new york state division of housing and … · new york state division of housing and ... %...

33
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 RENEWAL Neighborhood and Rural Preservation Companies ANNUAL PERFORMANCE REPORT Directions: 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: / / / /

Upload: lamtruc

Post on 19-Jul-2018

217 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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:/ / / /

initiator:[email protected];wfState:distributed;wfType:email;workflowId:1c4537b63e749f499cb653c470a95830
Page 2: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 3: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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).

Page 5: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 6: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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.

Page 7: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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 $

Page 9: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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).

Page 10: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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.

Page 11: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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.

Page 12: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 13: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 14: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 15: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 16: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 17: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 18: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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.

Page 19: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 20: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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.

Page 21: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 22: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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.

Page 23: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 24: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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:

Page 25: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 26: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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:

Page 27: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 28: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 29: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 30: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 31: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 32: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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

Page 33: NEW YORK STATE DIVISION OF HOUSING AND … · NEW YORK STATE DIVISION OF HOUSING AND ... % completed. Total Projects to ... Please use the space below to elaborate on work completed

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):