CDBG Compliance Form
Reporting Period: r Jan. 1 - Jun. 30, _____ r Jul. 1 - Dec. 31, _____ Condition of Facility Name of Building: ___________________________ Contact Person: _________________________ r Excellent Address: ___________________________________ Title:_____________________________________ r Good to Fair r Needs Repair Date Event Type Description Host Name Host Type Est. # of Attendees Event Type Host Type Social (S) Government (G) Educational (E) Non-Profit (NP) Recreational (R) For-Profit (FP) Comm. Outreach (O) Private (P) Political (P) Cultural; Arts (C) Religious (R) If none of the above, please specify: Comments: For CDBG Office Use: Inspected By: ________________________ Inspection Date: _____________________ I certify that, to the best of my knowledge, the above information is true and correct. …
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Reporting Period: r Jan. 1 - Jun. 30, _____ r Jul. 1 - Dec. 31, _____ Condition of Facility Name of Building: ___________________________ Contact Person: _________________________ r Excellent Address: ___________________________________ Title:_____________________________________ r Good to Fair r Needs Repair Date Event Type Description Host Name Host Type Est. # of Attendees Event Type Host Type Social (S) Government (G) Educational (E) Non-Profit (NP) Recreational (R) For-Profit (FP) Comm. Outreach (O) Private (P) Political (P) Cultural; Arts (C) Religious (R) If none of the above, please specify: Comments: For CDBG Office Use: Inspected By: ________________________ Inspection Date: _____________________ I certify that, to the best of my knowledge, the above information is true and correct. r Compliant with intended use Prepared By: ___________________________ Date: ___________ r Non compliant with intended use (Signature) (Title) Comments: Reviewed by: ____________________________ Date: ___________ (CDBG Staff) (Title) Total Virgin Islands Housing Finance Authority Division of Federal Programs Community Development Block Grant Program CODES This report is to be developed on an semi-annual basis by each organization that has received Community Development Block Grant funds for a Public Facility. This report is due semi-annually, on the following dates: July 10 and January 10, respectively. Failure to submit this report on a timely basis may result in the organization being found in violation of the federal requirements regarding on-going compliance. Possible remedies available to CDBG include foreclosure of the Notice of Equity Interest and ultimately repossession of the building. Annual Compliance Monitoring Report 3 3 3 3 3