Form Number: HUD-92045

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Form Description:

This collection of information is required for HUD’s Assisted Living Conversion Program (ALCP). This program is
authorized under Section 522(c) of the Appropriations Act of 2000. The information is necessary to assist HUD in
determining applicant eligibility and ability to convert multifamily housing projects designated for the elderly (in whole or
in part) into assisted living facilities. A thorough evaluation of an applicant’s qualifications and capabilities is critical to
protect the Government’s financial interest and to mitigate any possibility of fraud, waste, or mismanagement of public
funds. This collection of information does not collect any sensitive information. HUD does not ensure confidentiality.


Download HUD-92045 Form