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
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
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
Manufactured Home
Part B - Total Project Costs
Type activity financed (check one)
Rehabilitation Only
Acquisition Only
Acquisition & New Construction
New Construction Only
Acquisition & Rehabilitation
Total HOME Funds (sum of 1a + 1b + 1c)
HOME funds other than CHDO loans
CHDO Seed Loan
Total Public Funds (sum of 2a + 2b + 2c)
Other Federal funds
State/local appropriated funds
State/local tax exempt bond proceeds
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)


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