there are no uncorrected Exigent Health and Safety (EHS) violations; and

Neither I, nor any of my affiliates, are suspended or debarred, and/or requesting a contract renewal subject to HUD approval; and

This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

3	form HUD-9624 (7/2008)

RENEWAL WORKSHEET FOR OPTION TWO

Requesting Subsequent Renewal of Contract At or Below Comparable Market Rent

I hereby request a SUBSEQUENT RENEWAL of my Section 524 contract without restructuring and (Please select one of the following):

My Rent Comparability Study is less than five years old. I request that the contract rents be adjusted by the currently published OCAF.

The date of my Rent Comparability study is _____________________.

I am submitting the OCAF Adjustment Worksheet (Form HUD 9625).

My Rent Comparability Study is less than five years old. I request a budget-based rent adjustment.

The date of my Rent Comparability Study is _______________________.

I am submitting an attached budget, which reflects the projected costs for the first 12 months covered by the renewal contract.

I have abided by the requirements in 24 CFR 245 regarding tenant notification of a proposed rent increase.

The attached budget and rent schedule was available to tenants upon their request.

My Rent Comparability Study is five years old. I request that the contract rents be adjusted by the currently published OCAF.

I am submitting a new Rent Comparability Study.

New Comparable Market Rent Potential ______________________________

Comparable Rent Potential from original RCS____________________________

Year	OCAF	Prior Year Adjusted Rent	Adjusted Rent potential
	(I)	Potential (I x III)	(III)
OCAF year __ *
OCAF year __
OCAF year __
OCAF year __

New Comparable Market Rent Potential________________________________

Rent Potential Based on Attached Budget ____________________________

*Use the Comparable Rent Potential from original RCS (for Column 2) to find the Adjusted Rent Potential.

I am submitting the comparison chart from the Option Two Initial Renewal Request that reflects the results of the study and compares them to the expiring Section 8 units in my project.

I am submitting the OCAF Adjustment Worksheet (Form HUD 9625).

6	form HUD-9624 (7/2008)

I request a budget-based rent increase for capital repairs, not to exceed market.

The ownership entity is an eligible nonprofit and meets all of the requirements outlined in Chapter 15 of the Section 8 Renewal Guide.

The ownership entity agrees to accept a 20-year recorded Use Agreement. For example, if the owner has a 20-year agreement; the term must be extended for an additional 20 years.

My Rent Comparability Study is five years old. I request a budget-based rent adjustment.

I am submitting a new Rent Comparability Study.

I am submitting an attached budget, which reflects the projected costs for the first 12 months.

I have abided by the requirements in 24 CFR 245 regarding tenant notification of a proposed rent increase

The attached budget and rent schedule was available to tenants upon their request.

I am submitting the OCAF Adjustment Worksheet (Form HUD 9625).

I hereby certify that:

Neither I, nor any of my affiliates, are suspended or debarred OR

I, or my affiliates, are suspended or debarred and are requesting a contract renewal subject to HUD approval: AND

This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

7	form HUD-9624 (7/2008)

RENEWAL WORKSHEET FOR OPTION THREE-A

Requesting Referral to OAHP

I hereby elect to participate in the Mark-To-Market program and request a renewal of the Section 8 contract(s) shown on the attached Cover Sheet):

Option 3A- Based on the RCS, the current contract rent potential of the project is greater than the market rent potential of the comparable market rents. I would like a contract renewal at rents that do not exceed the comparable market rents, without a restructuring of the mortgage (OAHP-Lite);

I understand that I will receive an Interim Lite contract renewal at current rents while my renewal request is being processed.

I understand that an Interim Lite contract renewal does not establish a binding commitment for the purposes of Section 579(b) of the Multifamily Assisted Housing Reform and Affordability Act of 1997 (Title V of Public Law No. 105-65, October 27, 1997, 111 Stat. 1384ff), as amended (MAHRA). As a consequence, I understand that, upon the repeal of certain provisions of MAHRA on September 30, 2011, neither the Owner nor the Project will maintain eligibility for debt restructuring under MAHRA after October 1, 2011.

I hereby certify that:

The project rents exceed comparable market rents: AND

The project currently has a HUD-insured (or HUD-held) mortgage; AND

Neither I, nor any of my affiliates, are suspended or debarred, OR I, or my affiliates are suspended or debarred and are requesting a contract renewal subject to HUD approval; AND

This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Name and Title of Authorized Representative of HUD

(Print)____________________________________________________________________________

Signature________________________________________________Date:_____________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

8	form HUD-9624 (7/2008)

RENEWAL WORKSHEET FOR OPTION THREE-B

Requesting Referral to OAHP

I hereby elect to participate in the Mark-To-Market program and request a renewal of the Section 8 contract(s) shown on the attached Cover Sheet (Select one of the following Options):

Option 3B – I believe that the current contract rents are greater than the market rent potential of the comparable market rents. I would like to restructure the FHA insured or HUD-held insured mortgage and reduce the Section 8 contract rents to market (Mortgage Restructuring).

I understand that I will receive an Interim Full contract renewal at current rents while my project goes through the restructuring process if this Renewal Worksheet for Option 3B is accepted by HUD as specified above, subject to Appropriations.

I hereby certify that:

The project rents exceed comparable market rents: AND

The project currently has a HUD-insured (or HUD-held) mortgage; AND

Neither I, nor any of my affiliates, are suspended or debarred, OR I, or my affiliates are suspended or debarred and are requesting a contract renewal subject to HUD approval; AND

This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Name and Title of Authorized Representative of HUD

(Print)____________________________________________________________________________

Signature________________________________________________Date:_____________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

9	form HUD-9624 (7/2008)

RENEWAL WORKSHEET FOR OPTION FOUR

Request Renewal of Contract for Projects Exempted From OAHP

I hereby request a RENEWAL of my contract under Option Four and I am submitting an OCAF Worksheet and a budget calculation to determine which adjustments meets the “lesser of” test. My project is eligible to renew under this option because it falls into one of the following categories (Please select one of the following).

State or Local Government financing. I am submitting:

Copies of the original financing documents;

The underlying statutory authority which I believe conflicts with a Mark-To-Market restructuring plan; And

My bond counsel’s opinion as to the conflict.

Section 202/8 and/or Section 515/8 Project; and/or a Section 202 loan refinanced pursuant to Section 811 of the American Homeownership and Economic Opportunity Act of 2000

SRO Moderate Rehabilitation Project; OR

Section 512(2) of MAHRA

I am submitting a Rent Comparability Study that shows rents are at or below market.

Multifamily Housing Project not eligible under Section 512(2) of MAHRA, or

Risk Sharing Loan provided by qualified state or local housing finance agency.

I understand that at Renewal, the rent is set at the lesser of:

The Annual Adjusted Rent Potential of the Expiring Contracts (based on the attached OCAF Worksheet), OR

The Section 8 Contract Rent Potential from the budget-based rent determination (reflected in the attached budget)

AND

I have attached the completed OCAF Worksheet (Form HUD 9625):

I have included a budget and rent schedule completed in accordance with the requirements in HUD Handbook 4350.1.

I have abided by the requirements in 24 CFR 245 regarding tenant notification of a proposed rent increase. The attached budget and rent schedule was available to tenants upon their request

I hereby certify that:

Neither I, nor any of my affiliates, are suspended or debarred OR

I, or my affiliates, are suspended or debarred and are requesting a contract renewal subject to HUD approval: AND This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

10	form HUD-9624 (7/2008)

RENEWAL WORKSHEET FOR OPTION FIVE

Request Renewal of Contract for Portfolio Reengineering Demonstration or

Preservation Projects

My project is a Portfolio Reengineering Demonstration Project. I hereby request a RENEWAL of my contract under Option Five.

The project has a recorded Mortgage Restructuring Demo Program Use Agreement with rents adjusted annually by the OCAF.

The project has a recorded Budget Based Without Mortgage Restructuring Demo Program Use Agreement with rents adjusted annually by the OCAF. A RCS maybe required at the end of each 5-year period; at which time rents will be adjusted to comparable market rents.

I understand that the contract may be renewed as a multiyear contract with the term not to exceed the number of years under the Demo Program Use Agreement.

My project is a Preservation Project (LIPHRA or ELIPHRA). I hereby request a RENEWAL of my contract under Option Five in accordance with the approved Plan of Action. I understand that the contract may be renewed as a multiyear contract with the term not to exceed 20 years or the remaining term of the recorded Use Agreement.

I hereby certify that:

Neither I, nor any of my affiliates, are suspended or debarred OR

I, or my affiliates, are suspended or debarred and are requesting a contract renewal subject to HUD approval: AND

This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

11	form HUD-9624 (7/2008)

WORKSHEET FOR OPTION SIX

Notification of Non-Renewal of Contract

I hereby elect to OPT-OUT of the Section 8 program. I understand that notification of this opt-out is required to be given to the Department of Housing and Urban Development 120 days prior to the expiration of the contract.

I hereby certify:

I provided the assisted tenants and HUD with a one-year written notification of the contract expiration and our intention not to renew the contract as required by Section 8(c)(8) of the United States Housing Act of 1937. This notification was provided on

___________________. If I elected to opt out while my project was being reviewed by

OAHP, I have or will provide a second, 120 day, notification to tenants. This notification was provided on _________________. A copy of the notification letter(s) is (are) attached.

I am willing to execute a short-term renewal of my contract if HUD needs additional time to provide the tenant-based assistance.

I am not willing to execute a short-term renewal of my contract if HUD needs additional time to provide the tenant-based assistance.

I have submitted a copy of the written notification to the tenants, contract administrator if applicable, and HUD of the contract expiration and our intention not to renew the contract however; a full year has not elapsed. I agree to execute a contract renewal for a term that will fulfill the entire one-year notification requirement.

I hereby certify that:

The property does not have any Use Agreement in effect; AND

I agree to honor the tenants’ right to remain at the property, provided that the PHA approves a rent equal to the new rent charged for the unit. I agree not to terminate the tenancy of a tenant who exercises their right to remain except for cause under State or local law.

This information is true and complete.

Project Name ___________________________________________________________

Owner’s Name___________________________________________________________

Owner’s Signature_________________________________________Date________________

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions, including but not limited to: (i) fines and imprisonment under 18 U.S.C. §§ 287, 1001, 1010 and 1012; (ii) civil penalties and damages under 31 U.S.C. § 3729; and (iii) administrative sanctions, claims, and penalties under 24 C.F.R parts 24, 28 and 30.

12	form HUD-9624 (7/2008)