CDFI Form 0027 CDFI and NACA Program ARRA QILR

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Overview

QILR
Table I-8
Table II-15
Table II-16
Table III-17
Table IV-19
# of Jobs for FederalReporting

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Sheet 1: QILR

I - Organizational Information

I - Organizational Information

I - Organizational Information

I - Organizational Information

I - Organizational Information

II - Community Development Impacts

III - Financing

IV - Award Compliance (Expenditures)

myCDFIFund Organization Profile

myCDFIFund Organization Profile

Basic Information

Basic Information

Populations and Geography Receiving Financial Products

Populations and Geography Receiving Financial Products

Staff and Consultants (FTEs)

RECOVERY ACT SPECIFIC: Jobs Retained in Businesses at Origination During Reporting Quarter (FTEs)

RECOVERY ACT SPECIFIC: Jobs Created in Businesses at Origination During Reporting Quarter (FTEs)

RECOVERY ACT SPECIFIC: Loans/Investments

FY 2009 NACA Program/ Technical Assistance Recovery Act Awardees

FY 2009 Financial Assistance Recovery Act Awardees

Organization Name

Organization EIN

Date of Fiscal Year End (MM/DD)

Organization's Financial Institution Type

Organization Structure

Year of Incorporation (YYYY)

Year Began Financing Activities (YYYY)

FDIC Certification Number, Depository Institution Holding Company Identification Number, or NCUA Chater Number

Street Address

City

State

Zip + 4

Website Address

Person Responsible for Completing QILR

ORGANIZATION WIDE: Targeted Populations

ORGANIZATION WIDE: Hispanic Origin

ORGANIZATION WIDE: Geographic Areas

ORGANIZATION WIDE: FTE Resource Allocation

RECOVERY ACT SPECIFIC: Number of FTEs Funded by the Recovery Act During the Reporting Quarter:

RECOVERY ACT SPECIFIC: Loans/ Investments Originated During Performance Period

RECOVERY ACT SPECIFIC: Originated in Approved Target Market

RECOVERY ACT SPECIFIC: Expended Funds/ Completed Activities During Performance Period

RECOVERY ACT SPECIFIC: Amount of Award Expended (Cannot Exceed Total Award Amount)

Did targeted population or demographic sub-group receive any financial products from organization during the Performance Period?

Did organization provide any financial services to persons of Hispanic origin during the Performance Period?

Which of the following geographic areas did the organization provide any financing during the Performance Period?

Are 50 percent or more of the organization's customers or end users American Indian, Alaskan Native, or Native Hawaiian, or located in Native American Areas?

Native American Community Activities

Lending/ Investing

Development Service

Financial Services (Other than Lending/Investing)

Total FTEs Retained

Total FTEs Created

Consultant/ Contractor FTEs Retained

Consultant/ Contractor FTEs Created

Reporting Quarter

During Performance Period

Reporting Quarter

During Performance Period

DUNS

Award Number

Name

Telephone Number

E-mail Address

American Indian

Alaska Native

Asian

Black or African American

Native Hawaiian

Other Pacific Islander

White

Other

Appalachia

Colonias

Lower Mississippi Delta

Native American Areas

Rural Areas

Major Urban Area

Minor Urban Area

Administrative and Other

Amount ($)

Number

Amount ($)

Number

Amount ($)

Amount ($)

COMPLETE TABLE I-8

COMPLETE TABLE II-15

COMPLETE TABLE II-16

COMPLETE TABLE III-17

COMPLETE TABLE IV-19

M

M

M

M

M

M

M

M

M

R

M

M

M

M

R

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

M

R

M

M

M

M

M

M

M

M

R

R

R

M

M

M

M

R

M

M

M = Mandatory

M = Mandatory

R = Required, if applicable

R = Required, if applicable

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Sheet 2: Table I-8

ORGANIZATION WIDE
Table I-8: Native American Community Activities
Name of Native American Community Served	Percent of Total Financing

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Sheet 3: Table II-15

RECOVERY ACT SPECIFIC
Table II-15: Jobs Retained in Businesses During the Reporting Quarter
Source of FTE	FTEs Retained (#)	NAICS Code
FTEs Retained (Funded by the Recovery Act)	0

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Sheet 4: Table II-16

RECOVERY ACT SPECIFIC
Table II-16: Jobs Created in Businesses During the Reporting Quarter
Source of FTE	FTEs Created (#)	NAICS Code
FTEs Created (Funded by the Recovery Act)	0

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Sheet 5: Table III-17

RECOVERY ACT SPECIFIC
Table III-17: Loans/Investments Originated During Performance Period
Direct or Leveraged Use of Recovery Act Funding	Transaction Type	Purpose	Geography (Address or Description of Geography)	Organization				Total Project Cost
				Recovery Act Federal Amount	Non- Recovery Act Federal Amount	Non-Federal Amount	$ Originated

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Sheet 6: Table IV-19

RECOVERY ACT SPECIFIC
Table IV-19: FY 2009 NACA Program/Technical Assistance Recovery Act Awardees Expended Funds/Completed Activities Table
Award Control Number	Expended All TA Funds?	Date TA Funds Expended (MM/DD/YY)	Completed All TA Activities	Date TA Activities Completed (MM/DD/YY)

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Sheet 7: # of Jobs for FederalReporting

Organization
FTEs Retained (Funded by the Recovery Act)	0.00
FTEs Created (Funded by the Recovery Act)	0.00
Businesses
FTEs Retained (Funded by the Recovery Act)	0.00
FTEs Created (Funded by the Recovery Act)	0.00
Number of Jobs To Be Reported in FederalReporting.gov	0.00	FTEs