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1/1/2012 EXHIBIT A - Program Experience

Rental Assistance Administrator Application





Exhibit A - Program Experience

Please describe all housing program administration activates of the Administrator

Program partners, if Program status (ongoing,

Program Name Service Area Program Type any Population served # of households served Program budget Role in program temporary, complete)

1/1/2012 EXHIBIT B - Planned NEW Programs

Rental Assistance Administrator Application







Exhibit B - Planned NEW Programs, if any

Please describe any plans you have to expand your services to other programs, if any.

Est. # of households

Program Name Service Area Program Type Program partners, if any Population served served Role in program Anticipated Start Date

1/1/2012 EXHIBIT C - Program Experience 3

Rental Assistance Administrator Application







Exhibit C - Rental Assistance Budget Worksheet

Application Request Amount: $ -



Rental Assistance funds must be spent by no later than June 30, 2012. Applicants can apply for up to $600,000 in funds.



How to determine your application request:



There could be up to three different components making up the request: 1) rental assistance subsidy 2) housing related expenses, such as security

deposits 3) administrative fees. Complete the table below showing your estimated time to full utilization. Using the formula at the end of this

worksheet, calculate your estaimted Administrative Fees after you have determined the amount of rental assitance needed based on the totals of

the Average Subsidy columns for Single and Adults w/ Children and the Housing Related Expenese column.



Estimated monthly costs

# of Adults w/ Average Subsidy

# of Single children Total # of Average Subsidy Adults w/ Housing related

Month Households households households Singles children expenses Admin fee TOTAL

1 Sep-10 0

2 Oct-10 0

3 Nov-10 0

4 Dec-10 0

5 Jan-11 0

6 Feb-11 0

7 Mar-11 0

8 Apr-11 0

9 May-11 0

10 Jun-11 0

11 Jul-11 0

12 Aug-11 0

13 Sep-11 0

14 Oct-11 0

15 Nov-11 0

16 Dec-11 0

17 Jan-12 0

1/1/2012 EXHIBIT C - Program Experience 4

Rental Assistance Administrator Application







18 Feb-12 0

19 Mar-12 0

20 Apr-12 0

21 May-12 0

0

TOTAL 0 0 0 0 0 0 0 0





Administrative Fee Per Month = Total grant award * eligible percentatge / 21 months / # targeted households



% available for

# of households admin

0-10 8.0%

11-25 7.7%

26-50 7.6%

51-100 7.5%



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