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SECTION 3 BUSINESS SELF — CERTIFICATION FORM
(In compliance with Section 3 of the HUD Act of 1968)
This purpose of this form is to comply with Section 3 of the HUD Act of 1968 business
certification requirements. To count as a Section 3 Business your company must meet
one of the categories listed below. Each category will require additional documentation
to support the election. You must provide that supporting documentation with this form
to be properly and completely confirmed as a Section 3 business. If this form
is submitted without the required supplemental data, your certification will not be
processed.
Please make a selection below; additional documentati
Section 3 Business
Category
Additional Required Data
‘on will be on
Business is at least 51
percent owned and
controlled by low-or
very low-income persons.
Proof of ownership showing all
owners and their percentages
and a completed Section 3
Individual Self-Certification
form for all low- and very low-
income owners.
Over 75 percent of the labor
hours performed for the
business over the prior three-
month period was performed
by Section 3 workers.
Provide the last 90 days full
payrolls for the entire
company, make a list of the
names from the payrolls of the
Sections 3 workers, and
provide a completed Section 3
Individual Self-Certification
form for all low-and very low-
income workers listed.
Business is at least 51 percent
owned and controlled by
current public housing
residents or residents who
currently live in Section 8-
assisted housing
Proof of ownership showing
all owners and their
percentages and a Section 3
Individual Self- Certification
form for all public housing
and/or Section 8 residents.
Are you a Section 3 Business? (Circle one) YES NO
Financial Operations, IC & RA Review
RFP# FOICRAR-08-26
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