Form Hud-40094 - Homeownership Assistance/ Rental Housing Project Set-Up Report Page 2
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2Part C: Household Characteristics.
Complete one line for each unit to be assisted with HOME funds. Enter one code only in each block. If project
is a 2-4 unit owner occupied project with rental units, provide household characteristics for each occupied unit. For projects which include multiple addresses,
complete a separate Household Characteristics (Part C) for each address. Note: Do not complete for new construction projects.
Project Address
Project Number
Monthly Rent
Income Data
Household Data
(including Tenant Paid Utilities)
Unit
No. of
Tenant
Subsidy
Monthly Gross
% of Area Race/Ethnicity of
Size of
Type of
Rental
No.
Bedrooms
Occupancy Contribution
Amount
Total Rent
Income
Median
Head of Household Household
Household
Assistance
No. of Bedrooms
Occupancy Code
Race/Ethnicity of Head of
Size of Household
Type of Household Code
Rental Assistance Code
Code
1 - Tenant
Household Code
Code
1 - Single/non-Elderly
1 - Section 8
0 - 0 Bedroom
2 - Owner
1 - White (non-Hispanic)
1 - 1 Person
2 - Elderly
2 - HOME TBA
1 - 1 Bedroom
9 - Vacant
2 - Black (non-Hispanic)
2 - 2 Persons
3 - Related/Single
3 - Other
2 - 2 Bedrooms
3 - Native Amer.
3 - 3 Persons
Parent
4 - NoAssistance
% of Area Median
3 - 3 Bedrooms
4 - Asian/Pacific Islander
4 - 4 Persons
4 - Related/
9 - Vacant unit
4 - 4 Bedrooms
Code
5 - Hispanic (all races)
5 - 5 Persons
Two Parent
5 - 5 or more
1 -
0 - 30%
9 - Vacant unit
6 - 6 Persons
5 - Other
Bedrooms
2 - 30 - 50%
7 - 7 Persons
9 - Vacant unit
3 - 50 - 60%
8 - 8 or more
4 - 60 - 80%
Persons
9 - Vacant unit
9- Vacant unit
form HUD-40094 (12/92)
Page 2 of 4
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