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 Rental Housing Project Compliance Report
 Grantee:                                                                                                  Funding in Project                          Yes/No
 Grant #                                                                                                   LIHTC                                        Y     N
 Project Name:                                                                                             USDA-RD (FmHA) 515                           Y     N
 Reporting Period: January 1 – December 31                                                                 USDA-RD 538                                  Y     N
                                                                                                           HUD 202/811                                  Y     N
                                                                                                           Other Project Based Rental Assistance        Y     N
 Total # units in project:                    # of these vacant 12/31                  Individual Completing Report:
 # Low HOME units:                            # of these vacant 12/31                  Organization:
 #High HOME units:                            # of these vacant 12/31                  Contact Information:
 Other HOME units:                            # of these vacant 12/31                  (If different than Reported for
 Total # HOME units:                          HOME units fixed or floating             Property Management or Grantee)

   A         B               C            D           E        F             G          H         I          J           K            L            M         N
 Unit    # Bed-       Low HOME,      Tenant Name      #      Tenant       Date        Intial   Lease    Tenant-        Total      Allowable    Allowable   PBR
  #      rooms        High HOME,                     in     Annual        Last        Occ.     Rent     paid         Rent Plus     Rent &      % AMI         A
                     Other HOME or                   Hs      Gross      Income          of              Utilities     Utilities    Utilities               (Y/N)
                     Non-HOME Unit                   hld    Income        Cert.       Unit?
                                                                                      (Y/N)




 Property Management Contact Information                                              Grantee Contact Information
 Contact Name:                                                                        Contact Name:
 Organization:                                                                        Organization:
 Address:                                                                             Address:

 Phone Number:                                                                        Phone Number:
 Fax Number:                                                                          Fax Number:
 Email Address:                                                                       Email Address:
 Attach Additional Sheets if Necessary                             Page          of


Revised February 22, 2011
                                                                            Instructions
                                                            Project Compliance Report: Rental Housing
                                                          Nebraska Department of Economic Development

      Funding in Project – Select Y next to the sources that contributed to any     C. Low HOME, High HOME, Other HOME or Non-HOME Unit – Low
       stage of the project. Select N next to the sources that have not                 HOME units are designated for households at or below 50% of the Area
       contributed to the project.                                                      Median Income (AMI). High HOME units are designated for households
     Grantee – Name of HOME Funds Recipient                                            at or below 80% of the AMI (see DED contract for further guidance – the
     Grant # – HOME Award Number                                                       project may be restricted to at or below 60% of the AMI). Other HOME
     Project Name – Name of Project                                                    units have specific income and rent limits outlined in the contract (recent
     Reporting Period – Enter the Year of the reporting period.                        grants may have Other HOME units designated). Non-HOME units are
       **Report on each tenant household that occupied a unit anytime during            units not assisted with HOME funds.
       the reporting period. The same unit number may appear on the report           D. Tenant Name – Name of the tenant in the unit.
       more than once.**                                                             E. # in Hshold – How many people live in the unit
     Total # units in project – Number of units in project. # Vacant 12/31 –        F. * Tenant Annual Gross Income – What is the annual gross income of
       Total number of units vacant on 12/31 of the current year reported.              the tenant household in the unit?
     # Low HOME units – Number of designated Low HOME units in project.             G. * Date Last Income Cert. - Date of last time the tenant’s income was
       # Vacant 12/31 – Number of designated Low HOME units vacant on                   certified.
       12/31 of the current year reported.                                           H. Initial Occ. Of Unit? (Y/N) – Is this tenant the first inhabitant of this unit?
                                                                                        Yes or No.
     # High HOME units – Number of designated High HOME units in project.
                                                                                     I. * Lease Rent – What the owner charges for renting the unit.
       # Vacant 12/31 – Number of designated High HOME units vacant on
                                                                                     J. * Tenant-paid Utilities – If tenant pays utilities, enter appropriate utility
       12/31 of the current year reported.
                                                                                        cost figure from the local Public Housing Authority utility allowance
     # Other HOME units (Other HOME Units are designated in more recent
                                                                                        worksheet or information obtained from utility providers. If utilities are
       HOME Grants) – Number of designated Other HOME units in project. #
                                                                                        included in rent, enter “incl.”
       Vacant 12/31 – Number of designated Other HOME units vacant on
                                                                                     K. * Total Rent Plus Utilities – The sum of the lease rent and tenant-paid
       12/31 of the current year reported.
                                                                                        utilities.
     Total # HOME units – Number of HOME-assisted units in project. #               L. * Allowable Rent & Utilities – Enter from the published HUD limits or
       Vacant 12/31 – Number of HOME-assisted units vacant on 12/31 of the              other sources for High, Low or Other HOME rent as applicable
       current year reported.                                                        M. Allowable % AMI – The maximum % of AMI at initial income certification
     HOME units fixed or floating – Are the HOME units designated as fixed             allowed for a tenant household to qualify for renting the unit.
       or floating?                                                                  N. * PBRA (Y/N) – Did the tenant receive project-based rental assistance
    A. Unit # – Apartment unit number. Include all units in project. The same           that requires them to pay no more than 30% of their income?
       unit number may appear on the report more than once if different tenants
       occupied the unit during the reporting period.
                                                                                              Contact Information – complete the fields to reflect the current
    B. # Bedrooms– How many bedrooms does the unit have?
                                                                                               contacts for this project.


    * These fields are not required for Non-HOME assisted units

    Contact Lynn Franzen (402)-471-3781 or lynn.franzen@nebraska.gov if you have questions.




Revised February 22, 2011

				
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