Form HUD 93104 HUD 93104 Monthly Report of Excess Income

Monthly Report of Excess Income
Section 236 Projects

U.S. Department of Housing
and Urban Development
Office of Housing
Federal Housing Commissioner

OMB Approval No. 2502-0086
(exp. 5/31/2010)

Important: Follow the instructions on the back to prepare this form.

Submit this form by the 10th of the month following the month covered by this report.
FHA Project Number

Project Name & Address

Reporting Period (mm/yyyy)

Complete this block only if there is a
payment due HUD

Mail this report to (This form is designed to fit a window envelope.)

Check Number:

Amount:

HUD Multifamily Excess Rental Income Payments
P.O. Box 105423
Atlanta, GA 30348-5423

fold line

Project Owner's Name & Address

Phone Number

Management Agent's Name & Address

Employer ID Number

Phone Number

Employer ID Number

1. Total gross rental collections in excess of approved basic rental per unit for all units in the project

$

2. Less amount retained for HUD-approved purposes

$(

3. Total Net Excess Income due HUD this month

$

)

Certification: I certify that the information on this form is true and complete.
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)
Type the Name & Phone No. of the person preparing this report (include area code)

Name of Reviewing Mortgagor Official & Phone Number

Title

Title

Signature

Previous editions are obsolete.

Date (mm/dd/yyyy)

Signature

Date (mm/dd/yyyy)

form HUD-93104 (2/98)

Public reporting burden for this collection of information is estimated to average 5 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 collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
This information is collected to obtain full benefits authorized by the amended section 236(g) of the National Housing Act. The information will enable
HUD to ensure that project owners carry out their statutory obligations to remit to HUD all Excess Income that HUD has not authorized them to retain.
Responses are required to obtain and retain the benefits authorized and mandated by section 236 of the Act. The information is considered nonsensitive,
and there are no assurances of confidentiality.
Privacy Act Statement: The Department of Housing and Urban Development (HUD) is authorized to collect this information by Section 236 of the National
Housing Act, as amended, and the Employer Identification Number (EIN) by the Housing & Community Development Act of 1987, 42 U.S.C 3543 . The
information concerning the monthly reporting of excess income is being collected by HUD to: (1) ensure project owners comply with the program
requirements to accumulate, safeguard and pay HUD all rental charges collected in excess of the basic rental charges, (2) recover and enforce collection
actions through repayment plans and/or offset of future subsidy billings in accordance with 24 CFR 17, administrative claims, and assess civil money
penalties pursuant to Section 416 of the 1987 Housing and Community Development Act, as well as, (3) automate financial reporting needs. The EIN
is used as a unique identifier for closer monitoring of owners and agents. HUD may disclose this information to Federal, State and local agencies when
relevant to civil, criminal, or regulatory investigations and prosecutions. It will not be otherwise disclosed or released outside of HUD, except as required
and permitted by law. Failure to provide the information could affect your future participation in HUD programs.

Instructions for Preparing form HUD-93104,
Monthly Report of Excess Income
This form is designed to fit a window envelope.
The following (and similar) items are excluded from the computations: Late
fees, NSF Check fees, utility surcharges, security deposit damage surcharges, Section 8 damage surcharges, Section 8 vacancy payments, local
tax surcharges, and separate parking or cable television charges if these
amenities are not included in the Basic Rent.
All Section 236 project owners (Insured, Non-insured, and HUD-held) must
remit each month all rental receipts in excess of each unit's approved Basic
Rental Rate.
All Section 236 mortgagors are to:
1. Prepare and mail form HUD-93104 by the tenth of each month to report
the prior month's collections. A report must be submitted each month,
whether or not a remittance is required.
2. Forward the original form HUD-93104 to the address shown on the form,
with a copy to the local HUD Office that has jurisdiction over the project.
3. Keep copies of the completed forms as part of the books and records of
the project for at least seven years from the dates the forms are prepared.

A prorated amount of Excess Income must be computed and remitted
when only a partial month's rent payment is due and paid. Amounts
received in the current month for rents due in other months are to be
applied to sums due the Operating Account and due HUD for those other
months. If the information is not already available or readily extractable
from the project's rent rolls or ledger folios, the mortgagor must prepare
a detailed monthly schedule of each unit that did not receive Rent
Supplement, RAP, or Section 8 Assistance of any type; this schedule (or
the rent roll) must show the basic rental charge for each unit and the
amount collected as rent in excess of the basic rental charge for each unit.
This schedule (or rent roll) must be prepared each month regardless of
whether Excess Income is being remitted for that month. This schedule
(or rent roll) must show the following information for each unit that does
not receive Rent Supplement, RAP, or Section 8 Assistance of any type,
and it must be presented to the independent public accountant performing
the annual audit of the mortgagor at the time of the audit:
Unit
Number

Tenant
Name

Basic
Rent

Tenant
Rental
Payment

Excess
Above
Basic Rent

4. Attach a check for full payment of the total amount shown due, indicating
the project number and the month and year of the Excess Income
payment on the check.

Previous editions are obsolete.

form HUD-93104 (2/98)