50075.2i Instructions for Preparation of Form HUD-50075.2

Instructions for Preparation of Form HUD-50075.2, Capital Fund Program – Five-Year Action Plan
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------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 3 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

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Prepare a separate Form HUD-50075.2 for each annual formula grant, describing the activities, which are planned to be undertaken with the current year’s Capital Fund
Program Grant and Capital Fund Financing Program (CFFP) financing. Submit this form to HUD electronically as part of each Annual Plan submission. On an as-needed basis,
submit a revised form when there are significant deviation or significant amendment/modifications to the approved CFP Five-Year Action Plan.
Natural disasters and emergencies:
Prepare a separate Form HUD-50075.2 for each funding request from the reserve for natural disasters and emergencies.
Report Submission For the CFP Five –Year Action Plan.
At the end of the PHA’s fiscal year end, complete the sections as delineated. Submit the form(s) to HUD electronically together with other required documents. Continue
reporting at the end of each program year, until the program is completed or all funds are expended.
Revisions to the Capital Fund Program – Five-Year Action Plan, which are not significant deviation or significant amendment/modifications to the PHA Plan, (e.g.
expenditures for emergency work, revisions resulting from the PHA’s application of fungibility) shall be reported on the Capital Fund Program – Five-Year Action Plan.
Upon completion or termination of the activities funded in a specific grant year, complete the Capital Fund Program – Five-Year Action Plan and submit to HUD with the next
Annual Plan submission.
Part I: Summary.
PHA Name/Number
Locality
Original Five-Year Plan/Revision Number
Row A: Development Number/Name (PHA Wide)
Work Statement for Year 1
Work Statement for Years 2-5
Row B: Physical Improvements subtotal
Row C: Management Improvements
Row D: PHA-Wide Non-dwelling Structures and
Equipment
Row E: Administration
Row F: Other
Row G: Operations
Row H: Demolition

Enter the Name and PHA number
Enter City or County and State
Check the appropriate box. Consecutively number each revision submitted.
Group the planned capital projects by development first. List the PHA-wide projects last.
Enter the Federal Fiscal Year (FFY) only. Do not enter any other information on Year 1. That information is
already available on the Annual Statement.
Enter the FFY for Years 2-5.
Total the planned capital projects for each individual development by the corresponding year.
Total the planned management projects for each individual development by the corresponding year.
Total the planned PHA-wide non-dwelling structures and equipment costs by the corresponding year.
Total the planned administration costs by the corresponding year.
Total the planned other costs by the corresponding year.
Total the planned operations costs by the corresponding year
Total the planned demolition costs by the corresponding year

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Instructions HUD-50075.2 (4/2008)

Row I.: Development
Row J: Capital Fund Financing-Debt Service
Row K: Total CFP Funds (estimated)
Row L: Total Non-CFP Funds
Row M: Grand Total

Total the planned development costs by the corresponding year
Total the planned debt service costs by the corresponding year
Enter the total Capital Fund Program funding estimated for Years 2-5.
Enter the total non-capital funds anticipated for Years 1-5.
Total the grand total from rows B-K for Years 2-5.

Part I: Summary (Continuation for PHA-wide activities). See instructions above under Part I, Summary
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Part II: Supporting Pages – Physical Needs Work Statements.
Work Statement for Year 1
Enter the Federal Fiscal Year (FFY) only. Do not enter any other information on Year 1. That information is already available on the
FFY_
Annual Statement.
Work Statement for Years 2-5
Enter the corresponding Years 2-5 and add FFY years.
Development Number/Name
Enter the name and number of the developments with planned activities.
Major Work Categories
Identify the planned major work categories by Development for Years 2-5. (Example: install new exterior doors, replace windows, etc.)
Quantity
List the number of planned work items such as replace 100 exterior doors, etc.
Estimated Cost
Enter the estimated costs for work activities for Years 2-5.
Subtotal of Estimated Cost.
A subtotal amount must be entered for all work items listed.
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Part III: Supporting Pages – Management Needs Work Statements.
Work Statement for Year 1
FFY_
Work Statement for Years 2-5

Enter the Federal Fiscal Year (FFY) only. Do not enter any other information on Year 1. That information is already available on the
Annual Statement.
Enter the corresponding Years 2-5 and add FFY years.

Development Number/Name
Major Work Categories

Enter the name and number of the developments with planned activities.
Identify the planned major work categories by Development for Years 2-5. (Example: provide staff computer training; computer purchase,
etc.)
List the number of planned work items such as replace 10 desktop computers, etc.
Enter the estimated costs for work activities for Years 2-5.
A subtotal amount must be entered for all work items listed.

Quantity
Estimated Cost
Subtotal of Estimated Cost.

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Instructions HUD-50075.2 (4/2008)