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pdfOMB Approval No. 2506-0112 (Exp. 7/31/2012)
Certification of Consistenc\
with the Consolidated Plan
U.S. Department of Housing
and Urban Development
I certify that the proposed activities/projects in the application are consistent with the jurisdiction’s current, approved Con
solidated Plan.
(Type or clearly print the following information:)
Applicant Name:
___________________________________________________________________
Project Name:
___________________________________________________________________
Location of the Project:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Name of the Federal
Program to which the
applicant is applying:
___________________________________________________________________
Name of
Certifying Jurisdiction:
___________________________________________________________________
Certifying Official
of the Jurisdiction
Name:
___________________________________________________________________
Title:
___________________________________________________________________
Signature: ___________________________________________________________________
Date: _____________________________________
Page 1 of 1
form HUD-2991 (3/98)
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