Section 236 ACU Fax Form - For 2017

This form will create a standard Fax Transmittal Coversheet for 236 Annual Certifications of Use.
For a PowerPoint overview of this process, please click here.
* fields are required
Name of Reviewing Mortgagor Official: *
("Reviewing Mortgagor Official" Defined as the person responsible for reporting to HUD on the use of Excess Income.)

Title of Reviewing Mortgagor Official: *

Your Name:

Your Email Address:

Your Phone Number:

Name of Development:

Date Signed: (MM/DD/YYYY)

Amount Remitted to HUD for entire year:

Amount Retained by Development for entire year: (Displayed on submission)

Allowable Uses of Excess Income Retention will be displayed upon submission of this form

"I certify that: (1) the amount of Excess Income retained and used was for the purpose approved by HUD; (2) all eligibility requirements for retaining Excess Income were satisfied for the entire reporting period; and (3) all the facts and data on which this report is based are true and accurate. "

(Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties (18 U.S.C. Sections 1001, 1010, 1012, 31 U.S.C. Sections 3729, 3802.)

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If you have any problems using this form, submitting it or faxing it, please contact Colleen Kelly

The remission of Excess Income is a continuing contractual obligation of the owner and HUD may withhold regulatory approval where that obligation has not been satisfied.