+-----------+--------------------------------+----+------------------+
| **Guide   |                                |    |                  |
| for       |                                |    |                  |
| Review of |                                |    |                  |
| National  |                                |    |                  |
| Objective |                                |    |                  |
| of**      |                                |    |                  |
|           |                                |    |                  |
| **Low-    |                                |    |                  |
| and       |                                |    |                  |
| Modera    |                                |    |                  |
| te-Income |                                |    |                  |
| Job       |                                |    |                  |
| Creation/ |                                |    |                  |
| Retention |                                |    |                  |
| Act       |                                |    |                  |
| ivities** |                                |    |                  |
+-----------+--------------------------------+----+------------------+
| **Name of |                                |    |                  |
| Program   |                                |    |                  |
| Parti     |                                |    |                  |
| cipant:** |                                |    |                  |
|           |                                |    |                  |
| **     ** |                                |    |                  |
+-----------+--------------------------------+----+------------------+
| **Staff   |                                |    |                  |
| Con       |                                |    |                  |
| sulted:** |                                |    |                  |
|           |                                |    |                  |
| **     ** |                                |    |                  |
+-----------+--------------------------------+----+------------------+
| *         |                                |    |                  |
| *Activity |                                |    |                  |
| Name,     |                                |    |                  |
| Number    |                                |    |                  |
| and Brief |                                |    |                  |
| Descr     |                                |    |                  |
| iption:** |                                |    |                  |
|           |                                |    |                  |
| **     ** |                                |    |                  |
+-----------+--------------------------------+----+------------------+
| **Name(s) |                                | ** |                  |
| of        |                                | Da |                  |
| Revi      |                                | te |                  |
| ewer(s)** |                                | ** |                  |
+-----------+--------------------------------+----+------------------+

**NOTE:** All questions that address requirements contain the citation
for the source of the requirement (statute, regulation, NOFA, or grant
agreement). If the requirement is not met, HUD must make a finding of
noncompliance. **Except for questions "4.b, "8.b," and "9," a**ll other
questions (questions that do not contain the citation for the
requirement) do not address requirements, but are included to assist the
reviewer in understanding the participant\'s program more fully and/or
to identify issues that, if not properly addressed, could result in
deficient performance. Negative conclusions to these questions may
result in a \"concern\" being raised, but not a **\"finding.**\"

**[Instructions]{.underline}:** Use this Exhibit for activities the
program participant has classified as meeting the national objective of
low- and moderate-income job creation/retention activities. The Exhibit
is broken into ten sections. The reviewer may complete only those
sections applicable to the subject activity as follows: Job Creation:
Funding Start Date; Job Creation: Held By; Job Creation: Activity
Incomplete; Job Creation: Completed Activity; Job Creation: Made
Available To; Job Retention; If Two or More Years Have Elapsed Since the
Provision of CDBG Assistance for Retained Jobs; If Less than Two Years
Have Elapsed Since the Provision of CDBG Assistance for Retained Jobs;
Report Validation; and Pre-1995 Public Benefit Standard Activities. One
Exhibit is to be completed for each business that is reviewed **except**
for an activity that involves job aggregation. If the jobs are to be
counted in the aggregate, the provisions at 24 CFR 570.208(a)(4)(vi)(A)
through (F) will apply. The reviewer is requested to refer to the
paragraph that corresponds to the activity(s) undertaken, count the jobs
accordingly, and make a determination of compliance. (Attach a separate
sheet, if needed.) Also see Exhibit 3-12, Guide for Review of Individual
Economic Development Activities, Section B.

**[Questions]{.underline}**

A. [Job Creation: Funding Start Date]{.underline}

1\.

  -----------------------------------------------------------------------
  What is the date (MM/DD/YY) when the CDBG assistance was first
  obligated for this activity?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

B. [Job Creation: Held By]{.underline}

2\.

+----------------------------------------------------------+-----------+
| a\. If the assisted activity is to meet the national     |           |
| objective based on jobs being held by low- and           |           |
| moderate-income persons, is there a written agreement    |           |
| between the program participant and the assisted         |           |
| business that commits the business to have at least 51%  |           |
| of the jobs, on a full-time equivalent basis, to be held |           |
| by low- and moderate-income persons?                     |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(ii)(A)(1)\]                       |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| b\. Does the agreement contain a listing by job title of |           |
| the permanent jobs to be created, identifying which are  |           |
| part-time, if any?                                       |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(ii)(A)(2)\]                       |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

  ---------------------------------------------------------- ------------
  c\. Does the program participant have a method or system   
  for tracking the business's progress in meeting its        
  responsibilities under the agreement?                      

  **Describe Basis for Conclusion:**                         

                                                             
  ---------------------------------------------------------- ------------

+----------------------------------------------------------+-----------+
| d\. If the activity includes part-time jobs, were they   |           |
| computed on a full-time equivalent (FTE) basis using 40  |           |
| hours as an FTE (e.g., a 20 hour per week job equals 1/2 |           |
| of a job)?                                               |           |
|                                                          |           |
| \[24 CFR 570.208(a)(4) and 24 CFR 570.506(b)(5)\]        |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| e\. If this activity includes temporary jobs, were they  |           |
| excluded from the job figures?                           |           |
|                                                          |           |
| \[24 CFR 570.208(a)(4) and 24 CFR 570.506(b)(5)\]        |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

  -----------------------------------------------------------------------
  f\. If the answers to either "2.d." or "2.e." are "no," calculate the
  correct number of jobs for this assisted activity, converting the
  part-time jobs to a full-time equivalent basis and/or omitting all
  temporary jobs.

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

C. [Job Creation: Activity Incomplete]{.underline}

(Note: If this activity is not yet complete, end review with question 3.
If it is complete, skip to Section D. "Complete" means that all CDBG
funds have been expended and the jobs to be created/retained as a result
of the assistance have been realized.)

3\.

  -----------------------------------------------------------------------
  a\. If the activity is not complete (more jobs are expected to be
  created), what is the anticipated completion date?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

  ---------------------------------------------------------- ------------
  b\. Does it appear that the low- and moderate-income jobs  
  commitment will be met?                                    

  **Describe Basis for Conclusion:**                         

                                                             
  ---------------------------------------------------------- ------------

D. [Job Creation: Completed Activity]{.underline}

4\.

  -----------------------------------------------------------------------
  a\. If the activity is considered completed (i.e., all financial
  commitments have been expended and no additional jobs are expected to
  result from the CDBG- assisted activity), how many permanent FTE jobs
  were actually created?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

+----------------------------------------------------------+-----------+
| b.  Were at least 51 percent of the permanent jobs       |           |
|     created initially held by low- and moderate-income   |           |
|     persons on a FTE basis? (**Note:** if the assisted   |           |
|     activity can be shown to meet the "made available    |           |
|     to" requirement in questions at 8.b. or 9. below, a  |           |
|     finding **cannot** be made for this question.)       |           |
|                                                          |           |
|     \[24 CFR 570.208(a)(4)\]                             |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

5\.

+----------------------------------------------------------+-----------+
| a\. Is there documentation showing a listing by job      |           |
| title of the permanent jobs filled and which jobs were   |           |
| initially held by low- and moderate-income persons?      |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(ii)(B)\]                          |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| b\. Is there documentation showing for each low- and     |           |
| moderate-income person hired the size and annual income  |           |
| of the person's family prior to the person being hired   |           |
| for the job **OR** is there documentation showing a      |           |
| presumed benefit was used, based on the census tract     |           |
| where the person resides or the business is located per  |           |
| 24 CFR 570.208(a)(4)(iv)(A) and/or (B)?                  |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(ii)(C) or 24 CFR 570.506(b)(7)\]  |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| c\. Were the correct Section 8 income limits for family  |           |
| size and income used at the time the low- and            |           |
| moderate-income person applied and/or was hired for the  |           |
| job **OR** was the person presumed to be low and         |           |
| moderate income based on the census tract criteria set   |           |
| forth at 24 CFR 570.208(a)(4)(v), as applicable?         |           |
|                                                          |           |
| \[24 CFR 570.3 or 24 CFR 570.506(b)(1) and (7)\]         |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

E. [Job Creation: To be Made Available TO Low/Mod Persons]{.underline}
(Note: If this option is not applicable, skip to Section F.)

6\.

+----------------------------------------------------------+-----------+
| a\. If the assisted activity is to meet the national     |           |
| objective based on jobs being made "available to" low-   |           |
| and moderate-income persons, is there a written          |           |
| agreement between the program participant (or            |           |
| subrecipient) and the business that contains a           |           |
| commitment that the business will make at least 51       |           |
| percent of the jobs available to low- and                |           |
| moderate-income persons and will provide training for    |           |
| any jobs requiring special skills and education?         |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(i)(A)(1)\]                        |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| b.  Does the written agreement contain:                  |           |
|                                                          |           |
|     -   a listing by job title of the permanent jobs to  |           |
|         be created;                                      |           |
|                                                          |           |
|     -   which jobs (if any) are part-time;               |           |
|                                                          |           |
|     -   which jobs will be made available to low- and    |           |
|         moderate-income persons; and                     |           |
|                                                          |           |
|     -   which of those jobs require special skills or    |           |
|         education?                                       |           |
|                                                          |           |
|         \[24 CFR 570.506(b)(5)(i)(A)(2)\]                |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| c\. Does the written agreement contain a commitment by   |           |
| the business and a description of the actions to be      |           |
| taken by the recipient and the business to ensure that   |           |
| first consideration will be given to low- and            |           |
| moderate-income persons?                                 |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(i)(A)(1) and (3)\]                |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

  -----------------------------------------------------------------------
  d\. How does the program participant track the business's progress in
  meeting its contractual responsibilities?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

7\.

+----------------------------------------------------------+-----------+
| a\. Is there documentation that lists, by job title, the |           |
| number of full-time-equivalent permanent jobs filled,    |           |
| and which of those jobs were made available to low-and   |           |
| moderate-income persons?                                 |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(i)(B)\]                           |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| b\. Is there documentation showing how first             |           |
| consideration was given to low- and moderate-income      |           |
| persons for these jobs?                                  |           |
|                                                          |           |
| \[24 CFR 570.506(b)(5)(i)(B)\]                           |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| c.  If the answer to "b" above is "yes," does the        |           |
|     documentation include:                               |           |
|                                                          |           |
|     -   what hiring process was used;                    |           |
|                                                          |           |
|     -   which low- and moderate-income persons were      |           |
|         interviewed for a particular job; and            |           |
|                                                          |           |
|     -   which low- and moderate-income persons were      |           |
|         hired?                                           |           |
|                                                          |           |
|         \[24 CFR 570.506(b)(5)(i)(B)\]                   |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

8\.

  -----------------------------------------------------------------------
  a\. Of the total number of jobs filled, how many jobs were made
  available to low- and moderate-income persons?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

+----------------------------------------------------------+-----------+
| b.  Were at least 51 percent of the jobs made available  |           |
|     to low-and moderate-income persons? (**Note:** If    |           |
|     the assisted activity is complete and did not meet   |           |
|     the "held by" or "made available to" requirements in |           |
|     question "4.b." and this question, the reviewer must |           |
|     determine whether the completed activity can meet    |           |
|     the national objective based on a combination of the |           |
|     "held by" and made available to" requirements per    |           |
|     question "9" below. If the answer to question "9" is |           |
|     "yes," a finding **cannot** be made for this         |           |
|     question.)                                           |           |
|                                                          |           |
|     \[24 CFR 570.208(a)(4)(i)\]                          |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| c.  Is there documentation showing, for each low- and    |           |
|     moderate-income person hired, the size and annual    |           |
|     income of the person's family prior to the job being |           |
|     made available to the person **OR** is there         |           |
|     documentation showing a presumed benefit was used,   |           |
|     based on the census tract where the person resides   |           |
|     or the business is located per 24 CFR                |           |
|     570.208(a)(4)(iv)(A) and/or (B)?                     |           |
|                                                          |           |
|     \[24 CFR 570.506(b)(5)(ii)(C) or 24 CFR              |           |
|     570.506(b)(7)\]                                      |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| d\. Were the correct Section 8 income limits for family  |           |
| size and income used at the time the low- and            |           |
| moderate-income person applied and/or was hired for the  |           |
| job **OR** was the person presumed to be low and         |           |
| moderate income based on the census tract criteria set   |           |
| forth at 24 CFR 570.208(a)(4)(v), as applicable?         |           |
|                                                          |           |
| \[24 CFR 570.3 or 24 CFR 570.506(b)(1) and (7)\]         |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

9\.

+-----------------------------------------------------------------------+
| Describe how the low- and moderate-income income status of an         |
| employee or applicant was determined or how the location of the       |
| employee or applicant or business was verified and documented.        |
|                                                                       |
| \[24 CFR 570.3, 24 CFR 570.208(a)(4), 24 CFR 570.506(b)(5), or 24 CFR |
| 570.506(b)(7)\]                                                       |
+-----------------------------------------------------------------------+
| **Describe Basis for Conclusion:**                                    |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+

F. [Job Creation: Combining "Held By" and "Available To"]{.underline}

10\.

+----------------------------------------------------------+-----------+
| If the activity is completed (no more jobs are expected  |           |
| to be created) and the 51 percent threshold was not met  |           |
| for either jobs held by, or made available to, low- and  |           |
| moderate-income persons, can the threshold be met by     |           |
| combining the number of jobs held by and made available  |           |
| to low- and moderate-income persons (taking care not to  |           |
| double count the jobs) on a permanent FTE basis in order |           |
| to meet the national objective?                          |           |
|                                                          |           |
| \[24 CFR 570.208(a)(4) and 24 CFR 570.506(b)(5)\]        |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

g\. [Job RetentioN]{.underline} (Note: If this option is not applicable,
skip to Section I.)

11\.

  ---------------------------------------------------------- ------------
  Did the program participant qualify the assisted activity  
  on the basis of job retention?                             

  **Describe Basis for Conclusion:**                         

                                                             
  ---------------------------------------------------------- ------------

12\.

  -----------------------------------------------------------------------
  Provide the month and year that the CDBG assistance was first provided
  to this activity.

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

13\.

  -----------------------------------------------------------------------
  a\. What evidence does the business have to show that jobs would have
  been lost without the CDBG assistance?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

+----------------------------------------------------------+-----------+
| b.  Does this evidence clearly and objectively show that |           |
|     jobs would have been lost without CDBG assistance?   |           |
|                                                          |           |
|     \[24 CFR 570.208(a)(4)(ii) and 24 CFR                |           |
|     570.506(b)(6)(i)\]                                   |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

14\.

+-----------------------------------------------------------------------+
| How many FTE permanent jobs were retained?                            |
|                                                                       |
|                                                                       |
+-----------------------------------------------------------------------+
| **Describe Basis for Conclusion:**                                    |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+

15\.

+------------------------------------------------------------+---------+
| a\. Is there documentation for each assisted business that |         |
| lists the job title of the permanent jobs retained         |         |
| (including which jobs are part-time) and which jobs are    |         |
| held by low- and moderate-income persons (where it is      |         |
| known) at the time CDBG assistance was provided?           |         |
|                                                            |         |
| \[24 CFR 570.506(b)(6)(ii)\]                               |         |
+------------------------------------------------------------+---------+
| **Describe Basis for Conclusion:**                         |         |
+------------------------------------------------------------+---------+
|                                                            |         |
+------------------------------------------------------------+---------+

+----------------------------------------------------------+-----------+
| b\. Is there documentation as to which of the retained   |           |
| jobs are projected to become available to low- and       |           |
| moderate-income persons through job turnover within two  |           |
| years of the CDBG assistance being provided?             |           |
|                                                          |           |
| \[24 CFR 570.506(b)(6)(ii)\]                             |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+-----------------------------------------------------------------------+
| c\. What is the basis for the job turnover projections?               |
|                                                                       |
| \[24 CFR 570.506(b)(6)(ii)\]                                          |
+-----------------------------------------------------------------------+
| **Describe Basis for Conclusion:**                                    |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+

16\.

+----------------------------------------------------------+-----------+
| a.  Where jobs will be filled through job turnover, is   |           |
|     there documentation that lists, by job title:        |           |
|                                                          |           |
|     -   the permanent jobs;                              |           |
|                                                          |           |
|     -   which jobs, if any, were part-time;              |           |
|                                                          |           |
|     -   which jobs required special skills or education; |           |
|         and                                              |           |
|                                                          |           |
|     -   which of those jobs were made available to       |           |
|         low-and moderate-income persons?                 |           |
|                                                          |           |
|         NOTE: If the business is not using job turnover  |           |
|         to qualify the activity, skip to question 17.    |           |
|                                                          |           |
|         \[24 CFR 570.506(b)(6)(iv)\]                     |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| b.  Where jobs will be filled through job turnover, is   |           |
|     there documentation of how first consideration was   |           |
|     given to low- and moderate-income persons that       |           |
|     includes:                                            |           |
|                                                          |           |
|     -   what hiring process was used;                    |           |
|                                                          |           |
|     -   which low- and moderate-income persons were      |           |
|         interviewed for a particular job; and            |           |
|                                                          |           |
|     -   which low- and moderate-income persons were      |           |
|         hired?                                           |           |
|                                                          |           |
|         \[24 CFR 570.506(b)(6)(iv)\]                     |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| c.  Is there documentation, where jobs were filled       |           |
|     through job turnover, that lists:                    |           |
|                                                          |           |
|     -   each job *turned* *over* as of the date of this  |           |
|         monitoring;                                      |           |
|                                                          |           |
|     -   how first consideration was given to low- and    |           |
|         moderate-income persons; and                     |           |
|                                                          |           |
|     -   which of those jobs were either taken by, or     |           |
|         made available to, low- and moderate-income      |           |
|         persons?                                         |           |
|                                                          |           |
|         \[24 CFR 570.506(b)(6)(v)\]                      |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

17\.

+-----------------------------------------------------+----------------+
| a\. Of the jobs retained per question 14, were at   |                |
| least 51 percent held by low- and moderate-income   |                |
| persons on a permanent FTE basis at the time the    |                |
| CDBG assistance was first provided? (Include        |                |
| percentage in "Basis for Conclusion" below.)        |                |
|                                                     |                |
| \[24 CFR 570.208(a)(4)(ii)\]                        |                |
+-----------------------------------------------------+----------------+
| **Describe Basis for Conclusion:**                  |                |
+-----------------------------------------------------+----------------+
|                                                     |                |
+-----------------------------------------------------+----------------+

+-----------------------------------------------------+----------------+
| b\. Is there documentation showing, for each low-   |                |
| and moderate-income job retained, the size and      |                |
| annual income of the person's family at the time    |                |
| the job was proposed to be retained?                |                |
|                                                     |                |
| \[24 CFR 570.506(b)(6)(iii) or 24 CFR               |                |
| 570.506(b)(7)\]                                     |                |
+-----------------------------------------------------+----------------+
| **Describe Basis for Conclusion:**                  |                |
+-----------------------------------------------------+----------------+
|                                                     |                |
+-----------------------------------------------------+----------------+

+-----------------------------------------------------+----------------+
| c\. If the answer to "b" above is "no" or "N/A," is |                |
| there documentation showing a presumed benefit was  |                |
| used, based on the census tract where the person    |                |
| resides or where the business is located?           |                |
|                                                     |                |
| \[24 CFR 570.208(a)(4)(iv)(A) and/or (B)\]          |                |
+-----------------------------------------------------+----------------+
| **Describe Basis for Conclusion:**                  |                |
+-----------------------------------------------------+----------------+
|                                                     |                |
+-----------------------------------------------------+----------------+

+-----------------------------------------------------+----------------+
| d\. Were the correct Section 8 income limits for    |                |
| family size and income used at the time the CDBG    |                |
| assistance was first provided **OR** is there       |                |
| documentation showing the person may be presumed to |                |
| be low and moderate income based on the census      |                |
| tract criteria set forth at 24 CFR                  |                |
| 570.208(a)(4)(v), as applicable?                    |                |
|                                                     |                |
| \[24 CFR 570.3 or 24 CFR 570.506(b) and (7)\]       |                |
+-----------------------------------------------------+----------------+
| **Describe Basis for Conclusion:**                  |                |
+-----------------------------------------------------+----------------+
|                                                     |                |
+-----------------------------------------------------+----------------+

H. [If Two or More Years Have Elapsed Since the Provision of CDBG
Assistance for Retained Jobs]{.underline}

18\.

  -----------------------------------------------------------------------
  a\. How many retained jobs have turned over?

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

  -----------------------------------------------------------------------
  b\. Of the jobs listed in "a" above, were steps taken, per the written
  agreement, to ensure they were made available to low- and
  moderate-income persons on a permanent FTE basis during the two-year
  period? (Exclude those jobs held by low- and moderate-income persons
  when the CDBG assistance was first provided, as shown in question
  "17.a." above.)\
  \[24 CFR 570.506(b)(6)(ii)\]

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

+----------------------------------------------------------+-----------+
| c\. Was the 51 percent requirement met?                  |           |
|                                                          |           |
| \[24 CFR 570.208(a)(4)(ii)(A) and (B) and 24 CFR         |           |
| 570.506(b)(6)(ii)\]                                      |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| d.  Is there documentation showing, for each low- and    |           |
|     moderate-income person retained, the size and annual |           |
|     income of the person's family prior to the person    |           |
|     being hired for the job **OR** is there              |           |
|     documentation showing a presumed benefit was used,   |           |
|     based on the census tract where the person resides   |           |
|     or the business is located per 24 CFR                |           |
|     570.208(a)(4)(iv)(A) and/or (B)?                     |           |
|                                                          |           |
|     \[24 CFR 570.506(b)(6)(iii) or 24 CFR 570.506(b)(1)  |           |
|     or (7)\]                                             |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

+----------------------------------------------------------+-----------+
| e\. Were the correct Section 8 income limits for the     |           |
| family applied at the time the low- and moderate-income  |           |
| person was retained **OR** was the person presumed to be |           |
| low and moderate income based on the census tract        |           |
| criteria set forth at 24 CFR 570.208(a)(4)(v), as        |           |
| applicable?                                              |           |
|                                                          |           |
| \[24 CFR 570.3 or 24 CFR 570.506(b)(7)\]                 |           |
+----------------------------------------------------------+-----------+
| **Describe Basis for Conclusion:**                       |           |
+----------------------------------------------------------+-----------+
|                                                          |           |
+----------------------------------------------------------+-----------+

I. [If Less than Two Years Have Elapsed Since the Provision of CDBG
Assistance for Retained Jobs]{.underline}

19\.

  -----------------------------------------------------------------------
  a\. How many of the retained jobs (excluding those known to be held by
  low- and moderate-income persons at the time CDBG assistance was first
  provided, as shown in question "17.a.") are projected to become
  available to low- and moderate-income persons through job turnover
  within two years of the time the CDBG assistance was provided?\
  \[24 CFR 570.506(b)(6)(ii)\]

  **Describe Basis for Conclusion:**

       
  -----------------------------------------------------------------------

  ------------------------------------------------------------- ---------
  b\. Does the projected amount appear to be reasonable?        

  **Describe Basis for Conclusion:**                            

                                                                
  ------------------------------------------------------------- ---------

J. [Report Validation]{.underline}

20\.

+------------------------------------------------------------+---------+
| Did your review of the records validate the information    |         |
| and number of jobs provided by the program participant in  |         |
| the Integrated Disbursements and Information System (IDIS) |         |
| and/or the most recently completed (or applicable)         |         |
| Consolidated Annual Performance and Evaluation Reports?    |         |
|                                                            |         |
| \[24 CFR 91.520(c) and 91.525(a)(3)\]                      |         |
+------------------------------------------------------------+---------+
| **Describe Basis for Conclusion:**                         |         |
+------------------------------------------------------------+---------+
|                                                            |         |
+------------------------------------------------------------+---------+