HUD 52834 Five-Year Action Plan

OMB Approval No. 2577-0157
(exp. 11/30/2008)

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

Five-Year Action Plan
Part I: Summary
Comprehensive Grant Program (CGP)
HA Name

Locality (City/County & State)
Original

A.
Development Number/Name

Work Stmt.
for Year 1
FFY _______

Work Statement for
Year 2
FFY __________

Work Statement for
Year 3
FFY __________

Work Statement for
Year 4
FFY __________

Revision No. ________

Work Statement for
Year 5
FFY __________

See
Annual
Statement

B. Physical Improvements Subtotal
C. Management Improvements
D. HA-Wide Nondwelling Structures
and Equipment
E. Administration
F. Other
G. Operations
H. Demolition
I. Replacement Reserve
J. Mod Used for Development
K. Total CGP Funds
L. Total Non-CGP Funds
M. Grand Total
Signature of Executive Director

Date

Signature of Public Housing Director

Page ___ of ___

Date

form HUD-52834 (10/96)
ref Handbook 7485.3

Five-Year Action Plan
Part I: Summary (Continuation)

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

Comprehensive Grant Program (CGP)
A.
Development Number/Name

Work Stmt.
for Year 1
FFY _______

Work Statement for
Year 2
FFY __________

Work Statement for
Year 3
FFY __________

Work Statement for
Year 4
FFY __________

Work Statement for
Year 5
FFY __________

See
Annual
Statement

Page ___ of ___

form HUD-52834 (10/96)
ref Handbook 7485.3

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

Five-Year Action Plan
Part II: Supporting Pages
Physical Needs Work Statement(s)
Comprehensive Grant Program (CGP)
Work
Statement
for Year 1
FFY _____

Work Statement for Year _____
FFY __________
Development Number/Name/General Description of
Major Work Categories

Quantity

Work Statement for Year _____
FFY __________
Estimated Cost

Development Number/Name/General Description of
Major Work Categories

Quantity

Estimated Cost

See
Annual
Statement

Subtotal of Estimated Cost

Subtotal of Estimated Cost
Page ___ of ___

form HUD-52834 (10/96)
ref Handbook 7485.3

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

Five-Year Action Plan
Part III: Supporting Pages
Management Needs Work Statement(s)
Comprehensive Grant Program (CGP)
Work
Statement
for Year 1
FFY _____

Work Statement for Year _____
FFY __________
General Description of
Major Work Categories

Quantity

Work Statement for Year _____
FFY __________
Estimated Cost

General Description of
Major Work Categories

Quantity

Estimated Cost

See
Annual
Statement

Subtotal of Estimated Cost

Subtotal of Estimated Cost
Page ___ of ___

form HUD-52834 (10/96)
ref Handbook 7485.3

Public reporting burden for this collection of information is estimated to average 3 hours 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 collection displays a valid OMB control number.
This collection of information requires that each eligible applicant submit information to HUD in order to receive its annual formula grant. This information will be used by HUD to determine whether
the annual submission meets statutory and regulatory requirements for the annual formula grant. Responses to the collection are required by Section 14(e)(1)(D) of the U.S. Housing Act of 1937,
as amended. The information requested does not lend itself to confidentiality.

Instructions for Preparation of Form HUD-52834, Five-Year Action Plan
Report Submission: Prepare one form HUD-52834 for the entire HA and submit to HUD
as part of the submission of the original Comprehensive Plan in the first year of participation
in the Comprehensive Grant Program (CGP). Thereafter, submit annually an updated form
to eliminate the previous year and to add a new fifth year so that the form always covers the
present five-year period beginning with the current year. Use as many pages of this form
as necessary to cover all proposed work.
Part I: Summary
Heading Instructions:
HA Name. Enter the HA name.
Locality (City/County & State). Enter the City/County and State where the HA Central
Office is located.
Original/Revision No. Self-explanatory.
Year 1. Enter the current FFY.
Years 2 through 5. Enter each successive FFY.
A. Development Number/Name. Enter the abbreviated number (e.g. VA 36-1) and name,
if any, of each development that will be allocated funding for physical improvements
during the five-year period covered by this Action Plan.
Work Statement(s) Years 2 through 5
For each development entered in A., enter the estimated amount of CGP funds to be
allocated for physical improvements (development accounts 1450 through 1475) during
each year of years 2 through 5.
B. Physical Improvements Subtotal. Enter the estimated subtotal amount of CGP funds
to be allocated for physical improvements during each year of years 2 through 5.
C. Management Improvements. Enter the estimated amount of CGP funds to be allocated
for management improvements, including those that are HA-wide and/or developmentspecific, (development account 1408) during each year of years 2 through 5. Note: The
estimated amount may not exceed 20% of the annual grant, except where approved by
HUD or the PHA is both an overall high performer and a Mod-high performer under the
PHMAP.

D. HA-Wide Nondwelling Structures and Equipment. Enter the estimated amount of
CGP funds to be allocated for HA-wide nondwelling structures and equipment during
each year of years 2 through 5.
E. Administration. Enter the estimated amount of CGP funds to be allocated for
administration costs (development account 1410) during each year of years 2 through
5. Note: The estimated amount may not exceed 10% of the annual grant, excluding
certain costs, except where approved by HUD.
F. Other. Enter the estimated amount of CGP funds to be allocated for other costs
(development accounts 1411, 1415, 1430, 1440, 1495,) and for contingencies (development account 1502) for each year of years 2 through 5.
G. Operations. Enter the estimated amount of CGP Funds to be allocated to operations
(may not exceed 10% of line K) for each year of years 2 through 5.
H. Demolition. Enter the estimated amount of CGP funds to be used for demolition
activities (development account 1485) for each year of years 2 through 5.
I. Replacement Reserve. Enter the estimated amount of CGP funds to be allocated to the
replacement reserve (development account 1490) in accordance with the requirements
of Handbook 7485.3, for each year of years 2 through 5.
J. Mod Used for Development. Enter the estimated amount of CGP funds to be used for
development activities (development account 1498) for each year of years 2 through 5.
K. Total CGP Funds. Enter the total amount of CGP funds that is estimated for each year
of years 2 through 5. This is the sum of B through J and should equal the amount of the
current year annual grant.
L. Total Non-CGP Funds.
Enter the estimated amount of non-CGP funds (e.g.,
Community Development Block Grant funds, CIAP funds being reprogrammed for use
under the CGP, etc.) to be allocated in support of the CGP for each year of years 2
through 5.
M. Grand Total.

Enter the total of K and L.

Note: Enter all estimates as current cost; not trended for inflation.

Page ___ of ___

form HUD-52834 (10/96)
ref Handbook 7485.3

Part III: Supporting Pages—Management Needs Work Statement(s)
Part II: Supporting Pages—Physical Needs Work Statement(s)

FFY:

FFY:

Work Statement for Year 1. Enter the current FFY.

Work Statement for Year 1. Enter the current FFY.

Work Statements for Years 2 through 5. Enter each successive FFY.

Work Statements for Years 2 through 5. Enter each successive FFY.

General Description of Major Work Categories. In each year of years 2 through 5,
enter the major work categories for which CGP funding, including non-CGP funds, will
be allocated as well as those work categories that are no cost items. This includes work
identified through the Public Housing Management Assessment Program (PHMAP) for
PHAs, or through audits, HUD monitoring reviews, or HA self-assessments. The work
categories should be described in sufficient detail for HUD to make a determination of
eligibility. For example, training activities must describe how they relate to identified
physical or management improvements, e.g., staff training to improve PHMAP scores on
rent collection. If a particular work category is targeted to a specific development, e.g.,
conduct study to determine the feasibility of resident management, enter the development number in parenthesis.

Development Number/Name.
Enter the abbreviated development number (e.g., VA 36-1) and name, if any, of each
development which will be funded in each year of years 2 through 5 or enter "HA-wide."
General Description of Major Work Categories. For each development entered, list
the major work categories for which CGP funding, including non-CGP funds, will be
allocated in each year of years 2 through 5. The work categories should be described in
broad terms, such as kitchens, bathrooms, electrical, site, etc. A work category may
encompass various components; e.g., the major work category of kitchens may include
ranges, refrigerators, cabinets, floors, range hoods, etc.
For "HA-Wide," list HA-wide non-dwelling structures and equipment that will be
funded.
Quantity. Enter the quantity of the major work category to be undertaken as a
percentage or whole number, e.g., 50 percent of the units, 125 units, etc.
Estimated Cost. For each major work category or HA-wide nondwelling structures and
equipment listed, enter the estimated hard cost that will be allocated in each year of
years 2 through 5. Mark with an asterisk the estimated cost of each work item that will
be funded with non-CGP funds, including reprogrammed CIAP funds. Enter the subtotal
of estimated costs for each year of years 2 through 5 that will be funded with CGP funds,
excluding asterisked items. This subtotal should be reflected on line B in Part 1:
Summary for each year of years 2 through 5.

Quantity. Where appropriate, enter the quantity of the major work category to be
undertaken as a percentage or whole number, e.g., train 50 residents, train 10 percent
of the staff, etc.
Estimated Cost. For each major work category entered, enter the estimated cost that
will be allocated in each year of years 2 through 5 Mark with an asterisk the estimated
cost of each work item that will be funded with non-CGP funds, including reprogrammed
CIAP funds. Enter the subtotal for each year of years 2 through 5 that will be funded with
CGP funds, excluding asterisked items. This subtotal should be reflected on line C in
Part I: Summary for each year of Years 2 through 5.

Page ___ of ___

form HUD-52834 (10/96)
ref Handbook 7485.3