RD 3560-7 Restrictive Use Covenant

Section 515 Multi-Family Housing Preservation and Revitalization Restructuring (MPR) Demonstration Program

RD3560-0007_060500V01

Sec. 515 Multi-Family Housing Preservation & Revitalization - Individuals

OMB: 0575-0190

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USDA
Form RD 3560-7

FORM APPROVED
OMB NO. 0575-0189

MULTIPLE FAMILY HOUSING PROJECT BUDGET/
UTILITY ALLOWANCE

(Rev. 05-06)

PROJECT NAME

BORROWER ID AND PROJECT NO.

BORROWER NAME

Loan/Transfer Amount $
Reporting Period

Submit

Budget Type

Note Rate Payment $
Project Rental Type

IC Payment $

Profit Type

The following utilities are master
metered:

Annual

Initial

Family

Full Profit

Quarterly

Regular Report

Elderly

Monthly

Rent Change

Congregate

Limited Profit
Non-Profit

SMR

Group Home

Other Servicing

Mixed

I hereby request
units of RA. Current number

Electricity

Gas

of RA units

Water

Sewer

Borrower Accounting Method

.

Trash
LH

Cash

Other

Accrual

PART I-CASH FLOW STATEMENT
CURRENT
BUDGET

PROPOSED
BUDGET

ACTUAL

COMMENTS
or (YTD)

BEGINNING DATES>
ENDING DATES>
OPERATIONAL CASH SOURCES

1. RENTAL INCOME
2. RHS RENTAL ASSISTANCE RECEIVED

3. APPLICATION FEES RECEIVED
4. LAUNDRY AND VENDING
5. INTEREST INCOME
6. TENANT CHARGES
7. OTHER -PROJECT SOURCES
8. LESS (Vacancy and Contingency Allowance)
9. LESS (Agency Approved Incentive Allowance)
10. SUB-TOTAL [(1 thru 7) - (8 & 9)]

(
(

(
(

)
)

)
)

0.00

0.00

0.00

14. SUB-TOTAL (11 thru 13)

0.00

0.00

0.00

15. TOTAL CASH SOURCES (10+14)

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

NON-OPERATIONAL CASH SOURCES
11. CASH-NON PROJECT
12. AUTHORIZED LOAN (Non-RHS)
13. TRANSFER FROM RESERVE

OPERATIONAL CASH USES
16. TOTAL O&M EXPENSES (From Part II)
17. RHS DEBT PAYMENT
18. RHS PAYMENT (Overage)
19. RHS PAYMENT (Late Fee)
20. REDUCTION IN PRIOR YEAR PAYABLES
21. TENANT UTILITY PAYMENTS
22. TRANSFER TO RESERVE
23. RETURN TO OWNER/NP ASSET MANAGEMENT FEE

24. SUB-TOTAL (16 thru 23)
NON-OPERATIONAL CASH USES
25. AUTHORIZED DEBT PAYMENT (Non-RHS)
26. ANNUAL CAPITAL BUDGET (From Part III, Lines 4-6)
27. MISCELLANEOUS

28. SUB-TOTAL (25 thru 27)
29.

TOTAL CASH USES (24+28)

30. NET CASH (DEFICIT) (15- 29)
CASH BALANCE
31. BEGINNING CASH BALANCE
32. ACCRUAL TO CASH ADJUSTMENT

33. ENDING CASH BALANCE (30+31+32)

According to the Paperwork Reduction Act of I 995, an agency may not conduct sponsor and a person is not required to respond to a collection of information unless it displays a valid
0MB control number. The valid 0MB control number for this information collection is 0575-0189. The time required to complete this information collection is estimated to average 2 1/2 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.

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PART II-OPERATING AND MAINTENANCE EXPENSE SCHEDULE
CURRENT
BUDGET
1. MAINTENANCE AND REPAIRS PAYROLL
2. MAINTENANCE AND REPAIRS SUPPLY
3. MAINTENANCE AND REPAIRS CONTRACT
4. PAINTING
5. SNOW REMOVAL
6. ELEVATOR MAINTENANCE/CONTRACT
7. GROUNDS
8. SERVICES
9. ANNUAL CAPITAL BUDGET (From Part V- Operating)
10. OTHER OPERATING EXPENSES (Itemize)
11. SUB-TOTAL MAINT. & OPERATING (1 thru 10)

12. ELECTRICITY
If master metered
13. WATER
check box on
14. SEWER
front.
15. FUEL (Oil/Coal/Gas)
16. GARBAGE & TRASH REMOVAL
17. OTHER UTILITIES
18. SUB-TOTAL UTILITIES (12 Thru 17)

19. SITE MANAGEMENT PAYROLL
20. MANAGEMENT FEE
21. PROJECT AUDITING EXPENSE
22. PROJECT BOOKKEEPING/ACCOUNTING
23. LEGAL EXPENSES
24. ADVERTISING
25. TELEPHONE & ANSWERING SERVICE
26. OFFICE SUPPLIES
27. OFFICE FURNITURE & EQUIPMENT
28. TRAINING EXPENSE
29. HEALTH INS. & OTHER EMP. BENEFITS
30. PAYROLL TAXES
31. WORKMAN'S COMPENSATION
32. OTHER ADMINISTRATIVE EXPENSES (Itemize)
33. SUB-TOTAL ADMINISTRATIVE (19 thru 32)

34. REAL ESTATE TAXES
35. SPECIAL ASSESSMENTS
36. OTHER TAXES, LICENSES& PERMITS
37. PROPERTY& LIABILITY INSURANCE
38. FIDELITY COVERAGE INSURANCE
39. OTHER INSURANCE
40. SUB-TOTAL TAXES& INSURANCE (34 thru 39)

41. TOTAL O&M EXPENSES (11 +18+33+40)

Form RD 3560-7

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ACTUAL

PROPOSED

COMMENTS

BUDGET

or (YTD)

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Page 2

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PART III-ACCOUNT BUDGETING/STATUS
CURRENT
BUDGET

PROPOSED
BUDGET

ACTUAL

COMMENTS
or (YTD)

RESERVE ACCOUNT:
1. BEGINNING BALANCE
2. TRANSFER TO RESERVE
TRANSFER FROM RESERVE
3. OPERATING DEFICIT
4. ANNUAL CAPITAL BUDGET (Part V - Reserve)
5. BUILDING & EQUIPMENT REPAIR
6. OTHER NON-OPERATING EXPENSES
7. TOTAL (3 thru 6)
8. ENDING BALANCE [(1 +2)-7]

(

0.00 ) (

0.00 ) (

0.00

0.00

0.00 )
0.00

GENERAL OPERATING ACCOUNT:*
BEGINNING BALANCE
ENDING BALANCE
REAL ESTATE TAX AND INSURANCE ESCROW
ACCOUNT:*
BEGINNING BALANCE
ENDING BALANCE
TENANT SECURITY DEPOSIT ACCOUNT:*
BEGINNING BALANCE
ENDING BALANCE
(*Complete upon submission of actual expenses.)
NUMBER OF APPLICANTS ON THE WAITING LIST
NUMBER OF APPLICANTS NEEDING RA

Form RD 3560-7

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RESERVE ACCT. REQ. BALANCE
AMOUNT AHEAD/BEHIND

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PART IV-RENT SCHEDULE AND UTILITY ALLOWANCE
A CURRENT APPROVED RENTS/ UTILITY ALLOWANCE
UNIT DESCRIPTION
UNIT
BR SIZE TYPE

NUMBER

BASIC

RENTAL RATE S
NOTE
RATE

POTENTIAL INCOME FROM
EACH RATE
HUD

CURRENT RENT TOTALS:

BASIC

NOTE
RATE

$0.00

BASIC

UTILITY
ALLOWANCE

HUD

$0

NOTE

$0.00

HUD

B. PROPOSED RENTS - Effective Date:
UNIT DESCRIPTION

UNIT
BR SIZE TYPE

POTENTIAL INCOME FROM
EACH RATE

RENTAL RATES

NUMBER

NOTE
RATE

BASIC

HUD

BASIC

NOTE
RATE

HUD
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

PROPOSED RENT TOTALS:

0.00

BASIC

0.00

NOTE

0.00

HUD

C: PROPOSED UTILITY ALLOWANCE - Effective Date:

BR SIZE UNIT TYPE

Form RD 3560-7

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NUMBER

MONTHLY DOLLAR ALLOWANCES
ELECTRIC
GAS WATER SEWER TRASH

OTHER

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TOTAL

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PART V - ANNUAL CAPITAL BUDGET
Proposed
Number of
Units/Items

Proposed
from
Reserve

Actual from
Reserve

Proposed
from
Operating

Actual from
Operating

Actual Total
Cost

Appliances:
Range
Refrigerator
Range Hood
Washers & Dryers
Other:
Carpet & Vinyl:
1BR
2BR
3BR
4BR
Other:
Cabinets:
Kitchens
Bathrooms
Other:
Doors:
Exterior
Interior
Other:
Window Coverings:
List:
Other:
Heating & Air Conditioning:
Heating
Air Conditioning
Other:
Plumbing:
Water Heater
Bath Sinks
Kitchen Sinks
Faucets
Toilets
Other
Major Electrical:
List:
Other:
Structures:
Windows
Screens
Walls
Roofing
Siding
Exterior Painting
Other
Paving:
Asphalt
Concrete
Seal & Stripe
Other:
Landscape & Grounds:
Landscaping
Lawn Equipment
Fencing
Recreation Area
Signs
Other:
Accessibility Features:
List:
Other:
Automation Equipment:
Site Management
Common Area
Other:
Other:
List:
List:
List:

TOTAL CAPITAL
EXPENSES:
RD 3560-7 Page 5

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Total Actual
Units/Items

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PART VI -- SIGNATURES, DATES AND COMMENTS

Warning: Section 1001 of Title 18, United States Code provides: ''Whoever, in any matter within the jurisdiction of any
department or agency of the United States knowingly and willfully falsifies, conceals or covers up by any trick,
scheme, or device a material fact, or makes any false, fictitious or fraudulent statements or representations, or
makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement
or entry, shall be fined under this title or imprisoned not more than five years, or both.
I HAVE READ THE ABOVE WARNING STATEMENT AND I HEREBY CERTIFY THAT THE FOREGOING INFORMATION IS
COMPLETE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

(DATE)

(Signature of Borrower or Borrower's Representative)

(Title)

AGENCY APPROVAL (Rural Development Approval Official):

DATE:

COMMENTS:

Form RD 3560-7 Page 6

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