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Form Hud-40096-M - Multiple-Unit Homeownership Assistance Project Completion Report Form - U.s. Department Of Housing And Urban Development

U.S. Department of Housing

OMB Approval No. 2506-0171

Multiple-unit Homeownership

(exp.11/30/2001)

and Urban Development

Assistance Project Completion Report

Office of Community Planning

and Development

HOME Program

Cash and Management Information System

Public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions,

searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency

may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collecton displays a valid OMB control

number.

The HOME statute imposes a significant number of data collection and reporting requirements. This includes information on assisted properties, on the

owners or tenants of the properties, and on other programmatic areas. The information will be used: 1) to assist HOME participants in managing their

programs; 2) to track performance of participants in meeting fund commitment and expenditure deadlines; 3) to permit HUD to determine whether each

participant meets the HOME statutory income targeting and affordability requirements; and 4) to permit HUD to determine compliance with other statutory

and regulatory program requirements. This data collection is authorized under Title II of the Cranston-Gonzalez National Affordable Housing Act or related

authorities. Access to Federal grant funds is contingent on the reporting of certain project-specific data elements. Records of information collected will

be maintained by the recipients of the assistance. Information on activities and expenditures of grant funds is public information and is generally available

for disclosure. Recipients are responsible for ensuring confidentiality when public disclosure is not required.

Part A

1. Project number

2. Name of participant

3. Participant tax ID

4. CHDO tax ID

5. Name & phone number of person completing form

6. Type of property (check one)

1-4 SingleFamily

Condominium

Cooperative

Manufactured Home

(1)

(2)

(3)

(4)

Part B - Total Project Costs

Type activity financed (check one)

Rehabilitation Only

Acquisition Only

Acquisition & New Construction

(1)

(3)

(5)

New Construction Only

Acquisition & Rehabilitation

(2)

(4)

Total HOME Funds (sum of 1a + 1b + 1c)

HOME funds other than CHDO loans

(a)

CHDO TA Loan

(b)

CHDO Seed Loan

(c)

Total Public Funds (sum of 2a + 2b + 2c)

Other Federal funds

(a)

State/local appropriated funds

(b)

State/local tax exempt bond proceeds

(c)

Total Private Funds

Total HOME Program Income

Total Project Costs (total items 1 thru 4)

Page 1 of 4

form HUD-40096-M (6/93)

Form Hud-40096-M - Multiple-Unit Homeownership Assistance Project Completion Report Form - U.s. Department Of Housing And Urban Development

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