APPLICATION

CHECKLIST FOR 523 PROPOSALS

(1944-I)

Link: http://rdinit.usda.gov/regs/

 

 

 

 

Description of Document

Form/Instruction Number

Tab

Position

Date

Received/Comments

1.

Application for Federal Assistance Non-Construction Programs (Form SF424)

Include Intergovernmental Review Response

Executive Order 12372-enclose the response from appropriate agency.

Link: http://www.epa.gov/ogd/AppKit/form/SF424.pdf

SF – 424

1944.410(e)

 

 

2.

Waiting List of Participants

Give the names, addresses, household size, and total annual income of interested families.

1944.410(e)(1)

 

 

3.

Proof that the participants in the first group have qualified for assistance.

 Include letter/certificate of eligibility.

1944.410(e)(2)

 

 

4.

Lot options for first group

Include evidence that lots have been purchased or optioned for first group.

Link: http://www.rurdev.usda.gov/regs/forms/0440-34.pdf

1944.410(e)(3)

 

 

5.

Evidence of lot availability for remaining group(s)

1944.410(e)(3)

 

 

6.

House plans, specifications and detailed cost estimates.

Provide house plans, cost estimates, blueprints and specifications for houses you propose to build.

1944.410(e)(4)

 

 

7.

Staffing needs and hiring schedule

List the proposed staff positions needed, also give:

(1) Specific qualifications, skills and experience needed to staff the program. (job descriptions)

(2) staff hiring schedule, and

(3) Include resumes of prospective employees

1944.410(e)(5)

 

 

8.

Authorized representative of Applicant

Give the name, address and official position of the person authorized to work with RD.  Can be the same representative(s) named in your resolution.

1944.410(e)(6)

 

 

9.

Budget Information – Non-Construction Programs

Include a 2-year budget worksheet.

Link: http://www.acf.hhs.gov/programs/ofs/grants/sf424a.pdf

SF – 424A & Budget Narrative

1944.410(e)(7)

 

 

10.

Indirect or direct cost policy and proposed indirect cost rate.

Include your Indirect Cost Agreement or approved Cost Allocation Plan..

1944.410(e)(8)

 

 

11.

Monthly activities schedule

Include your Housing Development Plan and Implementation Schedule.

1944.410(e)(10)

 

 

12.

Personnel practices and procedures

Include your agency’s Personnel Policies and procedures and samples of forms to be used.

1944.410(e)(9)

 

 

13.

Authorizing Resolution

Provide a copy of the resolution adopted by (The Board of Directors or other Governing Body if public body) and authorizing the appropriate official(s) to execute Exhibit A, “Self-Help Technical Assistance Grant Agreement” and Form RD 400-4, “Assurance Agreement”.

1944.411(d)

 

 

14.

Assurance Agreement

Link: http://www.rurdev.usda.gov/regs/forms/0400-04.pdf

Form RD 400-4

1944.411(d)

 

 

15.

Fidelity Bond Coverage

Provide evidence of adequate coverage to protect the maximum amount of money a grantee will have on hand at any one time.  The policy should cover all employees that have access to funds

1944.411(e)

 

 

16.

Evidence of interest bearing checking account and a statement of interest repayment

By grant closing, you must establish an interest bearing checking account on which two or more bonded employees will sign checks.  Include a signed statement that any interest earned in excess of $250 annually will be submitted to Rural Development quarterly.

1944.411(g)

 

 

17.

Group Agreement including Exhibit B-2 of 1944-I

Provide a copy of the agreement incorporating Exhibit B-2 of 4 CFR Part 1944, Subpart I, clearly showing the labor tasks required by the participating families.  The agreement must be signed by an agency representative and each participating family.

1944/411(h)

 

 

18.

Request for Obligation of Funds

Link: http://www.rurdev.usda.gov/regs/forms/1940-01.pdf

Form RD 1940-1

1944.412

 

 

19.

Self-Help Technical Assistance Grant Agreement

Leave the date and amount blank.

Link:  http://www.rurdev.usda.gov/regs/regs/pdf/1944i.pdf

Exhibit A of

1944-I

1944.412

 

 

20.

Certificate Regarding Drug-Free Workplace

Authorized representative should sign.

Link: http://www.usda.gov/rus/water/forms/ad1049.pdf

Form AD-1049

RD Ins. 1940-M

1940.606(b)(2)

 

 

21.

Certification Regarding Debarment, Suspension, and other Responsibility Matters

Authorized representative should sign

Link/ http://www.ocio.usda.gov/forms/doc/AD1047-F-01-92.PDF

Form AD-1047

RD Ins. 1940-M

1940.606(b)(1)

 

 

22.

Certification Regarding Lobbying

Authorized representative should sign

Link: http://www.rurdev.usda.gov/regs/regs/pdf/1940q.pdf

Exhibit A-1 of  RD instruction 1940-Q

940.810

 

 

23.

Statement of Compliance with 7 CFR Part 3015 & 3019, if a nonprofit organization or, Part 3015 & 3016, if a State or Local Government.

Authorized representative should sign

1944.411(c)

 

 

24.

Assurances – Non-Construction Programs

Authorized representative should sign

Link: http://www.acf.hhs.gov/programs/ofs/grants/sf424b.pdf

Form SF 424B

1944.411(f)

 

 

25.

Rural Development Manager’s Recommendation

1944.410(b)

 

 

26.

T&MA Contractor’s Review and Recommendation Required Under National Office Contract with T& MA Contractor

Required under National Office Contract with T&MA Contractor

 

 

27.

National Office Review (if over $300,000 or if amount of new grant plus unexpended funds from previous grant total $400,000

1944.415(a)

 

 

In addition to the above information, existing grantees submitting an application for a new grant should also provide the following information as part of a complete application.  Since this information was already provided in the pre-application of a new grantee, they will not be required to duplicate this information.

28.

Narrative Statement

(h) Amount of request

(i) Areas to be served

(j) Number of houses proposed

(k) Housing conditions of low- income families

(l) Need for self-help housing

(m) Evidence of community support

1944.410(a)(4)

 

 

29.

Current Financial Statements for Applicant and any sponsor

The statement cannot be more than 12 months old and must be signed, dated and certified by a Board Officer. Usually the treasurer.

1944.410(a)(3)

 

 

30.

Outreach Plan for very low-income families

Outline a plan of how the organization proposes to reach very low-income families.

1944.410(a)(5)

 

 

31.

HUD Fair Housing Marketing Plan

Link: http://www.hud.gov/offices/adm/hudclips/forms/files/935-2a.pdf

HUD Form 935.2B

1944.410(a)(10)

 

 

32.

Determination of TA Grant Amount

Include a letter from your Rural Development Local Office giving the current, not more than 12 months old equivalent value of a comparable contractor-built 502 home.  Include total square feet and total living area.  The letter should include the actual or projected cost of an acceptable site and site development.  Show the formula your organization used to calculate the TA cost.

1944.407

 

 

33.

Intergovernmental Review Submittal

1944.409

 

 

34.

Civil Rights Impact Analysis Certification

Form RD 2006-38,

2006-P,  2006.754(b)

 

 

35.

OGC Review (if necessary)

1944.410(b)(2)

 

 

Applicants and existing Self-Help grantees applying for a new grant should submit their applications in an original and one copy containing the above applicable items to the Rural Development Office designated to receive the grant application as determined by the State.  Within 30 days of receipt of the application, the designated official will review the application for completeness, accuracy and conformance to program policy and regulation.  The designated official should then make their recommendation and forward along with a copy of the grantee’s package to the Technical and Management Assistance (T&MA) Contractor for review.  The T&MA contractor will make their recommendations and return the package to the State Office within 15 calendar days.  The State Office will issue a Letter of Conditions to the Grantee subject to: (1) review of the application package by the National Office, if applicable and (2) subject to submission of any additional items not included with the application.