50075 PHA 5-Year and Annual Plan

PHA 5-Year and
Annual Plan

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

OMB No. 2577-0226
Expires 4/30/2011

1.0

PHA Information
PHA Name: _____________________________________________________________________ PHA Code: _______________
PHA Type:
Small
High Performing
Standard
HCV (Section 8)
PHA Fiscal Year Beginning: (MM/YYYY): ______________

2.0

Inventory (based on ACC units at time of FY beginning in 1.0 above)
Number of PH units: _________________

3.0
4.0

Submission Type
5-Year and Annual Plan
PHA Consortia
Participating PHAs

5.0

Number of HCV units: _____________

Annual Plan Only

5-Year Plan Only

PHA Consortia: (Check box if submitting a joint Plan and complete table below.)
PHA
Code

Program(s) Included in the
Consortia

Programs Not in the
Consortia

No. of Units in Each
Program
PH
HCV

PHA 1:
PHA 2:
PHA 3:
5-Year Plan. Complete items 5.1 and 5.2 only at 5-Year Plan update.

5.1

Mission. State the PHA’s Mission for serving the needs of low-income, very low-income, and extremely low income families in the PHA’s
jurisdiction for the next five years:

5.2

Goals and Objectives. Identify the PHA’s quantifiable goals and objectives that will enable the PHA to serve the needs of low-income and very
low-income, and extremely low-income families for the next five years. Include a report on the progress the PHA has made in meeting the goals
and objectives described in the previous 5-Year Plan.

6.0

PHA Plan Update
(a) Identify all PHA Plan elements that have been revised by the PHA since its last Annual Plan submission:

(b) Identify the specific location(s) where the public may obtain copies of the 5-Year and Annual PHA Plan. For a complete list of PHA Plan
elements, see Section 6.0 of the instructions.

7.0

Hope VI, Mixed Finance Modernization or Development, Demolition and/or Disposition, Conversion of Public Housing, Homeownership
Programs, and Project-based Vouchers. Include statements related to these programs as applicable.

8.0

Capital Improvements. Please complete Parts 8.1 through 8.3, as applicable.

8.1

8.2

8.3

Capital Fund Program Annual Statement/Performance and Evaluation Report. As part of the PHA 5-Year and Annual Plan, annually
complete and submit the Capital Fund Program Annual Statement/Performance and Evaluation Report, form HUD-50075.1, for each current and
open CFP grant and CFFP financing.
Capital Fund Program Five-Year Action Plan. As part of the submission of the Annual Plan, PHAs must complete and submit the Capital Fund
Program Five-Year Action Plan, form HUD-50075.2, and subsequent annual updates (on a rolling basis, e.g., drop current year, and add latest year
for a five year period). Large capital items must be included in the Five-Year Action Plan.
Capital Fund Financing Program (CFFP).
Check if the PHA proposes to use any portion of its Capital Fund Program (CFP)/Replacement Housing Factor (RHF) to repay debt incurred to
finance capital improvements.

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form HUD-50075 (4/2008)

9.0

Housing Needs. Based on information provided by the applicable Consolidated Plan, information provided by HUD, and other generally available
data, make a reasonable effort to identify the housing needs of the low-income, very low-income, and extremely low-income families who reside in
the jurisdiction served by the PHA, including elderly families, families with disabilities, and households of various races and ethnic groups, and
other families who are on the public housing and Section 8 tenant-based assistance waiting lists. The identification of housing needs must address
issues of affordability, supply, quality, accessibility, size of units, and location.

9.1

Strategy for Addressing Housing Needs. Provide a brief description of the PHA’s strategy for addressing the housing needs of families in the
jurisdiction and on the waiting list in the upcoming year. Note: Small, Section 8 only, and High Performing PHAs complete only for Annual
Plan submission with the 5-Year Plan.

10.0

Additional Information. Describe the following, as well as any additional information HUD has requested.
(a) Progress in Meeting Mission and Goals. Provide a brief statement of the PHA’s progress in meeting the mission and goals described in the 5Year Plan.

(b) Significant Amendment and Substantial Deviation/Modification. Provide the PHA’s definition of “significant amendment” and “substantial
deviation/modification”

11.0

Required Submission for HUD Field Office Review. In addition to the PHA Plan template (HUD-50075), PHAs must submit the following
documents. Items (a) through (g) may be submitted with signature by mail or electronically with scanned signatures, but electronic submission is
encouraged. Items (h) through (i) must be attached electronically with the PHA Plan. Note: Faxed copies of these documents will not be accepted
by the Field Office.
(a) Form HUD-50077, PHA Certifications of Compliance with the PHA Plans and Related Regulations (which includes all certifications relating
to Civil Rights)
(b) Form HUD-50070, Certification for a Drug-Free Workplace (PHAs receiving CFP grants only)
(c) Form HUD-50071, Certification of Payments to Influence Federal Transactions (PHAs receiving CFP grants only)
(d) Form SF-LLL, Disclosure of Lobbying Activities (PHAs receiving CFP grants only)
(e) Form SF-LLL-A, Disclosure of Lobbying Activities Continuation Sheet (PHAs receiving CFP grants only)
(f) Resident Advisory Board (RAB) comments. Comments received from the RAB must be submitted by the PHA as an attachment to the PHA
Plan. PHAs must also include a narrative describing their analysis of the recommendations and the decisions made on these recommendations.
(g) Challenged Elements
(h) Form HUD-50075.1, Capital Fund Program Annual Statement/Performance and Evaluation Report (PHAs receiving CFP grants only)
(i) Form HUD-50075.2, Capital Fund Program Five-Year Action Plan (PHAs receiving CFP grants only)

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form HUD-50075 (4/2008)

_______________________________________________________________________________________________________________________________________
This information collection is authorized by Section 511 of the Quality Housing and Work Responsibility Act, which added a new section 5A to the U.S. Housing Act
of 1937, as amended, which introduced 5-Year and Annual PHA Plans. The 5-Year and Annual PHA plans provide a ready source for interested parties to locate basic
PHA policies, rules, and requirements concerning the PHA’s operations, programs, and services, and informs HUD, families served by the PHA, and members of the
public of the PHA’s mission and strategies for serving the needs of low-income and very low-income families. This form is to be used by all PHA types for submission
of the 5-Year and Annual Plans to HUD. Public reporting burden for this information collection is estimated to average 12.68 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. HUD
may not collect this information, and respondents are not required to complete this form, unless it displays a currently valid OMB Control Number.
Privacy Act Notice. The United States Department of Housing and Urban Development is authorized to solicit the information requested in this form by virtue of Title
12, U.S. Code, Section 1701 et seq., and regulations promulgated thereunder at Title 12, Code of Federal Regulations. 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

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Instructions form HUD-50075
2.

Financial Resources. A statement of financial resources,
including a listing by general categories, of the PHA’s
anticipated resources, such as PHA Operating, Capital and
other anticipated Federal resources available to the PHA,
as well as tenant rents and other income available to
support public housing or tenant-based assistance. The
statement also should include the non-Federal sources of
funds supporting each Federal program, and state the
planned use for the resources.

2.0 Inventory
Under each program, enter the number of Annual Contributions Contract
(ACC) Public Housing (PH) and Section 8 units (HCV).

3.

Rent Determination. A statement of the policies of the
PHA governing rents charged for public housing and HCV
dwelling units.

3.0 Submission Type
Indicate whether this submission is for an Annual and Five Year Plan, Annual
Plan only, or 5-Year Plan only.

4.

Operation and Management. A statement of the rules,
standards, and policies of the PHA governing maintenance
management of housing owned, assisted, or operated by
the public housing agency (which shall include measures
necessary for the prevention or eradication of pest
infestation, including cockroaches), and management of
the PHA and programs of the PHA.

5.

Grievance Procedures. A description of the grievance
and informal hearing and review procedures that the PHA
makes available to its residents and applicants.

6.

Designated Housing for Elderly and Disabled Families.
With respect to public housing projects owned, assisted, or
operated by the PHA, describe any projects (or portions
thereof), in the upcoming fiscal year, that the PHA has
designated or will apply for designation for occupancy by
elderly and disabled families. The description shall
include the following information: 1) development name
and number; 2) designation type; 3) application status; 4)
date the designation was approved, submitted, or planned
for submission, and; 5) the number of units affected.

7.

Community Service and Self-Sufficiency. A description
of: (1) Any programs relating to services and amenities
provided or offered to assisted families; (2) Any policies
or programs of the PHA for the enhancement of the
economic and social self-sufficiency of assisted families,
including programs under Section 3 and FSS; (3) How the
PHA will comply with the requirements of community
service and treatment of income changes resulting from
welfare program requirements. (Note: applies to only
public housing).

8.

Safety and Crime Prevention. For public housing only,
describe the PHA’s plan for safety and crime prevention to
ensure the safety of the public housing residents. The
statement must include: (i) A description of the need for
measures to ensure the safety of public housing residents;
(ii) A description of any crime prevention activities
conducted or to be conducted by the PHA; and (iii) A
description of the coordination between the PHA and the
appropriate police precincts for carrying out crime
prevention measures and activities.

Applicability. This form is to be used by all Public Housing Agencies
(PHAs) with Fiscal Year beginning April 1, 2008 for the submission of their
5-Year and Annual Plan in accordance with 24 CFR Part 903. The previous
version may be used only through April 30, 2008.
1.0 PHA Information
Include the full PHA name, PHA code, PHA type, and PHA Fiscal Year
Beginning (MM/YYYY).

4.0 PHA Consortia
Check box if submitting a Joint PHA Plan and complete the table.
5.0 Five-Year Plan
Identify the PHA’s Mission, Goals and/or Objectives (24 CFR 903.6).
Complete only at 5-Year update.
5.1 Mission. A statement of the mission of the public housing agency
for serving the needs of low-income, very low-income, and extremely
low-income families in the jurisdiction of the PHA during the years
covered under the plan.
5.2 Goals and Objectives. Identify quantifiable goals and objectives
that will enable the PHA to serve the needs of low income, very lowincome, and extremely low-income families.
6.0

PHA Plan Update. In addition to the items captured in the Plan
template, PHAs must have the elements listed below readily available to
the public. Additionally, a PHA must:
(a)

Identify specifically which plan elements have been revised
since the PHA’s prior plan submission.

(b)

Identify where the 5-Year and Annual Plan may be obtained by
the public. At a minimum, PHAs must post PHA Plans,
including updates, at each Asset Management Project (AMP)
and main office or central off ice of the PHA. PHAs are
strongly encouraged to post complete PHA Plans on its official
website. PHAs are also encouraged to provide each resident
council a copy of its 5-Year and Annual Plan.
PHA Plan Elements. (24 CFR 903.7)
1.

Eligibility, Selection and Admissions Policies, including
Deconcentration and Wait List Procedures. Describe
the PHA’s policies that govern resident or tenant
eligibility, selection and admission including admission
preferences for both public housing and HCV and unit
assignment policies for public housing; and procedures for
maintaining waiting lists for admission to public housing
and address any site-based waiting lists.

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Instructions form HUD-50075 (2008)

9.

that the public housing agency plans to voluntarily convert;
2) An analysis of the projects or buildings required to be
converted; and 3) A statement of the amount of assistance
received under this chapter to be used for rental assistance or
other housing assistance in connection with such conversion.
See guidance on HUD’s website at:
http://www.hud.gov/offices/pih/centers/sac/conversion.cfm

Pets. A statement describing the PHAs policies and
requirements pertaining to the ownership of pets in public
housing.

10. Civil Rights Certification. A PHA will be considered in
compliance with the Civil Rights and AFFH Certification
if: it can document that it examines its programs and
proposed programs to identify any impediments to fair
housing choice within those programs; addresses those
impediments in a reasonable fashion in view of the
resources available; works with the local jurisdiction to
implement any of the jurisdiction’s initiatives to
affirmatively further fair housing; and assures that the
annual plan is consistent with any applicable Consolidated
Plan for its jurisdiction.

(d)

Homeownership. A description of any homeownership
(including project number and unit count) administered by
the agency or for which the PHA has applied or will apply
for approval.

(e)

Project-based Vouchers. If the PHA wishes to use the
project-based voucher program, a statement of the projected
number of project-based units and general locations and how
project basing would be consistent with its PHA Plan.

11. Fiscal Year Audit. The results of the most recent fiscal
year audit for the PHA.
8.0
12. Asset Management. A statement of how the agency will
carry out its asset management functions with respect to
the public housing inventory of the agency, including how
the agency will plan for the long-term operating, capital
investment, rehabilitation, modernization, disposition, and
other needs for such inventory.
13. Violence Against Women Act (VAWA). A description
of: 1) Any activities, services, or programs provided or
offered by an agency, either directly or in partnership with
other service providers, to child or adult victims of
domestic violence, dating violence, sexual assault, or
stalking; 2) Any activities, services, or programs provided
or offered by a PHA that helps child and adult victims of
domestic violence, dating violence, sexual assault, or
stalking, to obtain or maintain housing; and 3) Any
activities, services, or programs provided or offered by a
public housing agency to prevent domestic violence,
dating violence, sexual assault, and stalking, or to enhance
victim safety in assisted families.
7.0

Capital Improvements. This section provides information on a PHA’s
Capital Fund Program. With respect to public housing projects owned,
assisted, or operated by the public housing agency, a plan describing the
capital improvements necessary to ensure long-term physical and social
viability of the projects must be completed along with the required
forms. Items identified in 8.1 through 8.3, must be signed where
directed and transmitted electronically along with the PHA’s Annual
Plan submission.
8.1

Hope VI, Mixed Finance Modernization or Development,
Demolition and/or Disposition, Conversion of Public Housing,
Homeownership Programs, and Project-based Vouchers
(a)

(b)

(c)

Hope VI or Mixed Finance Modernization or Development.
1) A description of any housing (including project number (if
known) and unit count) for which the PHA will apply for HOPE
VI or Mixed Finance Modernization or Development; and 2) A
timetable for the submission of applications or proposals. The
application and approval process for Hope VI, Mixed Finance
Modernization or Development, is a separate process. See
guidance on HUD’s website at:
http://www.hud.gov/offices/pih/programs/ph/hope6/index.cfm
Demolition and/or Disposition. With respect to public housing
projects owned by the PHA and subject to ACCs under the Act:
(1) A description of any housing (including project number and
unit numbers [or addresses]), and the number of affected units
along with their sizes and accessibility features) for which the
PHA will apply or is currently pending for demolition or
disposition; and (2) A timetable for the demolition or
disposition. The application and approval process for demolition
and/or disposition is a separate process. See guidance on HUD’s
website at:
http://www.hud.gov/offices/pih/centers/sac/demo_dispo/index.c
fm
Note: This statement must be submitted to the extent that
approved and/or pending demolition and/or disposition has
changed.
Conversion of Public Housing. With respect to public
housing owned by a PHA: 1) A description of any building
or buildings (including project number and unit count) that
the PHA is required to convert to tenant-based assistance or

Capital Fund Program Annual Statement/Performance and
Evaluation Report. PHAs must complete the Capital Fund
Program Annual Statement/Performance and Evaluation Report
(form HUD-50075.1), for each Capital Fund Program (CFP) to be
undertaken with the current year’s CFP funds or with CFFP
proceeds. Additionally, the form shall be used for the following
purposes:
(a)

To submit the initial budget for a new grant or CFFP;

(b)

To report on the Performance and Evaluation Report progress
on any open grants previously funded or CFFP; and

(c)

To record a budget revision on a previously approved open
grant or CFFP, e.g., additions or deletions of work items,
modification of budgeted amounts that have been undertaken
since the submission of the last Annual Plan. The Capital
Fund Program Annual Statement/Performance and
Evaluation Report must be submitted annually.

Additionally, PHAs shall complete the Performance and
Evaluation Report section (see footnote 2) of the Capital Fund
Program Annual Statement/Performance and Evaluation (form
HUD-50075.1), at the following times:

8.2

1.

At the end of the program year; until the program is
completed or all funds are expended;

2.

When revisions to the Annual Statement are made,
which do not require prior HUD approval, (e.g.,
expenditures for emergency work, revisions resulting
from the PHAs application of fungibility); and

3.

Upon completion or termination of the activities funded
in a specific capital fund program year.

Capital Fund Program Five-Year Action Plan
PHAs must submit the Capital Fund Program Five-Year Action
Plan (form HUD-50075.2) for the entire PHA portfolio for the first
year of participation in the CFP and annual update thereafter to
eliminate the previous year and to add a new fifth year (rolling
basis) so that the form always covers the present five-year period
beginning with the current year.

8.3

Capital Fund Financing Program (CFFP). Separate, written
HUD approval is required if the PHA proposes to pledge any

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Instructions form HUD-50075 (2008)

portion of its CFP/RHF funds to repay debt incurred to finance
capital improvements. The PHA must identify in its Annual and 5year capital plans the amount of the annual payments required to
service the debt. The PHA must also submit an annual statement
detailing the use of the CFFP proceeds. See guidance on HUD’s
website at:
http://www.hud.gov/offices/pih/programs/ph/capfund/cffp.cfm
9.0

Housing Needs. Provide a statement of the housing needs of families
residing in the jurisdiction served by the PHA and the means by which
the PHA intends, to the maximum extent practicable, to address those
needs. (Note: Standard and Troubled PHAs complete annually; Small
and High Performers complete only for Annual Plan submitted with the
5-Year Plan).
9.1 Strategy for Addressing Housing Needs. Provide a description of
the PHA’s strategy for addressing the housing needs of families in
the jurisdiction and on the waiting list in the upcoming year.
(Note: Standard and Troubled PHAs complete annually; Small
and High Performers complete only for Annual Plan submitted
with the 5-Year Plan).

10.0 Additional Information. Describe the following, as well as any
additional information requested by HUD:
(a)

(b)

Progress in Meeting Mission and Goals. PHAs must
include (i) a statement of the PHAs progress in meeting the
mission and goals described in the 5-Year Plan; (ii) the basic
criteria the PHA will use for determining a significant
amendment from its 5-year Plan; and a significant
amendment or modification to its 5-Year Plan and Annual
Plan. (Note: Standard and Troubled PHAs complete
annually; Small and High Performers complete only for
Annual Plan submitted with the 5-Year Plan).
Significant Amendment and Substantial
Deviation/Modification. PHA must provide the definition
of “significant amendment” and “substantial
deviation/modification”. (Note: Standard and Troubled
PHAs complete annually; Small and High Performers
complete only for Annual Plan submitted with the 5-Year
Plan.)

(c)

PHAs must include or reference any applicable memorandum
of agreement with HUD or any plan to improve performance.
(Note: Standard and Troubled PHAs complete annually).

11.0 Required Submission for HUD Field Office Review. In order to be a
complete package, PHAs must submit items (a) through (g), with
signature by mail or electronically with scanned signatures. Items (h)
and (i) shall be submitted electronically as an attachment to the PHA
Plan.
(a)

Form HUD-50077, PHA Certifications of Compliance with
the PHA Plans and Related Regulations

(b)

Form HUD-50070, Certification for a Drug-Free Workplace
(PHAs receiving CFP grants only)

(c)

Form HUD-50071, Certification of Payments to Influence
Federal Transactions (PHAs receiving CFP grants only)

(d)

Form SF-LLL, Disclosure of Lobbying Activities (PHAs
receiving CFP grants only)

(e)

Form SF-LLL-A, Disclosure of Lobbying Activities
Continuation Sheet (PHAs receiving CFP grants only)

(f)

Resident Advisory Board (RAB) comments.

(g)

Challenged Elements. Include any element(s) of the PHA
Plan that is challenged.

(h)

Form HUD-50075.1, Capital Fund Program Annual
Statement/Performance and Evaluation Report (Must be
attached electronically for PHAs receiving CFP grants
only). See instructions in 8.1.

(i)

Form HUD-50075.2, Capital Fund Program Five-Year
Action Plan (Must be attached electronically for PHAs
receiving CFP grants only). See instructions in 8.2.

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Instructions form HUD-50075 (2008)