| Capital Fund Financing Program |
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U.S. Department of Housing |
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OMB Approval No. 2577-0157 |
| Pooled Transaction: List of |
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and Urban Development |
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(exp. 1/17/2017) |
| Participating PHAs |
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| Name of Pool:______________________________________ |
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(a) |
(b) |
(c) |
(d) |
(e) |
(f) |
(g) |
(h) |
(i) |
(j) |
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Name of PHA |
Amount of Issuance |
Percentage of Pooled Transaction |
Annual Debt Service |
Current FY Capital Fund |
Debt Service as a Percent of Capital Fund |
Debt Service as Percent of Pooled Debt Service |
Cost of Issuance as a Percent of Issuance |
Number of Properities Modernized |
Current PHAS Score |
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| 1 |
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| 2 |
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| 3 |
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| 4 |
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| 5 |
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| 6 |
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| 7 |
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| 8 |
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| 9 |
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| 10 |
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| 11 |
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| 12 |
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| 13 |
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| 14 |
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| 15 |
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| 16 |
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| 17 |
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TOTAL |
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| Instructions: |
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| 1. Fill in the requested information for each PHA participating in the CFFP Pool. Cross-collateralization is not permitted. |
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| 2. Column (d) should include principal and interest payments, plus any other ongoing fees (e.g. trustee fees, rating agency fees, etc.). |
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| 3. Column (j) use PHAS rating name: High, Standard or Troubled. |
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| 4. If more that 17 PHAs are participating, use a second form for the remaining PHAS and provide a subtotal for the second form and grand total for the pool. |
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