Section 3 Worker and Targeted Section 3 Worker Employer Certification

MDHA – Section 3 Worker and Target Section 3 Worker Employer Certification

The purpose of MDHA’s Section 3 program is to provide employment, training and contracting opportunities to low-income individuals, particularly those who are recipients of government assistance for housing or other public assistance programs.

An employer may certify that their workers are Section 3 Workers or Targeted Section 3 Workers as defined in 24 CFR Part 75.

Employee Name	Enter Employee Name

Employee Address	Enter Employee Address

Company Name	Enter Company Name

Project Name	Enter Project Name

Project Location	Enter Project Location

A Section 3 Worker is any worker who currently fits or when hired within the last 5 years (since November 30, 2020) fit one of the following categories. Check all that apply.

☐ Worker’s income for the previous or annualized calendar year is below:

☐ $33,050	☐ $52,850

☐ Worker is employed by a Section 3 Business Concern.

☐ Worker is a YouthBuild Participant.

A Targeted Section 3 Worker must meet at least one of the following. Check all that apply.

☐ Worker is employed by a Section 3 Business Concern.

☐ Worker who currently fists or when hired within the last five years (since November 30, 2020) fit one of the following categories, as documented.

☐ Resident of Public Housing or Section 8 assisted housing

☐ Resident of other public projects or Section 8 assisted housing managed by the PHA that is providing assistance

☐ YouthBuild Participant

☐ Section 3 workers residing within the service area or the neighborhood of the project within a one-mile radius

Employer Attestation

I confirm that the statements on this form are accurate to the best of my knowledge and belief. I hereby certify, under penalty of law, that the following information in correct to best of my knowledge.

☐ I Agree

Date of Hire Enter Hire Date

This employee was hired because of the Section 3 project.

☐	Yes	☐	No

Employer Representative Name	Enter Employer Rep Name

By typing your name here, you are signing the document electronically. You agree that your electronic signature has the same legal validity and effect as your handwritten signature on the document, and that it has the same meaning as you handwritten signature.

Electronic Signature	Type Name Here

Today’s Date	Enter Today’s Date

If you are using another email service other than Outlook, you will need to save the document and email it to the following MDHA staff:

Angela Harrell	aharrell@nashville-mdha.org

Tina Meador	tmeador@nashville-mdha.org

LaSheakita Fayne	lfayne@nashville-mdha.org