HUD 50077-SL Certification by State or Local Official of PHA Plans Co

Certification by State or Local U. S Department of Housing and Urban Development

Official of PHA Plans Consistency Office of Public and Indian Housing

with the Consolidated Plan or OMB No. 2577-0226

State Consolidated Plan Issued: XX/XX/XXXX

(All PHAs) Expires XX/XX/XXXX

Certification by State or Local Official of PHA Plans

Consistency with the Consolidated Plan or State Consolidated Plan

I, _________________________________, the _____________________________________

Official’s Name Official’s Title

certify that the 5-Year PHA Plan and/or Annual PHA Plan of the

_________________________________________________________________________________

PHA Name

is consistent with the Consolidated Plan or State Consolidated Plan and the Analysis of

Impediments (AI) to Fair Housing Choice of the

______________________________________________________________________________

Local Jurisdiction Name

pursuant to 24 CFR Part 91.

Provide a description of how the PHA Plan is consistent with the Consolidated Plan or State Consolidated Plan and the AI.

I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

Name of Authorized Official Title

__________________________________________________________________________________________________________________________________

Signature Date

Page 1 of 1 form HUD-50077-SL (12/2011)