Date:	Click here to select date	9% LIHTC Board Approval Date: Click here to select date

Applicant Name: ________________________________________________________________

Development Name: _____________________________________________________________

Development Address: ___________________________________________________________

Total Development Cost: $ ____________________

Amount of 9% LIHTC Requested: $ ________________________

Application Self Score:	____________ CHFA Application Score: _______________

Did you request a debriefing?	☐Yes ☐ No

Please briefly describe your reassessment request:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The undersigned understands that: 1) the reassessment shall be conducted by Authority senior staff members, who were not directly involved in the evaluation of the application, 2) decisions regarding reassessments will be considered final, and will not be reconsidered. In the event that the application for reassessment is favorably revaluated the reassessment fee shall be fully refunded. At the discretion of the Authority’s Board of Directors, reassessments may result in a forward commitment of 9% LIHTCs in accordance with the current QAP and the policy objectives and administrative requirements of the Authority.

Signed:

_______________________________

Applicant Name	Title

Applicant Signature	Date