Form HUD 96009 HUD 96009 Benchmark Standards (42 Months)

										OMB Approval Number 2539-0015 (exp MM/DD/201Y)
* Grant Number:	Grantee Organization:							* Period of Performance:
PERIOD ACTIVITY	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10	Q11	Q12	Q13	Q14	Q15
Applicant Capacity (0-90 days)
Staff Hired
Approved Environmental Review and Release of Funds
Written Policies and Procedures
Number of Paint Inspections/ Risk Assessment Proposed:		< Enter Number of Units to be Assesssed
Paint Inspections/Risk Assessments:
Minimum Performance Standard	0%	5%	10%	15%	25%	35%	45%	55%	65%	75%	85%	95%	98%	100%
Proposed # Assessed
Actual # Assessed
Actual % Assessed
Units in Progress of Interventions
Number of Completed & Cleared Housing Units Proposed:		< Enter Number of Units to be Completed and Cleared.
Units Completed and Cleared:
Minimum Performance Standard	0%	1%	5%	10%	20%	30%	40%	50%	60%	70%	80%	90%	95%	99%	100%
Proposed # Completed
Actual # Completed
Actual % Completed
LOCCS DRAWDOWNS Grant Award Amount =		<Enter Requested OHHLHC Dollar Amount
LOCCS Drawdowns:
Minimum Performance Standard	2.50%	5%	10%	15%	20%	30%	40%	50%	60%	70%	80%	85%	90%	99%	100%
Drawdown Milestone
Proposed Dollars Drawn
Proposed Match Amount
Proposed Leverage
Actual Drawdown
Actual Drawdown %
Actual Match Amount
Actual Leverage Amount
Community Outreach / Education/ Training
Community Outreach Milestone
Community Outreach Achieved
Education Milestone
Education Achieved
Skills Training Milestone
Skills Training Achieved
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* Leave Grant Number and Period of Performance blank at time of application
											form HUD 9600x (xx/xxxx)