Instructions For Completing The State Designation Of State Recipients, Form Hud-40100
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1Public reporting burden for this collection of information is estimated to average 0.5 hour 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 number.
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.
Instructions for Completing the State Designation of State Recipients, form HUD-40100
HOME Program Cash & Management Information System
Allocation” column, enter the total amount of funds allocated to the
Read the instructions for each item before completing the form. Use a
recipient from this fiscal year source of funds after this action (previous
typewriter or print with a ball point pen. Prepare an original and one copy.
allocation plus or minus this action).
Mail the original to: HOME Program, P.O. Box 23997, L’Enfant Plaza
Station, Washington, DC 20026. Retain the copy.
Project Funds. Of the amount indicated on the “Total Allocation” line,
enter the amount of funds, if any, that are allocated to the recipient for
Applicability. The State Designation of State Recipients (HUD-40100)
projects (for costs except for administration costs, CHDO operating
form is only for State designation of State Recipients (units of general
expenses, and CHDO reallocation funds). If this is the recipient’s initial
local government to which the State allocates a portion of its HOME funds
allocation from this fiscal year source of funds, the amount previously
in accordance with 24 CFR 92.201(b)(2)). This form must be completed
allocated will be “0.” In the “This Action” column, enter the amount of
by each State participating jurisdiction that wishes to designate State
funds, if any, that are being added to (+) or taken from (-) the State
recipients to receive HOME Program funds. The form is to include funds
recipient’s allocation by this action that are project funds. In the “Revised
from one fiscal year only. If a State wishes to provide funds to a State
Allocation” column, enter the amount of project funds allocated to the
recipient from two different fiscal year sources of funds (e.g., 1992 and
recipient after this action from this fiscal year source of funds (previous
1993), a separate form must be used. The form is to be completed as follows:
allocation plus or minus this action).
Name and Address of State. Enter the name and address of the State
Administration Funds. Of the amount indicated on the “Total Alloca-
participating jurisdiction.
tion” line, enter the amount of funds, if any, that are for program
Type of Submission. Mark the appropriate box.
administration (for costs of administering the HOME Program). If this is
State Participant Number. Enter the State’s Participant Number as-
the recipient’s initial allocation from this fiscal year source of funds, the
signed by HUD in block 2 of the HOME Investment Partnership Agree-
amount previously allocated will be “0.” In the “This Action” column,
ment (HUD-40093).
enter the amount of funds, if any, that are being added to (+) or taken from
State Tax Identification Number. Enter the State’s Tax (Employer)
(-) the recipient’s allocation by this action that are program administration
Identification Number from block 3 of the HUD-40093.
funds. In the “Revised Allocation” column, enter the amount of funds
allocated to the recipient for program administration from this fiscal year
Name and Address of Recipient. Enter the name and address of each unit
source of funds after this action (previous allocation plus or minus this action).
of local government designated by the State to receive HOME Program funds.
CHDO Operating Expenses. Of the amount indicated on the “Total
Recipient Number. Enter the recipient number assigned by the State for
Allocation” line, enter the amount of funds, if any, that are allocated for
each State recipient. Note: See instructions for designating numbers in
operating expenses for CHDOs. If this is the recipient’s initial allocation
Attachment E to CPD Notice 92-18 (or its successor) entitled Cash and
from this fiscal year source of funds, the amount previously allocated will
Management Information System for the HOME Program.
be “0.” In the “This Action” column, enter the amount of funds, if any,
Recipient Tax Identification Number.
Enter the Tax (Employer)
that are being added to (+) or taken from (-) the recipient’s allocation by
Identification Number for each State recipient.
this action for CHDO operating expenses. In the “Revised Allocation”
Local Account. If State recipient is being authorized to draw down funds
column, enter the amount of funds allocated to the recipient for CHDO
directly from the U.S. Treasury account, mark "yes." If funds are to be
operating expenses from this fiscal year source of funds after this action
deposited in the State's local account, mark "no."
(previous allocation plus or minus this action). Note: The total amount
Functions Delegated to Recipient. Indicate that type of access the State
allowed for CHDO operating expenses cannot exceed 5 percent of a
recipient is authorized for the HOME Cash and Management Information
participating jurisdiction’s allocation for a fiscal year.
(C/MI) System, i.e., project set-up, disbursement of project funds, and/or
CHDO Reallocation. Of the amount of funds indicated on the “Total
disbursement of administration funds. Note: If a State recipient receives
Allocation” line, enter the amount of funds, if any, that are being
an allocation for CHDO operating expenses and has been authorized to
reallocated for CHDOs or deobligated from funds previously reallocated
draw down administration funds, the State recipient will also be able to
for CHDOS. If this is the recipient’s initial allocation from this fiscal year
draw down operating expenses for community housing development
source of funds, the amount previously allocated will be “0.” In the “This
organizations (CHDOs). If the State recipient is not authorized to access
Action” column, enter the amount of funds, if any, that are being added to
the HOME C/MI System, mark “None.”
(+) or taken from (-) the State recipient’s allocation by this action that are
Amount of Funds Allocated to Recipient.
CHDO reallocation funds. (Note: If this is a deobligation because the
State has not reserved 15% of its funds for CHDOs within 24 months of
Total Allocation. In the “Previous Allocation” column, enter the total
obligation, the deobligation would be put on the “project funds” line --
amount of funds previously allocated before this action to the recipient
unless it is a deobligation of previously reallocated CHDO reallocation
from this fiscal year source of funds. If this is the recipient’s initial
funds, in which case the deobligation would be put on the CHDO
allocation from this fiscal year source of funds, the amount previously
reallocation line.) In the “Revised Allocation” column, enter the amount
allocated will be “0.” In the “This Action” column, enter the total amount
of CHDO reallocation funds allocated to the recipient after this action from
of funds being added to the State recipient’s allocation (+) or being taken
this fiscal year source of funds (previous allocation plus or minus this action).
from the State recipient’s allocation (-) by this action. In the “Revised
form HUD-40100 (5/93)
Previous edition is obsolete.
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