HUD 52830 Portfolio Schedule Form

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Overview

Instructions
Data Entry Sheet
CFFP ACC Amend Attach

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Sheet 1: Instructions

Instructions for Completing Portfolio Schedule for Capital Fund Financing Proposal
	Note: All data entry is performed on the "Data Entry Sheet", this sheet is used by HUD staff during their review. The data is linked to the "CFFP ACC
	Amendment Attach sheet which will be attached to the CFFP ACC Amendment as part of the HUD Approval letter package.
(1)           Enter name of Public Housing Authority.
(2)           Enter number of Public Housing Authority.
(3)           Enter Data the Capital Fund Financing Proposal is being submitted.
(4)           Indicate any anticipated changes to the portfolio that would either increase or decrease the total units, and therefore affect the formula capital funds.
This calculation should also feed into the Adjusted Capital Fund estimate in the Term Sheet, and the debt services schedule. On Line (a), indicate whether
any units or properties will be demolished or disposed of, with a “Yes” or a “No”. On Line (b), indicate whether units will be merged into larger units either
through the CFFP or otherwise, responding with a “Yes” or a “No”. On Line (c) indicate whether new units will be developed and placed under the ACC,
responding with a “Yes” or a “No”. On Line (d) indicate any other anticipated change in unit count. Select from the Drop Down menu, which includes:
Conversion (Mandatory, Required, Voluntary, Other); HOPE VI Demolition; HOPE VI Revitalization; Homeownership Sales; Casualty Condemnation;
Asset Management [AMPS that are not economically viable that the PHA does not want to, or cannot, sustain]; or other.
(5)           Enter the Fiscal Year of the Most Recent Capital Fund Grant received by the PHA. Use four digits (e.g., 2005).
(6)           Enter the year of Capital Fund funding that will be used to make the first debt service payment. Use four digits (e.g., 2005).
(7)           On the rows under this heading, List the HUD Project Number for each public housing development in the PHA’s portfolio.
(8)           On the rows under this heading, List the Project Name that corresponds to the Project Number. All existing projects must be included on the form.
Insert additional rows to the extent needed to.
(10)       Enter the Capital Funding per unit. Note: HUD will provide you a per unit funding schedule showing the per-unit funding amount from prior grants.
(11)       Estimated annual Capital Funding per Project is calculated by a formula.
(12)       Enter any notes of explanation, if needed.
(13)       Subtract any capital funds that need to be used for purposes other than housing authority operations, such as a Voluntary Compliance Agreement (VCA),
a Consent Decree, or Litigation. The drop down menu will allow you to identify the nature of the reduction. In column (E), indicate the amount of the reduction
as a negative number so that it is deducted from the total. Insert as many additional rows for as needed to enter all relevant data.
(14)       Sign Certification that the information is accurate to the best of the PHA’s knowledge, and that the data for existing units agrees with data in PIC.
This form must be signed by the PHA’s chief executive officer.

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Sheet 2: Data Entry Sheet

Capital Fund Financing Program							U.S. Department of Housing										OMB Approval No. 2577-0157					U.S. Department of Housing						OMB Approval No. 2577-0208
Portfolio Schedule Form							and Urban Development										(exp. 11/2008)					and Urban Development						(exp. 11/2008)
							Office of Public and Indian Housing															Office of Public and Indian Housing
(1) PHA Name																												0
(2) PHA Number																												0
(3) Date Submitted																												12/30/1899
Person Completing Form/ Contact Person
Contact Phone Number
e-mail
(4) Portfolio Changes Planned
(a) Demolition or Disposition
(b) Unit Consolidation or Merger
(c) New Development with approved development proposal
(d) Other (select from List)
(5) FY of Most Recent Capital Fund Grant
(6) 1st Year of CFP for Debt Service Payment
(7) HUD Project Number	(8) Project Name	(9) Number of Units Under ACC	(10) Cap Fund Per Unit Funding	(11) Projected Funding by Development	(12) Comments	0	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	Total Units Removed												0	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
				$-		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
						0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
						0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
						0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0													$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
(13) LESS any Reductions	Consent Decree																											Less any reductions											$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
LESS any Reductions	Consent Decree																											Less any reductions											$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
Total Units		0				-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-												$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-	$-
Total Capital Funds				$-		-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
		I, the undersigned, hereby certify that the existing and projected number of units are true and correct to the best of the PHA's knowledge, and that the numbers for existing units agree with data in PIC.
		Signature:			Title:	Date:
																	form HUD-52830 (11/2008)											form HUD-52830 (11/2008)

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Sheet 3: CFFP ACC Amend Attach

Capital Fund Financing Program							U.S. Department of Housing								OMB Approval No. 2577-0157				U.S. Department of Housing						OMB Approval No. 2577-0157
Portfolio Schedule Form							and Urban Development								(exp. 11/2008)				and Urban Development						(exp. 11/2008)
							Office of Public and Indian Housing												Office of Public and Indian Housing
(1) PHA Name																										0
(2) PHA Number																										0
(3) Date Submitted																										12/30/1899
Person Completing Form/ Contact Person
Contact Phone Number
e-mail
(4) Portfolio Changes Planned
(a) Demolition or Disposition
(b) Unit Consolidation or Merger
(c) New Development with approved development proposal
(d) Other (select from List)
(5) FY of Most Recent Capital Fund Grant
(6) 1st Year of CFP for Debt Service Payment
(7) HUD Project Number	(8) Project Name	(9) Number of Units Under ACC	(12) Comments	0	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	Total Units Removed
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
(13) LESS any Reductions	Consent Decree	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		Less any reductions
LESS any Reductions	Consent Decree	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		Less any reductions
Total Units		0		-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
		I, the undersigned, hereby certify that the existing and projected number of units are true and correct to the best of the PHA's knowledge, and that the numbers for existing units agree with data in PIC.
		Signature:	Title:	Date: