93481-ORCF Schedule C - Schedule of Accounts Payable

See Instructions and Reporting Burden Statement on back.

For the Month of

Date Incurred

To Whom Owed

Purpose

Amount

$

Previous versions obsolete

Total Accounts Payable (enter on line 5 of form HUD-93479-ORCF)

$

Schedule C

Schedule of Accounts

Payable

U.S. Department of Housing and Urban Development

Office of Residential

Care Facilities

OMB Approval No. 2502-XXXX

(exp. mm/dd/yyyy)

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions. 

form HUD-93481-ORCF (mm/dd/yyyy)

Page 1 of 2

Previous versions obsolete

form HUD-93481-ORCF (mm/dd/yyyy)

Page 2 of 2

Authority for collection of information on this form is contained in 24 CFR, CH 11 (4-1-99 Edition), Section 200.105, Mortgagor Supervision, Page 22. The information is sent to the Department of Housing and Urban Development (HUD) the tenth day of each month by owner s or management agents of HUD-insured or Secretary-held properties. The information is used by HUD to assess the need for remedial actions to correct project deficiencies. If information is not collected the Department would not be able to monitor debt collection on HUD-held projects and it would increase the potential for fraud, diversions, defaults, and assignments. The information is not considered sensitive. While no assurance of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information request.

Public reporting burden for this collection of information is estimated to average 1 hour. This includes the time for collecting, reviewing, and reporting the data. The information is being collected to obtain the supportive documentation which must be submitted to HUD for approval, and is necessary to ensure that viable projects are developed and maintained. HUD will use this information to determine if properties meet HUD requirements with respect to development, operation and/or asset management, as well as ensuring the continued marketability of the properties. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. 

Instructions for Preparation of Monthly Reports for Establish­ing Net Income

One copy of the monthly report forms (forms HUD-93479-ORCF, HUD-93480-ORCF, and HUD-93481-ORCF) is due no later than the tenth of the month following the month of operation covered by the report. All applicable lines should be completed since partial information reduces the usefulness of the reports. The report must be signed by an authorized representative of the management agent or borrower.

Schedule C: Form HUD-93481-ORCF, Schedule of Accounts Payable

All delinquencies under the mortgage must be shown. Itemize principal, interest, type of escrow, and MIP.

All other amounts owed as of the end of the month must be shown and adequately identified as to who owed, the purpose of the obligation, and the date incurred.