HUD 52652-Cambodia Family Self-Sufficiency Program FSS Escrow Account Credi

kmµviFI åKYsar manåbak'cMNUl

åkdasKit elx sMrab’ kug rk§aTuk

Family Self-Sufficiency Program
FSS Escrow Account Credit Worksheet

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

OMB Approval No. 2577-0178
(exp. 07/31/2010)

Escrow credit enHsMrab’ sn~Idían enAeBlBinIt´emileLigvij eBlEdl kicÍsn´a FSS cUlCaFrman
lCaFrman eBlEdl¨KYsar

Gnuvt¶kmµviFi. FSS

em¨Kçsar rbs’kmµviFI FSS

«f© Ex

1.

åbak’cMNUl (sUmsresr cUl k~ug ¨kdas form HUD-50058.)

1.

2.

kMrit¨bak’cMNUl (sresrcUl åbak’cMNUl kugdMbn’Edl FSS EdlåKYsar rs’enA .)

2.

3.

åbak’cNYlbcÍubºn~ (sUmsresrcUl k~ugbnæat' 8y of the form HUD-50058.)

ebikalNa bnæab’ 3 manelxelis Bi bnæat’ 2 ¨KYsar min GacTTYlyk FSS credit.eT
eT

4.

åbak’cMNUl Vn mkBikargark~ug bnæat’ 1 (bUkcUlåbak’cMNUl B, M, F, HA, and W in bnæat’

5.

7f of form HUD-50058.)
åbak’cMNYl Tag Gs’åbcaMq~aM ,cab’BieBlkicÍsn´acUlFrman FSS Contract of Participation.
(sresrcUlcMnYn .)

6

åbak’cMNUlekin cab’tMag Bi FSS Contract of ParticipationcUlCaFrmanmk . (dkBibnæat’elx
5 Bibnæat;elx 4ebi elis sresr elx 0.)

7.

åbak’cMNUlbcÍubºn~ tucCag ¨bak’ekincNUl enAe¨kayBikmµviFI FSS

30 PaKry «nåbak’cMNUl (bnaæt’elx 3 Eck elx 40 . cMnYnenaH¨tUv esiµ nwg
bnæat’elx9 form HUD-50058.)

9.

4.

5.

6.

Contract of

Participation.cUlCaFrman (dkbnæat’elx 6 Bi bnæat’elx 1 .)

8.

3.

åbak’cMNUlbcuÍbºn~ ticCag cMnYnekinen¨bak’cMNUl cab’tag Bi FSS Contract of
ParticipationcUlCaFrman mk (dk bnæat’ 6 Bi bnæat’ elx 3

10. 30% en åbak’cMNUl Et ticCag åbak’ekin cab’taMg Bi FSS Contract of
Participation.cUlCaFrmanmk (bnæat’ 9 Eck nwg 40 )

11. 10% en¨bak’cMNUl mUy q~aM ticCag cMnYn¨bak’ekin cab’taMg Bi FSS Contract of
Participation.culCaFrman mk (bnæat’ 7 Eck nwg 120)

12. ebiGnuvt Vn QY~çlCYlpæH t (sresrcMnYn eli elx 9 form HUD-50058 line 10c of form

7.

8.

9.

10.

11.

12.

HUD-50058)
13. TTP eyageTAtam ¨bak’cMNUlbcuÍbºn~ ticCag cMnYnekinen¨bak’cMNUlcab’taMg Bi the FSS
Contract of ParticipationcUlCaFrman . (sresrcUleli bnæat’ 10, otherwise, enter the

13.

greater of line 10, 11, or 12.)
14. karxusK~a rvag 30 PaKry en¨bak’cMNUlåbcMaEx (dkelx 13 Bibnaæt’ elx 8.)
15

bcÍbºbn~ TTP (cuHelx 9j of form HUD-50058 or, k~ugkrNi of housing choice voucher

sresrcuH elx 8 enAk~ugåkdasenH .)

16. TTP enAef© cUlCaFrman en kmµviFi FSS EbikalNa evAqrenaH elis Bikarekin¨bak’cMNUl
(sresrcuH cMnYn .)

17. karxusK~a rvag TTP nwg

TTP. enAeBlkmµviFi cUlCaFrman

kareVHBum¸p§Bp§ayBielIkmunVn¨tUvTukCaemaX:

14.
15.

16.

17.

TMB&r 1 of 2

form HUD-52652-Cambodian (1/05)
ref. Handbook 7420.8

18. sresrcuH cMnYntic elibnaæt’ 14 or line 17.

18.

19. sresr cUl åbak’cMNUltic bMput kug kmviFi FSS kugdMbn’EdlåKYsar rs’enA li.)

19.

20. cMnYn¨bak’cMNUl elis kMrit¨bak’cMNUl tic bMput (dk bnæat’ 19 ecjBi 3.)

20.

21. 30 PaKry encMnYnåbak’cMNUl elis Bi kMrit TabbMput enåbak’cMNUL (bnæat’ 20 Eck nwg
40 )

22. åbak’ Escrow credit (dkBibnæat’ 21 Bi bnæat’ 18)

21.
22.

åkdas enH Gac ykeTAe¨biedimºi bUkelx bgúúaj rebob . PHA Gacmanrebobep§g
TIP~ak'gar (HA) nimYy@ ¨tUvsresrcUlk~ugkicÍsn´a nUveQµaH¨KYsar Edlsuxcit¶yl'¨BmcUlrYmk~¬gkmµviFI FSS. HA nimYy@ ¨tUvTak'TgCamUy m¨ni¶d
bn' edimºierobcM Epnkar EdlbJÍak'GMBi GMhMu¨KYsar escki¶i¨tUvkarrbs'Blrd Edlcg'Vn esva BikmµviFi FSS,skmµPaB , nwgesva . GMBifaetikmµviFIen

enaH edir rebobNa : ¨bPBsaFarN: nwg äkCn tamry:esva" nwg skmµPaB nwgVnåtUv p¶l'[ tamry:esva . eBlevlakMNt' enkarGnuvt¶n_
ehiy nwg Tin~n&yep§g@ eTot caMVc'dl' HUD edimºiFana karGnuvtën_kmµviFi nwg esva nwg skmµPaB ;

esck¶iraykar eyageTA tam kar¨bmUläksar Bt_man Vn¨tUv V"nsµanfacMNayeBl mUy em"ag sMrab'cMeLiy rabTageBlevla Binti´

emileLigvij kar¨bmUläksarnwg Tin~n&y ehiy nwg karBinit´emileLigvij Bt_manEdlVnTTYl mkenaH . bJͬesck¶iGFibºay nwg Bt_manTaMg

Gs'enaH eTA [ Reports Management Officer, Paperwork Reduction Project (2577-0178) , Office of Information Technology. US department of Housing and Urban
Development Washington, D.C. 20410-3600.
sUmkMuep©i åkdas bMeBjenH eTA [ Gas&ydìan enAxagelienH ..

kareqÂiytb nwg kar¨bmUl Bt_manenH CakarcaMVc' dMruv tamcºab ' (Section 23 (c) & (g) of the U.S. Housing Act of 1937, as added by Section 554 of

the Cranston-Gonzalez National Affordable Housing Act (PL 101-625) for participation in the FSS program.
The Bt_man TTYlVn enAk~¬g¨kdasbMeBjenH Vn¨tUv cat'Tuk Ca karsMgat' ;Privacy Act. The Privacy Act EdldMrUv [äksarenH rk§aTuk tamrebob

rdìVl, becÍkeTs nwg rk§aTuk eday¨by&t~bMput .bEnÄm äksarTagenaH ¨tUvrk§aTuk min[mankarKMram NamUyeLiy EdlGacnaM [e¨KaHf~ak' É
karxUckiti¶ys nwg xµaseK, .

.
HUD Gac dwknaM É CYy{bfm,ehiy buKðl mindMrUv [eqÂiytb eTAnwg karsYrBt_man luH¨taEt CnenaH bgúaj elxGt¶sJïaN¨bcaMxÂçn.
esck¶iENnaM edimºi Kitelx k~¬g

FSS Escrow Account

1. An escrow credit ò ¨bak'sn§Mu¬Tuk nwgVn¨tUvBinit´emilenA¨Kb'eBlevla ehiy nwg karsnidìan e¨kayBi kMNt'eBlCaFrman rbs' kicÍsn´a
k~¬gkmµviFi FSS

2. cMnYn¨bak' rbs' ESCROW CREDIT ACCOUNT GacKitKUr eday yk ¨kdasbMeBj HUD-52652. É äksarep§geTot EdlPØab'CamUy ¨kdas
Form HUD .

3. cMnUn¨bak'enAk~ég kug Gac eLigcuH eyageTAtam ¨bak'cMNUl rbs'åKYsar FSS Edlekin¨bak'cMNUl cab'tagBikicÍsn´aenH
VncUlCAFrmanmk . ebikalNaåKYsar Ek ¨bak'cMNUlrbs'xÂçn enAk¬~gdMbn' EdlåKYsars'enA åKYsarenaH min
GacCab'eQµaH TTYl yk åbak' Escrow Credit enaH eT . k~¬gkrNienH bnæat' 4 nwg 22

FORM HUD-52652 minGacbJÍb'VneLiy.

äksarenH Ca esck¶IbkE¨b rbs' äksar¨sbcºab'rbs'Ggðkar HUD Edl Vn¨tUvp§Bp§ay. Ggðkar HUD p¶l' karbkE¨b dl'
Gs'elak G~k, Edl Ca karsmrm´
karsmrm´ gay¨sYlnwgCYyelak G~k [ yl'dwg GMBIsiTìirbs'elak G~k nwgkatBÃkicÍ .
äksarCaPasaGg'eKÂ enH mansPaBtampÂèvkar ¨sbcºab' nwg mansuBlPaB . äksar bkE¨bPasa minEmn äksar tampÂèvkareT

kareVHBum¸p§Bp§ayBielIkmunVn¨tUvTukCaemaX:

TMB&r 2 of 2

form HUD-52652-Cambodian (1/05)
ref. Handbook 7420.8