Form Hud-40070 - Annual Performance Report January 2004

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U.S. Department of Housing
Rental Rehabilitation Program
OMB Approval No. 2506-0080
(exp. 01/31/2004)
and Urban Development
Annual Performance Report
Office of Community Planning
and Development
See Public Reporting Burden Statement on back
This form is intended to collect numeric data to be aggregated nationally as a complement to data collected through the Cash and Management
Information (C/MI) System. Grantees should enter the reporting period in the first block. The reporting period should be August 1 to July 31.
Instructions are included for each section if further explanation is needed.
This report is for period: ( mm/dd/yy )
Date Submitted:
Rental Rehabilitation Program, Rm 7174
Submit this form on or before August 31.
Starting:
Ending:
451 7th St. S.W.
Send one copy to the appropriate HUD
Field Office and one copy to:
Washington, D.C. 20410
1. Grantee Number
2. Grantee Name
Part A: Grantee Identification
R X X
3. Name of Person Completing Report
4. Phone No., (Include Area Code)
5. Address
6. City
7. State
8. Zip Code
Enter in block 1 the amount of income generated from RRP projects during the reporting period. In blocks 2 and 2a., enter
Part B: Program Income
the number of projects and units completed during the reporting period with program income as the only RRP subsidy and
not reported in the C/MI System. Note: Attach a project Completion Report for each project indicated.
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1. Amount Generated During
2 . Number of Projects
2 a. Number of Units
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
Reporting Period
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
Part C: Minority Business
In 1a and 2a, below, indicate the total dollar value of the rehabilitation work, not just the RRP amount. The numbers should
reflect only those contracts for projects completed during the reporting period.
Enterprises (MBE) and
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
Women Business
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1. Total Program Contracts
1a. Dollar Value
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
Enterprises (WBE)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
$
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
2. MBE / WBE Contracts
2a. Dollar Value
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
$
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
3. Percent of Contracts MBE / WBE
3a. Percent of Dollars MBE / WBE
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
%
%
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
Part D: Minority Property
In 1a and 2a, below, indicate the total dollar value of the rehabilitation work, not just the RRP amount. The numbers should
reflect only those contracts for projects completed during the reporting period.
Owners
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1. Total Number of Property Owners
1a. Total Rehab Cost
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
$
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
2. Number of Minority Property Owners
2a. Total Rehab Cost
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
$
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
3. Percent Minority Owners
3a. Percent of Rehab Cost to Minority Owners
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
%
%
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
For all projects completed during the reporting period, indicate in column 1 the total number of units completed and in column
Part E: Displacement and
2 the total number of households (families or individuals) occupying the completed units prior to rehabilitation. Of the
Relocation
households indicated in column 2, enter in column 3 the number occupying units after rehabilitation. In column 4, enter the
number of households no longer occupying a unit but not displaced (e. g. moved voluntarily). And in column 5, enter the
number of households displaced. Please include in your narrative statement an explanation for all households indicated
in columns 4 and 5. Also, please give an explanation in the narative statement for any businesses displaced.
1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2
1
2
3
4
5
1 2 3 4 5 6 7 8 9 0 1 2
Units
Households
Households
Households
Households
1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2
Completed
In Residence
In Residence
No Longer In
Displaced
1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2
Prior to Rehabilitation After Rehabilitation Residence but who
1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2
are not Displaced
Dwelling Units
form HUD-40070 (9/90)

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