new york state division of housing and … · new york state division of housing and ... %...
TRANSCRIPT
ACTIVITIES Check Appropriate Work Plan Activities
Property Rehabilitation and Construction
Client Assistance
Community Renewal
Page 1 July 2012
NEW YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWALNeighborhood and Rural Preservation Companies
ANNUAL PERFORMANCE REPORTDirections: Please submit your Annual Performance Report via Internet E-mail no later than 60 days after completion of the contract program year to [email protected]. A printed and signed copy of Pg. 30 must be mailed to your Regional Representative within the same time frame. The information contained in your report will be included in DHCR's Annual Report to the Legislature, and your organizations's profile will be updated in DHCR's Affordable Housing Directory.
Check One:
Contract Program Year:
NPP RPP SHARS ID#:
Contract Number:
Date of Latest Approved Workplan:
to/ / // /
/ /
Company Name:
Mailing Address: City:
State: NY Zip Code: County:
Telephone Number: ( ) - ( ) -
Email Address (for publication on the AHD):
Internet Web Site (if applicable):
Executive Director:
Email Address (for Executive Director):
Contact Person, if other than E.D.: Title:
Email Address for Contact:
Employer ID#: Charitable Registration Number:
Board Chair:
Fax Number:
*Note - Please use 'Tab' key to move between fields.
Work Plan Activities: Please indicate the Work Plan activities for this contract from the latest approved Work Plan. The funds requested under this application are for the administration, planning, and implementation of the Work Plan activities checked below.
Date of Most Recent Needs Assessment: Date of Most Recent Strategic Plan:/ / / /
Company Name: SHARS ID#:
Service Area ProfilePlease visit DHCR's Affordable Housing Directory at http://nysdhcr.gov/ahd/ then click on "Community-Based Housing Organizations", and read the current profile for your organization. In the space below provide an updated profile of your organization or indicate, "No Changes". The profile should briefly describe your organization and the type of services provided to your service area.
If the needs of your community have changed since submitting the Application for Funding or current Work Plan, please describe them and how your program activities were modified to meet those needs. If not, please indicate "No Changes".
Page 2 July 2012
Company Name: SHARS ID#:
OWNER OCCUPIED %completedProperty Rehabilitation and Construction
# of 1-4 Unit Buildings/
Co-Ops(Latest Approved)
# of 1-4 Unit
Buildings/Co-Ops
# of Units at or Below 90% (Latest Approved)
# of Units at or Below 90%
(In Progress & Completed)
# of Units Above 90%
(Latest Approved)
# of Units Above 90% (In Progress &
Completed)
TotalUnits
Units In Progress
Units Completed
Total Units at or Below 90%(In Progress &
Completed)
Total Units Above 90%(In Progress &
Completed)
Minor Repair (Up to $5,000/unit)
Home Improvement ($5,001-$25,000)
Moderate Rehabilitation ($25,001-$75,000)
Substantial Rehabilitation (Over $75,000)
New Construction
TENANT %completedProperty Rehabilitation and Construction
Minor Repair (Up to $5,000/unit)
Home Improvement ($5,001-$25,000)
Moderate Rehabilitation ($25,001-$75,000)
Substantial Rehabilitation (Over $75,000)
New Construction
NON-RESIDENTIAL %completedProperty Rehabilitation and Construction
# of Units(Latest Approved)
# of Units
Units In Progress
Units Completed
# of Buildings # of Units
Capital Improvements (up to $25,000/unit)
Capital Improvements ($25,001-$75,000)
Capital Improvements (over $75,000)
New Construction
Exhibit A - Property Rehabilitation and Construction Activities
# of Owner Occupied Special Needs/Supportive Housing Units: # of Rental Special Needs/Supportive Housing Units:
# of Owner Occupied Buildings/Units placed on tax rolls: # of Rental Buildings/Units placed on tax rolls: Buildings: Units: Buildings: Units:
July 2012 Page 3
Preservation Program Contract Activities - Numbers of Units Assisted Activities Performed NOT Under N/RPP Contract
Page 4 July 2012
Company Name: SHARS ID#:
Please describe the tasks completed under Property Rehabilitation and Construction in pursuit of the outputs listed in Exhibit A on page 3. Appendix 1 lists some of the various tasks associated with Property Rehabilitation and Construction activities. In order to receive the appropriate credit for your work, please list all the tasks associated with your project(s). Category weighting based on percentage of allocation (both on this page and page 3) will serve as the basis for determining work plan completion.
% of Contract completed in Property Rehabilitation and Construction category.
% of Contract to be expended in Property Rehabilitation and Construction category (From Latest Approved Work plan).
Company Name: SHARS ID#:
Please list the goals in your Strategic Plan relating to Property Rehabilitation and Construction that your Company has addressed in your work plan. Please make sure to link your goals to your outputs and outcomes.
Page 5 July 2012
Company Name: SHARS ID#:
Page 6 July 2012
Workshops % completed# of Participants at or Below 90%(Latest Approved)
# of Participants at or Below 90%
# of Participants Above 90%
(Latest Approved)
# of Participants Above 90% TOTAL # of Households
at or Below 90%# of Households
Above 90%
First Time Homebuyer Workshops
Home Maintenance/Repair
Foreclosure/Mortgage Workshops
Tenant Education Workshops
Loan/Grant Availability Workshops
Affordable Housing Opportunity Workshops
Property Management % completed# of Participants at or Below 90%(Latest Approved)
# of Participants at or Below 90%
# of Participants Above 90%
(Latest Approved)
# of Participants Above 90% TOTAL # of Households
at or Below 90%# of Households
Above 90%
Units in Buildings Managed
Human Services Provided - List:
Linkages to Support Services Provided - List: (*Note)
Financial/Other Assistance (Individuals) % completed
# of Participants at or Below 90%(Latest Approved)
# of Participants at or Below 90%
# of Participants Above 90%
(Latest Approved)
# of Participants Above 90% TOTAL # of Households
at or Below 90%# of Households
Above 90%
Debt Consolidation/Credit Counseling
First Time Homebuyer AssistanceMortgage Restructuring/Foreclosure
Prevention CounselingMortgage/Grant Origination
Subsidy Assistance
Relocation Assistance
Eviction Prevention
Housing Court Assistance
New HomeownersTotal # of Loans (Latest Approved) Total # of Loans Total Loan(s) $
(Latest Approved)Total Loan(s)
Amount $
Provision of Loan Products for Individuals
Tenant Associations % completed# of Associations/
Meetings (Latest Approved)
# of Associations/Meetings
Total # of Members(Latest Approved)
Total # of Members
# of Associations/Meetings
Total # of Members
Tenant Associations Formed and/or Assisted
Tenant Association Workshops/Orientations
Exhibit B - Client Assistance
*NOTE - M.O.U. (Memorandum of Understanding) - Please check each box in the left column for every Preservation Program activity under 'Linkages to Support Services Provided' which will have a M.O.U. Please check each box on the right side for every NON-Preservation Program activity which will have a M.O.U.
Activities Performed NOT Under N/RPP ContractPreservation Program Contract Activities - Number of Units Assisted
Other:
M.O.U.
M.O.U.
M.O.U.
M.O.U.
July 2012
Company Name: SHARS ID#:
Page 7
% of Contract completed in Client Assistance category.
Please list the goals in your Strategic Plan relating to Client Assistance that your Company has addressed in your work plan. Link your goals to your outputs and outcomes. Category weighting based on percentage of allocation (both on this page and page 6) will serve as the basis for determining work plan completion.
% of Contract to be expended in Client Assistance category (From Latest Approved Work plan).
Page 8 July 2012
Company Name: SHARS ID#:
Exhibit C - Community RenewalActivities Performed NOT Under N/RPP
Contract
Assistance to Neighborhoods/Municipalities - Infrastructure % completed
Total Projects to be In Progress (Latest Approved)
Total Projects In Progress
Total Projects to be Completed
(Latest Approved)
Total ProjectsCompleted
Total Projects In Progress/Completed
Parks Built/Maintained
Sidewalks/Roads Built/Maintained
Street Lighting Installed/Enhanced
Open Space Maintenance
Waste Manage Systems Developed
Water Systems Developed
Assistance to Neighborhoods/Municipalities-Planning %completed Latest Approved TOTAL TOTALNeighborhood Plan/Municipal Plan/
Comprehensive Plan/Historic Preservation
Smart Growth Plan/Program
Land Use/Zoning Ordinance
Housing Study/Market Studies
Energy Savings/Green Building Initiatives
Marketing and Promotion of Neighborhood Assets
Assistance in Tourism or Other Community Revitalization Project
Assistance to Neighborhoods/Municipalities-Grants %completed Latest Approved TOTAL TOTAL
Number of Grant Applications to be Written
Number of Grant Applications to be Administered
Loan/Grant Assistance % completed Latest Approved TOTAL (Latest Approved) TOTAL TOTAL
Provision of Loan Products for Businesses
Assistance in Local Investment
Business Assistance % completed Latest Approved TOTAL TOTAL
Businesses Attracted
Businesses Retained
Formation of or Participation in Local Merchants Association
Crime Prevention %completed Latest Approved TOTAL TOTAL
Crime Watch Programs
Weed and Seed Programs
Block Clubs/Neighborhood Associations Formed/Sustained
Youth Programs (Number served)
Organizational Activities % completed Latest Approved TOTAL TOTALStaff/Board Development (Trainings/Conferences/Workshops)
Involvement with DHCR Activities
Preservation Program Contract Activities - Number of Projects Assisted
Other:
Other:
Total Loan(s) Amount $
Company Name: SHARS ID#:
Page 9 July 2012
Please describe the tasks completed under Community Renewal in pursuit of the outputs listed in Exhibit C on page 8. Appendix 2 lists some of the various tasks associated with Community Renewal activities. In order to receive the appropriate credit for your work, please list all the tasks associated with your community renewal activities. Category weighting based on percentage of allocation (both on this page and page 8) will serve as the basis for determining work plan completion.
% of Contract completed in Community Renewal category.
% of Contract to be expended in Community Renewal category (From Latest Approved Work plan).
Company Name: SHARS ID#:
Page 10 July 2012
Please list the goals in your Strategic Plan relating to Community Renewal that your Company has addressed in your work plan. Please make sure to link your goals to your outputs and outcomes.
Company Name: SHARS ID#:
Page 11 July 2012
Please use the space below as necessary to provide any additional information regarding your Work Plan activities. DHCR is particularly interested in activites/projects that have achieved success and may be replicable by other organizations.
Please use the space below to describe unique projects initiated by your company which may be highlighted by DHCR.
Please use the space below to elaborate on work completed outside the contract service area.
Company Name: SHARS ID#:
APPENDIX 1Property Rehabilitation and Construction Tasks
Capital Projects Tasks
The following tasks represent some of the generic tasks associated with the development of a capital project or a local program under the "Property Rehabilitation and Construction" category. You may add or delete tasks as appropriate. Any task, whether listed or not listed, is eligible to be included in calculating the percentage of time your organization is expending for specific activities.
Feasibility- Review waiting lists of area projects- Review market rents- Conduct feasibility study- Determine construction financing availability/sources of public subsidy- Determine need for relocation plan
Assemble Development Team- Project architect- Project contractor- Construction manager- Project engineer- Project consultant- Project attorney- Project accountant- Project syndicator- Market analyst- Managing agent
Site Control/Pre-Development- Find appropriate site(s)- Conduct title search- Complete survey - Complete soil borings- Receive appraisal- Obtain appropriate insurances
Local Approvals- Secure local zoning approval- Complete environmental reviews- Complete SHPO review- Determine the feasibility of tax abatements or PILOTs
Special Needs- Determine appropriate population to be served- Contact appropriate government agencies- Determine the availability of services for the population- Develop linkages to special needs providers- Develop Memorandum of Understanding(s)- Develop Housing Services Agreement- Develop Aging in Place Plan
Application- Develop development budgets - Develop operating budget- Develop rent plan- Develop relocation plan - Seek financing and investor commitments- Determine timetable for construction- Complete architectural concept plan- Complete marketing plan
Pre-Construction- Advertise for M/WBE- Establish HDFC, LLC, Limited Partnership or any entity required for application- Complete all bid documents- Develop marketing plan - Submit Affirmative Action plan
Page 12 July 2012
APPENDIX 1 (continued)Property Rehabilitation and Construction Tasks
Company Name: SHARS ID#:
Project Construction- Complete all contracts- Complete all subcontracts- File Davis Bacon documents- Submit progress payments requests (with required documentation)- Complete and deliver to funder any change orders- Supply "as-built" drawings- Final inspection- Submit final payment request (with required documentation)- Complete "punchlist" items - Submit M/WBE utilization plan - Develop marketing materials- Update title
Post-Construction- Register project on NYS Accessible Housing website - Obtain cost certification - Establish bank accounts (working capital, reserves, tenant security deposits, etc.)- Update title- Rent-up conference- Develop lease
Market Project- Conduct intakes- Select tenants- Certify prospective tenants- Establish waiting list- Submit appropriate reports
Local Program Tasks
Application/Pre-Development Phase (non-specific application)- Receive CHDO certification- Make organizational changes required for CHDO certification- Determine scope of unmet need in service area (type of application to submit)- Develop waiting lists- Identify waiting lists- Identify staff to operate program (development team)- Recruit qualified contractors, inspectors, lead risk assessors, energy auditors, etc.- Develop administrative plan- Write/submit application
Application/Pre-Development Phase (application specific)First-Time Homebuyer- Determine financing gap for available homes - Determine if available homes meet code/HTFC rehabilitation standards or need rehab prior to occupancy- Develop grant/loan limits and terms- If rehab work is needed, see "New Construction" tasks
Housing Rehab- Conduct windshield survey of target area- Conduct income/interest survey of occupants of substandard housing in target area- Identify sample pool of substandard home to determine average cost for rehab- Develop loan/grant limits and terms- Secure zoning/planning approval- Secure building permit
Tenant-Based Rental Assistance- Review Section 8 waiting list to determine the number of households that can be bridged onto Section 8 within a two-year timeframe. - Determine average amount of assistance needed to assist the planned number of beneficiary households
Page 13 July 2012
APPENDIX 1 (continued)Property Rehabilitation and Construction Tasks
Company Name: SHARS ID#:
New Construction- Identify building site(s)- Secure site control- Complete unit design- Secure zoning/planning approval- Secure building permit- Develop marketing plan- Secure construction financing commitment- Secure permanent financing commitment- Determine average amount of assistance needed to assist the planned number of beneficiary households
Implementation Phase (non-specific application)- Execute grant agreement/contract with funder- Complete environmental review, including SHOP signoff- Complete Release of Funds- Develop operating forms, books, and files- Canvass waiting list- Develop marketing materials to solicit applicants- Conduct intake- Close out project and submit required forms, liens, and/or security instruments
Implementation Phase (application specific)First-Time Homebuyer- Develop homebuyer education program- Begin education and counseling process- Assist applicants to find a home to purchase- Inspect home and prepare rehab specs - Put rehab work out to bid - Underwrite financing to qualify homebuyer for mortgage, grant, and secondary rehab loan financing- Assist applicant in working with bank on mortgage approval- Assist applicant on closing on loans and grants- Oversee rehab work - Submit liens and security instruments with closeout documents
Housing Rehab- Inspect home - Prepare rehab specs- Put rehab work out to bid- Underwrite financing to qualify homeowner for grant and secondary rehab loan if needed- Oversee rehab work- Submit liens and security instruments with closeout documents
Tenant-Based Rental Assistance- Develop master leases- Develop rental assistance agreements- Inspect apartments- Authorize rental assistance- Issue monthly rent payments- Certify tenant eligibility- Recertify tenant eligibility annually
New Construction- Underwrite financing to qualify homebuyer for mortgage, grant, etc.- Assist applicant in getting mortgage approval- Complete construction- Close on permanent financing- Submit liens and security instruments with closeout documents
Project Completion- Submit financial audit- Federal A-133 compliance and tracking
Page 14 July 2012
Company Name: SHARS ID#:
APPENDIX 2Community Renewal Tasks
Page 15 July 2012
The following tasks represent some of the generic tasks associated with the development of a capital project or a local program under the "Community Renewal" category. You may add or delete tasks as appropriate. Any task, whether listed or not listed, is eligible to be included in calculating the percentage of time your organization is expending for specific activities.
Pre-Application Phase - Determine need- Identify existing services and service providers- Determine service area- Determine service population (service area must be defined)- Determine scope of unmet need in service area (type of application to submit)- Determine income levels of service population (income survey vs. census data)- Identify staff to operate program/manage facilities (development team)- Develop administrative plan- Contact appropriate government agencies (permits and funding sources)
Feasibility- Determine cost for service/construction- Determine funding sources and the availability of funds.- Set timeline for project implementation
Application Phase (application specific) - Determine Eligibility- Conduct windshield survey of target area- Develop application- Develop project budget- Investigate other financial leveraging- Determine timetable for construction- Develop project budget- Investigate other financial leveraging- Determine timetable for construction
Site Control- Find appropriate site(s)- Conduct title search- Complete survey- Receive appraisal where purchase involved- Obtain appropriate insurances- Secure necessary rights-of-way
Development Team- Project architect- Project contractor- Construction manager- Project engineer- Project consultant- Project attorney- Project accountant- Labor compliance officer
Construction Planning- Develop facility/project design- Determine costs and identify all sources of funds.- Obtain commitments/agreements for program management/operation- Initiate zoning/planning/special district formation approval and other approvals needed and initiate approval processes- Develop outreach plan for service population- Determine if other resources needed for service population to access new facilities- Secure additional financing/funding commitments
Implementation Phase - Set-up appropriate project files- Execute grant agreements/contracts with funders- Initiate procurement process to secure engineering/architectural/administrative assistance- Complete environmental review and corresponding approvals- Complete facility design- Meet with construction management team: construction manager; project engineer; labor compliance officer; on-site inspector; etc.- Set-up operating forms, books, and files
Company Name: SHARS ID#:
APPENDIX 2 (continued)Community Renewal Tasks
- Secure labor compliance/wage rate information- Initiate procurement process for project contractor(s)- Develop marketing materials for service population- Review and award contracts for construction
Pre-Construction- Hold pre-construction meeting- Ensure compliance with all procurement standards- Ensure Labor Standards compliance for bidding (Davis-Bacon, NYS Labor rates, etc.)- Include M/WBE in bidding process and compliance with required CDBG Contract Provisions, Exhibit 4-1- Ensure appropriate/necessary legal/regulatory clauses included in proposed and final bid documents and contracts
Project Construction- Complete all bid documents- Complete all contracts- Complete all subcontracts- File Davis Bacon documents- Oversee construction/management of project- Submit progress payments requests (with required documentation)- Comply with requirements of all funding sources- Conduct final inspection- Complete "punchlist" items
Post-Construction- Establish service- Document use of new/upgraded facilities by service population- File final closeout reports
Page 16 July 2012
Company Name: SHARS ID#:
July 2012
Total Salaries
Program Year 07/01/2009 to 06/30/2010
Total # Agency Staff: Total # Preservation Staff:
Page 17
TOTAL SALARIES Label
(A)
Staff PersonName/Title
(B)
Weekly Hours Worked on
N/RPC ContractActual
N/RPP OnlyTotal Agency
Salary
(C)Annual Salary
Company Name: SHARS ID#:
July 2012
BUDGET TO ACTUAL
Program Year 07/01/2009 to 06/30/2010
Total Salaries
Total Fringe Benefits
Total Personnel Services
Regulated Other Than Personnel Services (OTPS)
Insurance/Bonding
Professional Services: Certified Financial Report
Agency Audit
Legal
Equipment
Total Regulated OTPSGeneral Other Than Personnel Services (OTPS)
Rent/Mortgage/Utilities
Telephone
Office Supplies
Printing/Postage
Travel
Staff Development/Training
Service Agreements & Maintenance
Bank Charges (not interest)
Other:
Total General OTPS
TOTAL BUDGET
What is your organization's total annual administrative budget?
(A)
Item
(B)NPC/RPC
Budget Contract
(C)Actual NPC/RPC
Expenditures
Other:
Other:
Page 18
*NOTE: Please provide line item detail for General Other Than Personnel Services. While line item detail for this current program year might not exceed $5,000, the three year total may exceed $5,000.
Company Name: SHARS ID#:
July 2012
Total Salaries
Program Year 07/01/2010 to 06/30/2011
Total # Agency Staff: Total # Preservation Staff:
Page 19
TOTAL SALARIES Label
(A)
Staff PersonName/Title
(B)
Weekly Hours Worked on
N/RPC ContractActual
N/RPP OnlyTotal Agency
Salary
(C)Annual Salary
Company Name: SHARS ID#:
July 2012
BUDGET TO ACTUAL
Program Year 07/01/2010 to 06/30/2011
What is your organization's total annual administrative budget?
Page 20
Total Salaries
Total Fringe Benefits
Total Personnel Services
Regulated Other Than Personnel Services (OTPS)
Insurance/Bonding Insurance/Bonding
Professional Services: Certified Financial Report
Agency Audit
Legal
Equipment
Total Regulated OTPSGeneral Other Than Personnel Services (OTPS)
Rent/Mortgage/Utilities
Telephone
Office Supplies
Printing/Postage
Travel
Staff Development/Training
Service Agreements & Maintenance
Bank Charges (not interest)
Total General OTPS
TOTAL BUDGET
(A)
Item
(B)NPC/RPC
Budget Contract
(C)Actual NPC/RPC
Expenditures
Other:
Other:
Other:
*NOTE: Please provide line item detail for General Other Than Personnel Services. While line item detail for this current program year might not exceed $5,000, the three year total may exceed $5,000.
Company Name: SHARS ID#:
July 2012
Total Salaries
Program Year 07/01/2011 to 06/30/2012
Total # Agency Staff: Total # Preservation Staff:
Page 21
TOTAL SALARIES Label
(A)
Staff PersonName/Title
(B)
Weekly Hours Worked on
N/RPC ContractActual
N/RPP OnlyTotal Agency
Salary
(C)Annual Salary
Company Name: SHARS ID#:
July 2012
BUDGET TO ACTUAL
Program Year 07/01/2011 to 06/30/2012
What is your organization's total annual administrative budget?
Page 22
Total Salaries
Total Fringe Benefits
Total Personnel Services
Regulated Other Than Personnel Services (OTPS)
Insurance/Bonding Insurance/Bonding
Professional Services: Certified Financial Report
Agency Audit
Legal
Equipment
Total Regulated OTPSGeneral Other Than Personnel Services (OTPS)
Rent/Mortgage/Utilities
Telephone
Office Supplies
Printing/Postage
Travel
Staff Development/Training
Service Agreements & Maintenance
Bank Charges (not interest)
Total General OTPS
TOTAL BUDGET
(A)
Item
(B)NPC/RPC
Budget Contract
(C)Actual NPC/RPC
Expenditures
Other:
Other:
Other:
*NOTE: Please provide line item detail for General Other Than Personnel Services. While line item detail for this current program year might not exceed $5,000, the three year total may exceed $5,000.
Company Name: SHARS ID#:
July 2012 Page 23
TOTAL EXPENDITURES
Contract Term:
Item Expenditure
Total Salaries Total Salaries
Total Fringe Benefits
Total Personnel ServicesRegulated Other Than Personnel Services (OTPS)
Insurance/Bonding
Professional Services: Certified Financial Report
Agency Audit
Equipment
Total Regulated OTPSGeneral Other Then Personnel Services (OTPS)
Rent/Mortgage/Utilities
Telephone
Office Supplies
Printing/Postage
Travel
Staff Development/Training
Service Agreements & Maintenance
Bank Charges (not interest)
Total General OTPSTOTAL BUDGET
Other:
Other:
Legal
Other:
07/01/2009 to 06/30/2012
Company Name: SHARS ID#:
July 2012 Page 24
Funding Sources (Match and Leveraged)
Program Year / / to / /
Agency/Program Name Administrative Non-Administrative Affordable Home Ownership Development Program (AHC)
Affordable Rental Housing Program
Homeless Housing Assistance Program (HHAP)
Homeless Prevention Program
Homeless Rehousing Assistance Program
Housing Shelter Allowance
Housing Opportunities for Persons with AIDS (HOPWA)
Housing Trust Fund (HTF)
Legislative Member Item Program (MI)
Main Street New York
RESTORE
Rural Area Revitalization Program (RARP)
Rural Rental Assistance Program (RRAP)
Urban Initiatives (UI)
Access To Home
TOTAL STATE
STATE AMOUNT LEVERAGEDAMOUNT OF MATCH
Other:
Company Name: SHARS ID#:
July 2012 Page 25
Funding Sources (Match and Leveraged)
Agency/Program Name Administrative Non-Administrative
CDBG
Community Service Block Grant
Rural Housing Services 502 (FMHA)
Rural Housing Services 504
Rural Housing Services 514/516
Rural Housing Services 515
Rural Housing Services 533
Federal Home Administration
HEAP
HOME
HOPE
HUD 202
Low Income Housing Tax Credits
Section 8 Voucher Program
Section 8 Construction
Section 8 Moderate Rehabilitation
Weatherization Assistance Program
TOTAL FEDERAL
Other:
FEDERAL AMOUNT OF MATCH AMOUNT LEVERAGED
Company Name: SHARS ID#:
July 2012 Page 26
Funding Sources (Match and Leveraged)
Agency/Program Name Administrative Non-Administrative
Municipal Program
Permanent Housing for Homeless
Other:
TOTAL LOCAL
LOCAL AMOUNT OF MATCH AMOUNT LEVERAGED
Agency/Program Name Administrative Non-Administrative
Building Revenue (Management Fees)
Equity and Developers Fees
Individual Fundraisers
Foundations/Corporate Contributions
Local Utility (NYSEG, NIMO, ConEd, etc.)
TOTAL PRIVATE
PRIVATE AMOUNT OF MATCH AMOUNT LEVERAGED
Other:
Bank, Identify:
Company Name: SHARS ID#:
July 2012 Page 27
Funding Sources (Match and Leveraged)
Agency/Program Name Administrative Non-Administrative
Personnel Services
Other than Personnel Services
TOTAL IN-KIND
Identify:
Identify:
Please describe the in-kind source including the method for determining the dollar value associated with the service.
IN-KIND AMOUNT OF MATCH AMOUNT LEVERAGED
Funding SourceAdministrative Non-Administrative
Total Leverage Source Total
State
Federal
Private
Local
In-Kind
GRAND TOTAL
TOTAL MATCH
Company Name: SHARS ID#:
July 2012
BOARD ROSTERName: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Page 28
Company Name: SHARS ID#:
July 2012
BOARD ROSTER (continued)Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Page 29
Company Name: SHARS ID#:
July 2012
BOARD ROSTER (continued)Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Page 30
Company Name: SHARS ID#:
July 2012
BOARD ROSTER (continued)Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Page 31
Company Name: SHARS ID#:
July 2012
BOARD ROSTER (continued)Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Name: Occupation:
Home Address:
State: Zip Code: Home Telephone Number:
Board Title: Initial Date Elected to Board:
Resident of Neighborhood: Yes No
( ) -
/ /
Page 32
Company Name: SHARS ID#:
July 2012
Company Certification of Annual Report
I certify that all information contained in this report is true and accurate and that is in compliance with Article XVI or XVII of the Private Housing Finance Law, the Rules and Regulations of Article XVI or XVII and the N/RPP Manual.
Signature Executive Director:
Signature Board Chair:
Date:
Date:
/ /
//
Page 33
FOR DHCR USE ONLY
DHCR Authorization
Directions: After the Regional Office has reviewed the Annual Report and verified the accuracy of the original submission or the accuracy of corrected data, authorization to include the data in the Annual Report to the Legislature must be sent to Local Programs at Hampton Plaza.
Reviewer's Comments:
Reviewer's Name:
Company has substantially completed work plan: Yes No
Company's Board of Directors is in compliance: Yes No
Company has met 1/3 match requirement: Yes No
Company's activities have had impact on community's needs: Yes No
Total % of work plan completed (Must complete 80% of work plan):