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HUD Form 9917 | OMB Approval Number 2501-0035 (Exp. XX/XX/XXXX) |
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| Promise Zone Community |
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Due: January 20th | April 20th | July 20th | November 20th |
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| Promise Zone Director |
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Instructions: On a quarterly basis, Promise Zones are asked to make a good faith effort to list federal and non- federal investments, grant awards, in-kind donations, (technical) assistance, and capital investments secured by the Promise Zone lead agency and the Promise Zone partners. FEDERAL: Please include any new submissions, or denials or awards on past application submissions of investments that contribute to the Promise Zone effort. NON-FEDERAL: Only non-federal awards need to be tracked; please do not include the application submissions and rejections. The Promise Zone Investment Grant Report will be cumulative and will help to document what funding has been invested in the Promise Zone over time. |
What to track and include: Promise Zones are free to, but do not have to, track federal investments such as the Community Development Block Grant (CDBG) or the Low-Income Housing Tax Credit (LIHTC) program if they would like - and if those investments tie into their goals and Strategic Plan. |
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Updating the form: New submissions for investment or assistance should be entered as a new row in the speadsheet. To provide an update on a previously reported submission/application, the Promise Zone should provide the new information to the relevant field and provide a new date to the 'Date Last Updated' column. Because this report is now cumulative, the 'Date Last Updated' column is the way to flag what updates are being reported in a given Quarter. Please note that this means that each unique instance of grant assistance/investment should only be listed once; there should not be multiple rows for the same investment/grant. |
Reporting Information: Public reporting burden is estimated to average 20, including the time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing collection of information. The information is not considered sensitive. Provision of this information is voluntary. The agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid Office of Management Budget (OMB) Control Number. The purpose of this information collection is to track the progress made by the Promise Zone towards completing the 10-year plan. HUD uses this information to quantify the monetary impact on Promise Zone communities and to facilitate communication between local and federal partners. |
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| Funding Entity |
Funding Entity Type |
Funding Opportunity Name |
Identifying Number |
Funding Type |
Applicant |
Promise Zone Preference Available |
PZ Support |
Funding Amount |
[Application] Submission Date |
Notification Date |
Beginning of Funding Period |
End of Funding Period |
Status |
Description |
Notes |
Date Last Updated |
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| Please list the entity that is providing the investment or the grant. |
What type of entity is providing the assistance/investment? |
Enter the name of the program, grant opportunity, etc. from which the applicant is receiving assistance/investment. |
If a federal grant, please input the CDFA number (catalog of federal domestic assistance). If not federal, input the local identifying opportunity number, if applicable. |
Please indicate the type of assistance or investment the Promise Zone or Promise Zone partner is receiving. |
Who is applying for/receiving the assistance/investment? |
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Please indicate if the Promise Zone lead agency provided any support to the application, either a letter of Support (LOS), and/or a PZ Preference Point certification form (HUD 50153). |
If known, please indicate the amount requested in an application. |
Please indicate the date the application was submitted. If this is not known, please list the date of the deadline to apply. |
The date the applicant was notified of their award or denial. |
The date the funds are deployed to/spendable by the applicant. |
The date that all funds must be spent down by. |
Please indicate whether the assistance/investment has been Awarded, Denied, or is still Pending. |
Briefly describe how these funds will be used to advance the Promise Zone's goals. |
Enter comments and caveats to the entry here. |
Please use this column to indicate that the status of a given investment has changed within the last quarter. |
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| Please list federal agencies in the following format: Dept. of Treasury |
RESPONSE OPTIONS |
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RESPONSE OPTIONS |
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RESPONSE OPTIONS |
RESPONSE OPTIONS |
For awarded grants/investments, the total amount for all years funded should be listed here. |
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| Do not include the specific granting Office or Department name here; only include the cabine-level agency name. |
Federal government |
You may include the specific granting Department or Program Office in parentheses after the name of the opportunity. |
CDFA, or any other type of unique identifier |
Grant = direct monetary assistance earmarked for certain activities that does not have to be paid back; e.g. educational services, job-training, additional money for SNAP recipients to buy fruits and vegetables, etc. |
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Preference Points |
LOS = letter of support provided by PZ lead agency |
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AWARDED |
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| (List federal agencies as shown in Grants.gov) |
State government |
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Technical Assistance |
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Priority Consideration |
Preference Point Certification Form (HUD 50153) |
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DENIED |
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| Dept. of Health and Human Services |
Municipal/County government |
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In-kind assistance is not direct monetary assistance, but has monetary value. If you allocate human capital, or technological equipment are exmaples. |
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Other (some kind of local PZ preference) |
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PENDING |
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| Dept. of Agriculture |
Philanthropic |
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Capital investment |
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| Dept. of Housing and Urban Development |
Private means a for-profit entity. Non-profit foundations that are off-shoots of for-profit companies should be considered philanthropic, not Private. |
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| Dept. of Commerce |
Other |
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| Dept. of Education |
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| Dept. of Energy |
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| Dept. of Treasury |
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| Dept. of Transportation |
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| National Science Foundation |
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| Dept. of Defense |
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| Dept. of Justice |
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| Dept. of Labor |
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| Dept. of Veteran's Affairs |
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| Small Business Administration |
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| National Endowment for the Arts |
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| Environmental Protection Agency |
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