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Get HHS-690 2019-2024

S.W. Washington D.C. 20201 Name of Healthcare Facility Receiving/Requesting Funding Street Address City State Zip Code Form HHS-690 3/2011. ASSURANCE OF COMPLIANCE REHABILITATION ACT OF 1973 TITLE IX OF THE EDUCATION AMENDMENTS OF 1972 AND THE AGE DISCRIMINATION ACT OF 1975 The Applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants loans contracts property discounts or other Federal financial assistance from the U.S. Department of Health and Human Services. THE APPLICANT HEREBY AGREES THAT IT WILL COMPLY WITH 1. Title VI of the Civil Rights Act of 1964 Pub. L* 88-352 as amended and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services 45 C. F*R* Part 80 to the end that in accordance with Title VI of that Act and the Regulation no person in the United States shall on the ground of race color or national origin be excluded from participation in be denied the benefits of or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department. 2. Section 504 of the Rehabilitation Act of 1973 Pub. L* 93-112 as amended and all requirements imposed by or pursuant to the his or her disability be excluded from participation in be denied the benefits of or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department. 3. Title IX of the Education Amendments of 1972 Pub. L* 92-318 as amended and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services 45 C. F*R* Part 86 to the end that in accordance with Title IX and the Regulation no person in the United States shall on the basis of sex be excluded from participation in be denied the benefits of or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Department. 4. The Age Discrimination Act of 1975 Pub. L* 94-135 as amended and all requirements imposed by or pursuant to the in or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department. and that it is binding upon the Applicant its successors transferees and assignees for the period during which such assistance is provided* If any real property or structure thereon is provided or improved with the aid of Federal financial assistance extended to the Applicant by the Department this assurance shall obligate the Applicant or in the case of any transfer of such property any transferee for the period during which the real property or structure is used for a purpose for which the Federal financial assistance is extended or for another purpose involving the provision of similar services or benefits. If any personal property is so provided this assurance shall obligate the Applicant for the period during which it retains ownership or possession of the property.

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