• AHC
• DHCR
• HFA
• HTFC
• MBBA
• MIF
• SONYMA
• TSFC

Division of Housing & Community Renewal

All Legislative Member Item Program (MIP) forms are available for download by award recipients. Forms are available in either PDF or OmniForm format. Please refer to the Legislative Member Item Program Manual for further information on each form.

Program Forms:

• Application Cover Pages (DHCR use only):

• Awards Up to and Including $25,000
• Awards $25,001 - $49,999
• Awards $50,000 and Over

• Application for Funds | Omniform file format

• Certificate of Hardship | Omniform file format

• Conflict of Interest Form (NPP/RPP/MIP)

• Disbursement Request Form for Contracts/Voucher Agreements over $25,000 | Omniform file format

• Standard Voucher | Omniform file format

• Final Report Forms:

• Final Report (for vouchers less than $50,000) | Omniform file format
• Final Report (for contracts $50,000 and over) | Omniform file format

Contract Documents:

• Contract: State of NY Agreement

• Contract Face Page | Word file format

• Contract Signature Page

• Appendix A: Standard Clauses for All New York State Contracts

• Appendix A-1 MIP: Agency-Specific Clauses - Member Item Program

• Appendix A1A: Additional Contract Language

• Appendix A2: Description of Neighborhood/Area Boundaries

• Appendix B: Budget

• Appendix C: Payment and Reporting Schedule

• Appendix D: Work Plan

• Appendix S: Vendor Responsilibilty Questionnaire

• Appendix X: Modification Agreement

• Certification Appendix under $50,000

• Certification Appendix $50,000 and Above

• Insurance Requirements

Last updated on 08/31/10