Form HUD-9840 Purchasers Certification of Compliance with State and Lo

Purchaser’s Certification of
Compliance with State and Local
Housing Laws and Requirements

U.S. Department of Housing
and Urban Development
Office of Housing
Federal Housing Commissioner

OMB Approval No. 2502-2502-0559
(Exp. 7/31/2008)

Public Reporting Burden for this collection is estimated to average 15 minutes per response, including the time for reviewing instructions.
This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control
number. The information is used by HUD to ensure compliance with 24 CFR Part 200, Subpart H which requires potential purchasers of
multifamily housing projects to certify that all other projects owned by the potential purchaser are in substantial compliance with applicable
state or local government housing statutes, regulations, ordinances, and codes. HUD does not ensure confidentiality to respondents.

Instructions: List all multifamily housing projects currently owned (project name and project address) in the city or town as the
project to be purchased and check the appropriate certification box. This form must be completed, signed, and submitted to the
local HUD office. If necessary, attach sheets for additional projects along with the information below.
Project Name:
I certify that the project is in compliance with all state and
Project Address:

local housing codes.
I certify that the project is not in compliance with all state and
local housing codes.

Project Name:
Project Address:

I certify that the project is in compliance with all state and
local housing codes.
I certify that the project is not in compliance with all state and
local housing codes.

Project Name:
Project Address:

I certify that the project is in compliance with all state and
local housing codes.
I certify that the project is not in compliance with all state and
local housing codes.

Project Name:
Project Address:

I certify that the project is in compliance with all state and
local housing codes.
I certify that the project is not in compliance with all state and
local housing codes.

Project Name:
Project Address:

I certify that the project is in compliance with all state and
local housing codes.

I certify that the project is not in compliance with all state and
local housing codes.
For each project that is not in compliance as indicated above, please provide an explanation. Use additional sheets and attach if
necessary.

I certify that this information is true and accurate.
Warning: HUD will prosecute false claims and statements. Convictions may result in criminal and/or civil penalties. (18 U.S.C.
1001, 1010, 1012; 31 U.S.C. 3729, 3802)

___________________________________________
Name of Potential Purchaser (please print)

______________________
Date

___________________________________________
Signature of Potential Purchaser
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)

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form HUD-9840 (7/2005)