Form Hud-40118 - Annual Progress Report

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Grantee:
HUD Grant or Project Number:
Project Sponsor:
Project Name:
Operating Year:
)
Reporting Period:
(Circle the operating year being reported on
(month/day/year)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Indicate if extension:
yes no
from:
to:
Indicate if renewal:
yes no
Previous Grant Numbers for this project:
_________________________
________________________
__________________________
_________________________
________________________
__________________________
_________________________
________________________
__________________________
_________________________
________________________
__________________________
Check the component for the program on which you are reporting.
Supportive Housing Program (SHP)
Shelter Plus Care (S+C)
Section 8 Moderate Rehabilitation
¨ Transitional Housing
¨ Tenant-based Rental Assistance (TRA)
¨ Single Room Occupancy
¨ Sponsor-based Rental Assistance (SRA)
¨ Permanent Housing for Homeless
(Sec. 8 SRO)
¨ Project-based Rental Assistance (PRA)
Persons with Disabilities
¨ Single Room Occupancy (SRO)
¨ Safe Haven
¨ Innovative Supportive Housing
¨ Supportive Services Only
Summary of the project:
(One or two sentences with a description of population, number served and accomplishments this operating year)
Name & Title of the Person who can answer questions about this report:
Phone: (include area code)
Address:
Fax Number: (include area code)
I hereby certify that all the information stated herein is true and accurate.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001,
1010, 1012; 31 U.S.C. 3729, 3802)
Name & Title of Authorized Grantee Official:
Signature & Date:
X
Name and Title of Authorized Project Sponsor Official:
Signature & Date:
X
4
HUD-40118 (11/00)

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