HUD 52672 Financial Form

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

Supporting Data for Annual
Contributions Estimates

OMB Approval No. 2577-0169
(Exp. 07/31/2007)

Section 8 Housing Assistance
Payments Program
Public reporting burden for this collection of information is estimated to average 1.50 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 you are not required to respond to, a collection of information unless that collecton displays a valid OMB control number.
Authority for this collection of information is the Housing and Community Development Act of 1987. Housing Agencies (HAs) required to maintain financial
reports in accordance with accepted accounting standards too permit timely and effective audits. The financial records identify the amount of annual
contributions that are received and disbursed by HAs. Responses to the collection of information are required to obtain a benefit or to retain a benefit.
The information requested does not lend itself to confidentiality.
1. Public Housing Agency (Name and Address)

2. Project No.

3. Submission

Original

Revision No.

4. No. of Dwelling Units

5. No. of Unit Months

0
Part I Estimate of
Annual
Housing
Assistance
Payments
Required

Part II Calculation of
Estimated
Ongoing
Administrative
Fee

6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Number of
Dwelling
Units

16.
17.
18.

Amount
Monthly Gross Payable by
Rent/Payment Family Toward
Standard
Gross Rent

Non-Expendable Equipment
Expenses

General Expenses

Total Preliminary Expenses
Submit three copies
Previous editions are obsolete

Unit Months
Under
Lease

Total

0 BR
1 BR
Total

Annual Housing
Assistance Payments

0
0
0
0
0
0
0
0
0
0

$
HUD Published 2-BR
Fair Market Rent
x
(b)
=

Product of
Columns (a) x (b)
(c)

0
0

Allowable
Percent
x (d)

=

Administrative Fee
(e)

100%
100%

0.00
0.00
0.00

0
Estimated Number of Families
(a)

x

Fee Per Family
(b)

Total Hard-to-House Fee
=
(c)

19.

0.00
Requested Amount

Part IV Calculation of Estimated
Preliminary Expense
Administrative Expenses

Monthly
Housing
Assistance
Payments

0
0
0
0
0
0
0
0
0

Unit Months
(a)

Part III Calculation of
Estimated
Hard- to- House
(Existing Housing
Certificates and
Housing Vouchers
Only)

Bedroom Size
of Dwelling
Units
0 BR
1 BR
2 BR
3 BR
4 BR

0

20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.

Requested Amount
Administrative Salaries
Employee Benefit Contributions
Legal Expense
Travel Expense
Sundry
Office Rent
Accounting and Auditing Fees
Total Administrative Expenses
Office Equipment
Office Furnishings
Automotive
Other
Total Non-Expendable Equipment Expenses
Maintenance and Operation (Non-Expend. Equip. Only)
Insurance
Sundry
Total General Expense
Sum of Lines 27, 32, and 36
Page 1 of 1

HUD Modifications

$0.00

$0.00

$0.00
$0.00
form HUD-52672 (2/85)
ref Handbook 7420.7