HUD-53421 Choice Neighborhoods Planning Grant Budget

OMB Approval No. 2577-0269
(exp. 4/30/2018)

Choice Neighborhoods Planning Grant Budget
Part I: Summary

Public Reporting Burden for this collection of information is estimated to average 1.25 hour 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.
This information is necessary to provide details on the funds requested by applicants/grantees. The
form displays the amount requested, broken down by budget line item, with each use explained on Part
II. Any Non-Choice Neighborhoods funds needed in association with the Planning Grant effort must be

The requested information will be reviewed by HUD to determine if the amount requested is
reasonable and whether the required percentages of capital and supportive services funds are met.
Responses to the collection are required by the appropriation under which the Choice Neighborhoods Planning grant
was funded. The information collected does not lend itself to confidentiality.
HUD may not conduct or sponsor, and a person is not required to respond to collection of information
unless it displays a currently valid OMB control number.

explained on Part III.

Grantee Name:
Site Name:

Choice Neighborhoods Planning Grant Number:
Budget Revision Number:
Summary by Budget Line Item

Revised Overall
Choice Neighborhoods
Planning Grant Budget

Line No.

1408

Management Improvements/
Capacity Building

2

1410

Administration

3

1430

Fees and Costs

1

4
5
6
7

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

Funds held in Reserve

Amount of Planning Grant ( Sum Of Lines 1-5)
Non-CN Total Non-Choice Neighborhoods Funds

Signature of Lead Applicant/Grantee Executive Officer

HUD-Approved Total
Authorized Amount
of Funds in LOCCS

Changes in LOCCS
Authorization in this Revision

$

Total Funds Authorization ( Sum Of Lines 1-3)
U2000

Previous
Authorized Amount
of Funds in LOCCS

$

-

$

HUD Certification: In approving this budget and providing assistance to a specific housing development(s),
I hereby certify that the assistance will not be more than is necessary to make the assisted activity feasible
after taking into account assistance from other government sources (24 CFR 12.50).

Signature of Authorized HUD Official
X

Date

X

Date

HUD Form 53421 (02/2012)

page 1 of 6

Choice Neighborhoods Planning Grant Budget

Part II: Supporting Pages for Revision to Overall Budget, Expenditure Allocation and/or Authorized Spending Amount
0

Grant Number

Budget Revision Number

0

0

0

Budget
Line Item
Number

Description of Proposed/Approved Action
Use of Additional Authorized Funds

Current Overall
Choice
Neighborhoods
Planning Grant
Budget

1

2

3

1408

Total Funds to be
Authorized for
Expenditure
(New Spread)

8

MANAGEMENT IMPROVEMENTS / CAPACITY BUILDING

Total Changes
Previous Approved Totals $
NEW TOTALS
BLI Percentage of Overall Budget
1410

Requested
Requested Change Current Authorized Requested Change
Change in Overall in Disbursed Funds
Amount
in Amount
Choice
(Realignment)
(Current Spread)
Authorized for
Neighborhoods
Expenditure
Planning Grant
(Change in Spread)
Budget
4
5
6
7

$

-

$

$

$

-

$

-

-

$

-

-

-

%

$

$
$
$
$
$
$
$
$
$

%

%

ADMINISTRATION

Total Changes
Previous Approved Totals $
NEW TOTALS
BLI Percentage of Overall Budget

$

-

$

$

$
%

page 2 of 6

-

$

-

$

-

$
$
$
$
$
$
$
$
$

-

$

-

-

%

%

form HUD-53421

Choice Neighborhoods Planning Grant Budget
Budget
Line Item
Number

Description of Proposed/Approved Action
Use of Additional Authorized Funds

Current Overall
Choice
Neighborhoods
Planning Grant
Budget

1

2

3

1430

Requested
Requested Change Current Authorized Requested Change
Change in Overall in Disbursed Funds
Amount
in Amount
Choice
(Realignment)
(Current Spread)
Authorized for
Neighborhoods
Expenditure
Planning Grant
(Change in Spread)
Budget
4
5
6
7

Total Funds to be
Authorized for
Expenditure
(New Spread)

8

FEES AND COSTS

Total Changes
Previous Approved Totals $
NEW TOTALS
BLI Percentage of Overall Budget

Overall Totals $

$

-

$

$

$

-

$

-

-

$

-

-

-

%

-

$

-

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$

%

$

page 3 of 6

-

%

$

-

$

-

$

form HUD-53421

-

Choice Neighborhoods Planning Grant Budget
Part III: Match, Leverage and other Non-Choice Neighborhoods Funds
Source

Dollar Amount

TOTAL

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$

Activity/Costs for which Non-Choice Neighborhoods Funds will be used

-

page 4 of 6

HUD-53421

Memorandum For: OPHI LOCCS Administrator

From:

[enter HUD Team Coordinator Name]

Re: Choice Neighborhoods Grant #:
Grantee:
Budget Revision #:

0
0
0

Please make the following changes in LOCCS for the subject grant.
OVERALL CN BUDGET
Current
Overall CN
BLI
Budget
1408
$
1410
$
1430
$
BLI Totals
$0.00

Increase/
Decrease
$
$
$
$0.00

Choice Neighborhoods Director

REALIGNMENT OF EXPENDITURES
Revised
Overall CN
Budget
$
$
$
$
-

BLI
1408
1410
1430
BLI Totals

Current
LOCCS
Expenditures

$0.00

Increase/
Decrease
$
$
$
$0.00

Revised
LOCCS
Expenditures
BLI
$0.00
1408
$0.00
1410
$0.00
1430
$0.00 BLI Totals
U2000

CHANGE IN SPREAD

$
$
$
$
$

Current
Spread
-

Increase/
Decrease
$
$
$
$
$
-

$
$
$
$
$

Revised
Spread
-

Instructions for Choice Neighborhoods Planning Grant Budget Form
1. Part I
A. Fill in "Grantee Name", "Grant Number", "Site Name"and "Budget Revision #" above the table.
B. Cells in lines 1-6 of the table autopopulate with information from Part II; Line 7 autopopulates with
information from Part III.
2. Part II
Refer to the "Choice Neighborhoods Planning Grant Budget Guidance" posted to the program website at
www.hud.gov/cn for information about how to classify each activity.
A. Under each BLI list each activity/contract separately. Provide enough detail for your grant management
team to understand each activity.
B. "Current Overall Choice Neighborhoods Planning Grant Budget" (Column 3) is the amount previously
approved by HUD for each activity. If this is Budget Revision #1, enter the budget as proposed in your original
grant application.
C. "Requested Change in Overall Choice Neighborhoods Planning Grant Budget" (Column 4) is the amount
by which you are changing from the previously approved amount for each activity.
D. "Requested Change in Disbursed Funds (Realignment)" (Column 5) is used if funds were erroneously
drawn from LOCCS from the wrong BLI. HUD will use this information to 'realign' the LOCCS draw
information.
E. "Current Authorized Amount" (Column 6) is the amount of funding currently availble for draw down (i.e. has
been 'spread') in LOCCS for each activity.
F. "Requested Change in Amount Authorized for Expenditure (Change in Spread)" (Column 7) is the amount
by which you are changing the funding available in LOCCS for each activity.
G. All other cells have formulas and will autopopulate based on your entry in columns 3-7.
3. Part III
A. List on this spreadsheet any Non-Choice Neighborhoods funds (e.g., from match/leverage funds) that will
be used to pay for costs associated with the Planning Grant effort that are not paid for by the Choice
Neighborhoods grant funds.
- This form must include cash match and leverage. You may also include in-kind leverage. If including both,
you must clearly label each source of leverage as "cash" or "in-kind."
4. LOCCS form
A. Enter your Grant Management Team Coordinator's name.
B. "Current LOCCS Expenditures" is the amount of funds you have drawn from LOCCS for each BLI.
C. All other cells have formulas and will autopopulate.
5. Complete the form
A. Review budget totals to make sure budgeted amounts equal the grant amount.
B. Print Parts I, II, and III.
C. Authorized Executive Officer signs and dates form on Part I.
D. Submit completed workbook and signed form to your grant management team. You may submit the
signed budget form either via email with a pdf or via mail with a hard copy. In either case, please also email
the Excel workbook to your Team Coordinator.