Hud 9834 Form – Fill Out and Use This PDF

Date of On-Site Review, Date of Report, Project Number and Contract Number.

Section of the Act, Name of Owner, Project Name and Project Address.

Loan Status: Insured, HUD-Held, Non-Insured or Co-Insured.

Contract Administrator: HUD, CA or PBCA.

Type of Subsidy: Section 8, PAC, Section 236, Section 221(d)(3) BMIR, Rent Supplement, RAP, PRAC or Unsubsidized.

Type of Housing: Family, Disabled, Elderly, Elderly/Disabled or Other (please specify).

For each applicable category, assess the overall performance by checking the appropriate column.

Indicate A (Acceptable) or C (Corrective action required).

Include target completion dates (TCD) for all corrective action items.

For those items not applicable, place N/A in the TCD column.

For each of the seven major categories (A, B, C, D, E, F, and G), rate each category by entering a score between 1 and 100. If a category was not reviewed, enter a score of zero (0).

General Appearance and Security: enter a score between 1 and 100 for the General Appearance and Security Rating; if this Section was not reviewed, enter 0; General Appearance and Security is 10% of the overall score.

Follow-up and Monitoring of Project Inspections: enter a score between 1 and 100 for the Follow-up and Monitoring of Project Inspections Rating; if this Section was not reviewed, enter 0; Follow-up and Monitoring of Project Inspections is 10% of the overall score.

Maintenance and Standard Operating Procedures: enter a score between 1 and 100 for the Maintenance and Standard Operating Procedures Rating; if this Section was not reviewed, enter 0; Maintenance and Standard Operating Procedures is 10% of the overall score.

After rating the individual categories, an overall rating must be assessed.

Overall Rating: Superior, “Above Average”, Satisfactory, “Below Average” or Unsatisfactory.

To calculate an overall score: Multiply the derived performance value by the assigned percentage of the overall rating for each category.

Once all tested categories have been calculated based on the performance indicator and performance indicator values, the total calculated points is divided by the total percentage of overall rating and rounded to the nearest whole number.

For convenience, a utility is included with this form which will perform all of the necessary calculations.

If this review is conducted by a CA or PBCA as indicated in Contract Administrator, the overall rating reflects a review as it relates to compliance with the Housing Assistance Payment Contract (HAP) only.

If a “below average” or unsatisfactory rating is determined, the owner/agent must be afforded an opportunity to appeal.

Signature and Date for each.

For each “C” item checked on the summary report, reference the appropriate citing, and target completion date.

Findings must include the condition, criteria, cause, effect and required corrective action.

The condition describes the problem or deficiency. The criteria cites the statutory, regulatory or administrative requirements that were not met.

The cause explains why the condition occurred. The effect describes what happened because of the condition.

Corrective actions are required for all findings.

Item Number, Finding and Target Completion Date.

Housing reviewers will forward all completed FHEO checklists and attachments to FHEO within five (5) business days of their own on-site reviews or within 5 business days of receipt of the checklists from the CA, as applicable.

Distribute the Summary Report and cover letter as follows: (1) Project Owner (original) (2) Management Agent (copy) (3) HUD office for PBCA reviews rated “below average” or unsatisfactory (4) HUD office for all traditional CA reviews.

On Addendum B, HUD will prosecute false claims and statements. Convictions may result in criminal and/or civil penalties.

On Addendum B: “I certify that this information is true and accurate.”