HUD-9900 Certification of Consistency with RC/EZ/EC-II Strategic

Application for
Approval as a Housing
Counseling Agency

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

OMB Approval No. 2502-0573
(Exp. 08/31/2014)

Housing Counseling Program
See last page for public burden statement.
______________________________________________________________________________________________________
This form is to be used by all organizations requesting HUD approval as a housing counseling agency, Intermediary, or Multi-State
Organization. Before applying, HUD recommends applicants review HUD Handbook 7610.1, 24 CFR Part 214, and information on
HUD’s website at: http://portal.hud.gov/hudportal/HUD?src=/program_offices/housing/sfh/hcc/hcc_home. State Housing Finance
Agencies are not required to submit an application for HUD approval but must comply with the requirements outlined in this form in
order to participate in the Housing Counseling Program.
Intermediary applications must be sent to:
U.S. Department of Housing and Urban Development
Office of Single Family Housing
Program Support Division, B-133/ L’Enfant 2206 East
451 7th Street, SW
Washington, DC 20410
All other applicants must submit form HUD-9900 to the appropriate HUD Office according to the following website:
http://www.hud.gov/offices/hsg/sfh/hoc/hsghocs.cfm
Note: HUD may, at its discretion, request clarification or additional information from an agency for use in determining the agency’s
eligibility for the Housing Counseling Program. If an application package does not meet all Program requirements, HUD will provide
the agency with the reasons for the denial in writing. Within 30 calendar days of the written notice of denial, the agency may submit a
revised application, or appeal HUD’s decision in writing to HUD, as provided in 24 CFR § 214.205. If an agency decides to submit a
revised application, the agency may consult HUD to determine the specific actions needed to resolve the deficiencies.
SECTION A - Complete and submit this section.
Official Name of the Organization:

Website (if applicable):
Acronym; aka, or dba, if applicable:

Counseling Program Manager’s Name & Title:

Agency Telephone Number:

Address of the Main Office (list branch & affiliate offices on
a separate sheet of paper):
(Street Address)
(City)
(State)(Zip)
Executive Director's Name:

Name, Title, Telephone Number, Date & Signature of
Authorized Person:

Date Counseling Services Started (include month, day and
year (MM/DD/YYYY)):

_______________________________________________________________________________________________________________________
Page 1 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

Agency E-mail Address:

Agency’s Federal Taxpayer Identification Number (TIN):

Name of Agency Point of Contact for HUD on matters
involving this application:

Telephone number, facsimile and e-mail address of Agency
Point of Contact for HUD on matters involving this
application:

Type of organization. Please check one box.
National Intermediary Organization – Provides, in multiple regions of the United States: (i) housing counseling services
through its branches and/or affiliates, which are physically located in nine or more states; and (ii) training, technical assistance,
oversight, and pass-through funding to its network of branches and/or affiliates.
Regional Intermediary Organization – Provides, in a generally recognized region within the United States, such as the
Southwest, Mid-Atlantic, New England: (i) housing counseling services through its branches and/or affiliates, which are physically
located in eight or fewer states; and (ii) training, technical assistance, oversight, and pass-through funding to its network of branches
and/or affiliates.
Multi-State Organization (MSO) – Provides housing counseling and education services through a main office and branches in
two or more states. All branches operate and are identified under main office tax ID number.
Local Housing Counseling Agency (LHCA) – Provides housing counseling and education services directly through one location
or a main office with one or more branch offices, in no more than two contiguous states. An exception can be made for a local
housing counseling agency that serves a single metropolitan area covering more than two contiguous states.
State Housing Finance Agencies (SHFAs) – SHFAs are not required to submit an application for HUD approval. However, to
participate in HUD’s Housing Counseling Program, SHFAs must either submit a housing counseling grant application through the
HUD Super Notice of Funding Availability (NOFA) or submit a request and provide HUD with a list of affiliates, if applicable, and
assure that they meet all program requirements. SHFAs submitting a request must complete: Section A; Section B, Part 1, item 7; and
Section C, ASSURANCES AND CERTIFICATIONS. SHFAs must also submit a copy of the relevant statutory authority to operate as a
SHFA and provide housing counseling services throughout the entire state.
List all States in which your organization provides counseling services:

Type(s) of Support Provided:
Is your organization Faith-Based?

Yes

No

(Faith-based organizations must recognize that their non-discrimination responsibilities are not only to serve anyone who is eligible
for counseling, but also that they must affirmatively conduct outreach to those least likely to apply for the services, even if they are not
members of the organization’s faith group.)
Does your organization provide services to migrant farm workers?

Yes

No

_____________________________________________________________________________________________________________________
Page 2 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

Does your organization provide services in Colonias?

Yes

No

(Colonias are rural economically distressed communities located with 150 miles of the US-Mexican border that lack basic
infrastructure; running water, electricity, paved roads, etc.)
Is your organization designated as a legal services agency?

Yes

No

Type(s) of Housing Counseling Services. Check all services for which the agency is seeking HUD approval. As a condition of
approval, HUD may require training or an exam, for example, training on FHA programs and products, prior to approving an agency
to provide a specific service.
A. Pre-Purchase / Homebuying:
PPC – Pre-Purchase Counseling
FHW – Fair Housing Pre-Purchase Education Workshops *
PLW – Predatory Lending Education Workshops *
PPW – Pre-Purchase Homebuyer Education Workshops *
B. Resolving or Preventing Mortgage Delinquency or Default:
DFC – Mortgage Delinquency and Default Resolution Counseling
(This includes FHA’s loss mitigation counseling)
DFW – Resolving/Preventing Mortgage Delinquency Workshops *
C. Non-Delinquency Post-Purchase:
FBC – Financial Management/Budget Counseling
FBW – Financial, Budgeting and Credit Repair Workshops*
HIC – Home Improvement and Rehabilitation Counseling
RMC – Reverse Mortgage Counseling
NDW – Non-Delinquency Post-Purchase Workshops for Homeowners
D. Locating, Securing, or Maintaining Residence in Rental Housing:
RHC – Rental Housing Counseling
RHW– Rental Housing Workshops *
E. Shelter or Services for the Homeless:
HOM - Services for Homeless Counseling
Other (please list): ________________________________________________________
* An applicant that offers group, education sessions must also offer counseling on the same topic.
SECTION B - SUBMIT THE FOLLOWING DOCUMENTATION AND NARRATIVES
PART 1 - APPLICANT INFORMATION
LHCAs must respond to items 1 - 6 in this part and item 7, if applicable.
Intermediaries and multi-state organizations must respond to items 1 – 7 in this part for every HUD program affiliate or branch
included in your application, including the main office if housing counseling services are directly provided there.

_____________________________________________________________________________________________________________________
Page 3 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

Intermediaries and multi-state organizations must also respond to items 1 – 5 on behalf of the main office even if housing counseling
services are not directly provided there. Item 4 B, however, is not applicable if direct services are not provided at the main office.
Intermediaries must also respond to item 8.
1.

Non-profit Status: Send a legible copy of the document that supports the agency's claim to be a non-profit organization (i.e., 501
(c) letter issued by IRS). The attachment must include the official name, address, and telephone number of the legal authority
that granted the non-profit status. The applicant must assure HUD that its branches or affiliates must also be non-profit entities.
or
Local Government: Submit a copy of the document that authorizes you to provide housing counseling if you are a unit of local,
county, or State government.

2.

Charter: Submit a copy of the recorded document (i.e., Charter, Articles of Incorporation, By-laws, governing body meeting
minutes, etc.) that specifically authorizes your organization to provide housing counseling.

3.

Community Base: Indicate when the agency began providing housing counseling services. Describe the agency’s achievements
in providing housing counseling for the past 12 months for the communities in which you seek approval to operate. This
statement should include specific activities relating to the services described in your housing counseling plan. Quantify the
number of households to whom the agency provided counseling and education services during the past 12-month period by
completing form HUD-9902.

4.

Counseling Resources: Describe your agency's resources for the topics A-D listed below.

A.

Staff:
1)

2)
3)

4)

5)
6)

B.

List all staff involved in the housing counseling program, including all board members, supervisors, housing
counselors, and clerical support staff. State position title, duties, and whether the position is full-time or part-time, is
paid or volunteer capacity. Include hours worked per week for all positions provided and length of employment.
Submit a resume/dossier for each staff person that will be involved in delivering any or all parts of housing counseling
activities, including supervisory staff and housing counselors. Do not include clerical support staff.
Indicate the extent of each counselor's knowledge of HUD housing programs, and other programs available in the target
community. Cite training received, including date and source of training. Submit copies of training certificates
received relating to the above programs.
Provide a written supervisory monitoring and quality control compliance procedures plan for monitoring the work of
the housing counselors. The plan must describe in detail the supervisor review procedures and outline corrective
actions to be initiated immediately when discrepancies are found. This must include reviewing client files with the
counselors to determine the adequacy and effectiveness of the counseling and how often the supervisor will review and
monitor counselors’ work.
Identify counselors fluent in other languages. List the non-English languages available for each office.
Identify any other jobs or activities, apart from the housing counseling agency, an employee, volunteer or board
member of the agency performs that could result in a conflict of interest as identified in Chapter 6 of HUD Handbook
7610.1.

Facilities: For each facility where direct counseling services will be provided:
1)

2)
3)
4)

Indicate whether the agency owns or rents the facility. If rented, include a copy of your lease. Attach photograph
copies of the facility that include signage; meeting space for private in-person counseling, as well group education
sessions; storage area(s) for client files; and facility space accessible to disabled and elderly clients.
Indicate whether your agency shares any part of its facility with any other organizations. If so, identify the
organizations and explain the relationships that exist between your agency and those organizations.
Indicate the agency's operating hours and extended hours when necessary.
Describe accessibility features for disabled and elderly clients that may have special needs or how your organization
makes alternate accommodations to serve disabled and elderly clients that have special needs.

_____________________________________________________________________________________________________________________
Page 4 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

5)
6)
C.

Funding:
1)

2)
3)
4)

D.

Describe what space is available for one-on-one counseling and group education.
Describe how client files are kept confidential.

List the sources and amounts of funds specifically for housing counseling that are currently available to you. Please
submit copies of any written funding commitments, including relevant grant agreements, from entities and/or
individuals committing resources to the housing counseling program. The funding commitment documentation must
include: (i) the identity of the entity or individual committing the resources; (ii) the dollar value of the commitment;
(iii) an indication that the resources will be available during the initial 12-month period of HUD approval or program
participation; and (iv) the signature, title, telephone number and e-mail address of the individual or entity official
legally able to make the funding commitment.
Submit a copy of your current annual housing counseling budget. Only include income and expenses associated with
your housing counseling program.
List the amount of income received during the last 12 months from housing counseling fees, if applicable.
Submit a copy of the agency’s most recent fiscal year-end financial statement prepared in accordance with generally
accepted accounting principles and reporting practices. The financial statement must include an auditor's review report,
a treasurer's report and any supplemental schedules.

Community Resources: Submit a list of the names and addresses of the local, State, Federal, public and private agencies
with whom your agency and branches or affiliates have established working relationships and may refer your clients when
additional services not offered by your agency are needed. Include a brief description of the type(s) of community resources
or services each agency listed will provide for your clients, and explain the nature of the working relationships between your
agency and each of these community resources. Community resources include HUD-approved counseling agencies with
which the applicant and its branches or affiliates will work cooperatively.

5.

Other Agency Housing Activities: Describe the nature and extent of any additional housing programs or activities, other than
housing counseling services, that your agency and branches or affiliates offer. Examples include administering down payment
assistance programs, developing housing projects, managing apartment buildings, rehabilitating and reselling HUD homes, and
selling real estate. Explain your agency’s plans to avoid conflicts of interest, as well as the personnel policies and practices to
prevent and, if necessary, remedy real or apparent conflicts of interest. Additionally, identify any external housing programs,
products or activities to which housing counseling clients may be referred. Provide a sample Disclosure Statement that the
agency will provide to a client and each participant in group education that explicitly describes the various types of services or
products provided by the agency and any financial relationships between this agency and any other industry partners. The
disclosure must clearly state that the client is not obligated to use any other services or products offered by the agency, its
branches or affiliates or any industry partners, and that receiving housing counseling services is not contingent on the use of any
service or product. Furthermore, the agency must also provide information on at least three other relevant alternative services,
programs, or products.

6.

Client Management System: Identify the automated housing counseling Client Management System (CMS) used by the agency
for the collection of client-level information including, but not limited to, financial and demographic data, counseling services
provided, and outcomes data. The CMS must provide data, as required by HUD, on the agency’s profile and counselors. At the
time of application to HUD’s Housing Counseling Program, and prior to approval, agencies must utilize a CMS that satisfies
HUD’s requirements and interfaces with HUD’s databases to download required information into HUD’s Housing Counseling
System. For additional guidance on the required CMS, see the information on HUD’s website, as referenced on Page One of this
application.

7.

Affiliates and Branches: Provide the following information for each affiliate and branch in your proposed HUD housing
counseling program:
1)
2)
3)
4)
5)
6)

Official name
Federal Taxpayer Identification Number (TIN), if applicable
Physical address, including zip code
Mailing address if different from address on line 2 above
Telephone number(s), including toll-free if available
Name, title, and telephone number of the person in charge of the housing counseling program at each location

_____________________________________________________________________________________________________________________
Page 5 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

8.

Intermediary Activities: For intermediaries, describe and date the organization’s experience in operating as a housing counseling
intermediary. In connection with the intermediary’s activities and parent entity responsibilities related to branches and affiliates,
describe, quantify, as applicable, and provide documentation related to the policies and procedures to: (i) provide training and
technical assistance; (ii) perform oversight and monitoring; (iii) monitor financial performance, including the use of pass-through
funding; (iv) perform accounting of administrative costs; (v) ensure compliance with federal regulations, OMB Circulars A-110
and A-133, and other federal guidelines; and (vi) perform any other housing counseling intermediary activities.

PART 2 - HOUSING COUNSELING WORK PLAN
Submit a concise but detailed housing counseling plan based on the information requested below. The plan should explain the needs
and housing problems of the target population and how your agency will address those needs and problems with your available
resources. Intermediaries and multi-state organizations must submit a work plan for each proposed HUD program affiliate or branch
office.
HUD considers an acceptable housing counseling plan to be a reasonable interlocking of the needs and housing problems of the target
areas with the resources available to the applicant and its branches or affiliates to address those needs and problems successfully on
behalf of clients. HUD will not approve a well-meaning but ill-conceived plan that lacks the necessary resources.
1.

Target Area(s):
A.

Submit a concise but detailed description of the target area you propose to provide the housing counseling services identified
in your work plan and selected in Part A of the application form. The description must include, but is not limited to, such
items as size of population, socio-economic factors, racial and ethnic makeup of the population, and age and condition of
housing.

B.

Provide a brief statement as to your reasons for selecting the target area and how your organization can serve the
community.

B.

If other HUD approved housing counseling agencies serve the same area, provide justification for the overlapping of
services.

C.

Clearly define the geographic boundaries of your proposed service area(s). Include only those areas from which your
agency received "clients" during the 12-month period immediately preceding the date of your application.

D.

On a map, indicate the location of your counseling facility(ies). On the same map, outline and identify the geographic areas
you now serve as you indicated in "D" above.

E.

On the same map, indicate the locations and the names of other HUD approved housing counseling agencies within the same
areas you serve.

2.

Housing Needs and Problems: Submit a descriptive statement of the housing needs and problems of the target population. The
statement must cite the specific sources from which you obtained your data. Include special needs and problems, such as those
related to low income or poverty, homelessness, language barrier, ethnic, minority, and racial factors.

3.

Affirmatively Furthering Fair Housing: Identify the barriers to fair housing choice in your agency’s proposed target area.
Describe the counseling, education, outreach and other activities that the agency provides to affirmatively further fair housing for
classes protected under the Fair Housing Act. The persons least likely to be aware of or pursue housing opportunities within a
particular housing market area are likely the ones who need housing counseling services the most.

4.

Description of Services: Describe in detail the housing counseling activities that you will be providing as a HUD approved
housing counseling agency as indicated in Part A of this form. The Plan should be specific as to these activities and how you will
deliver each type of service. Your plan must reflect an understanding of HUD's definition of each housing counseling service as
set forth in HUD Handbook 7610.1.

5.

Outcomes: Describe the anticipated results (outcomes) to be achieved within the initial period of approval. For each category of
housing counseling activity described above in “Description of Services,” provide the projected number of households your
agency will serve during the initial 12-month period of HUD approval or program participation.
_____________________________________________________________________________________________________________________
Page 6 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

6.

Alternative Settings/Formats: Describe, if applicable, the alternative settings or formats your agency will utilize to provide
housing counseling services in your target area(s) as a result of either mutual agreement with the client or the inaccessibility of
your facilities. Alternative formats can include telephonic counseling or remote counseling systems designed to use Skype
technology, video cameras and the Internet.

7.

Client Follow-up: Explain your agency’s plan for follow-up communication with clients to ensure that you are in compliance
with the requirements of HUD Handbook 7610.1 and 24 CFR Part 214.

8.

Fee Schedule: If you plan to charge for counseling, submit a schedule of charges to ensure that you are in compliance with the
requirements of HUD Handbook 7610.1 and 24 CFR Part 214.

9.

Non-English Speaking or Limited English Proficiency (LEP) Clients: Describe how you plan to serve non-English speaking or
LEP clients.

SECTION C - ASSURANCES AND CERTIFICATIONS
By signing below, the applicant assures and certifies the following:
1.

2.

Assurances: I assure that this agency, and HUD program branches and affiliates, if applicable, will:
A.

Administer the housing counseling in accordance with Title VI of the Civil Rights Act of 1964, Title VIII of the Civil
Rights Act of 1968, Executive Order 11063, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of
1975; and Title IX of the Education Amendments of 1972.

B.

Provide housing counseling services without sub-agreements with other agencies for the delivery of all or any part of the
services in our proposed housing counseling work plan as approved by HUD.

C.

Represent our clients without any conflict of interest by our agency, paid and volunteer staff, or board members which
might compromise our ability to represent fully in the best interests of the client in accordance with HUD Handbook
7610.1.

D.

Meet all local, State, and Federal requirements necessary to provide our agency's housing counseling services, including, if
applicable, the management and liquidation services.

E.

Comply with the fee guidelines set forth in HUD Handbook 7610.1 and 24 CFR Part 214, if we plan to charge counseling
fees.

F.

Accept all clients that our agency has the capacity to serve and affirmatively outreach to those least likely to apply for the
agency’s housing counseling services.

G.

Provide HUD with all required Housing Counseling Program data and information, in a timely manner, for use by HUD
both internally and externally on HUD’s web listing and other media.

Certifications: I certify that this agency, and HUD program branches and affiliates, if applicable:

A.

Are acting on our own behalf and are not under the influence, control, or direction of any outside party such as a landowner,
real estate broker, contractor, builder, lender, or consultant seeking to derive a profit or gain from our housing counseling
program clients.

B.

Meet the applicable accessibility requirements of Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), 24 CFR
parts 8 and 9, and the Americans with Disabilities Act (42 U.S.C. 12101 et seq). Our facilities provide accessibility features
for persons with disabilities and elderly persons, or we will arrange to meet with such persons at an alternative accessible
location or format.

_____________________________________________________________________________________________________________________
Page 7 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1

C.

No employee, board member, or partner has been suspended, debarred, or otherwise restricted under the Department’s or
any other federal regulations (see 24 CFR Part 214).

D.

Have not been indicted for, or convicted of, a criminal offense that reflects upon the responsibility, integrity, or ability of the
agency to participate in housing counseling activities. These offenses include criminal offenses that can be prosecuted at a
local state, or federal level.

E.

Are not subject to unresolved findings as a result of HUD or other government audit or investigations (see 24 CFR Part
214).

F.

Meet all HUD Housing Counseling program approval requirements outlined in HUD Handbook 7610.1 and 24 CFR Part
214.

G.

I further certify that the information submitted in response to this Application for Approval as a Housing Counseling
Agency is accurate.

Note: HUD may change a HUD approved or participating agency’s status to inactive, in lieu of termination, under certain
circumstances that may temporarily impair an agency from complying with its housing counseling plan. HUD may change any
agency’s status through either a request submitted to HUD or as a result of information obtained by HUD.

Name and Title of Authorized Agency Representative: ______________________________________________________

Original Signature: ______________________________________________________

Date: _________________

_________________________________________________________________________________________________________
WARNING: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18U.S.C.
1001, 1010, 1012; 31 U.S.C. 3729, 3802)
Public reporting burden for this collection of information is estimated to average 8 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless that collection displays a valid OMB control number.
This information is collected in connection with HUD's Housing Counseling Program and will be used by HUD to determine
eligibility for Program participation under Section 106 of the Housing and Community Development Act of 1974. The information is
considered sensitive and is protected by the Privacy Act which requires the records to be maintained with appropriate administrative,
technical and physical safeguards to ensure their security and confidentiality.

_____________________________________________________________________________________________________________________
Page 8 of 8

form HUD-9900 (06/2011)
Ref Handbook 7610.1