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pdfAFS Submission
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Organization
Wonderful Manor Associates
Tax ID
888888881
Mortgagor Type
Limited Dividend
Legal Structure
Limited Partnership
Type of Submission
Audited Submission IAW IG Handbook 2000.04
Federal Award Threshold
N/A
Property Name
WONDERFUL MANOR
FHA/Contract Number
M2M
010TC111
Date From
Date To
01/01/2004
12/31/2004
Do not continue if information is incorrect or missing from these fields.
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Have you verified that the Tax ID listed above is your correct Tax ID?
Have you verified that all of the HUD related properties listed above are
correct?
Have you verified that the Federal Award Threshold is correct (if
applicable)?
Have you verified that the Mortgagor Type listed above is correct?
Have you verified that the Legal Structure listed above is correct?
Have you verified that the M2M Indicator listed for all the HUD related
properties above is correct (if applicable)?
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AFS Submission
Page 1 of 5
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Balance Sheet Data
Date From
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Profit and Loss Data
Equity Data
Description
Account
Supplemental
Data
Cash Flow Data
Value
Details
Assets
1120
Cash - Operations
$
N/A
1121
Construction Cash Account
$
N/A
1125
Cash - Entity
$
N/A
1130
Tenant/Member Accounts Receivable (Coops)
$
N/A
1131
Allowance for Doubtful Accounts
$
N/A
1130N
Net Tenant Accounts Receivable
$
N/A
1135
Accounts Receivable - HUD
$
N/A
1137
Medicare/Medicaid/Other Insurance Receivable
$
N/A
1140
Accounts and Notes Receivable - Operations
$
[Details]
1145
Accounts and Notes Receivable - Entity
$
[Details]
1160
Accounts Receivable - Interest
$
N/A
1165
Interest Reduction Payment Receivable
$
N/A
1170
Short Term Investments - Operations
$
N/A
1175
Short Term Investments - Entity
$
N/A
1180
Inventory
$
N/A
1190
Miscellaneous Current Assets
$
[Details]
1200
Miscellaneous Prepaid Expenses
$
N/A
AFS Submission
1100T
Page 2 of 5
Total Current Assets
$
N/A
1191
Tenant/Patient Deposits Held in Trust
$
N/A
1310
Escrow Deposits
$
N/A
1320
Replacement Reserve
$
N/A
1330
Other Reserves
$
N/A
1340
Residual Receipts Reserve
$
N/A
1355
Bond Reserves
$
N/A
1367
Sinking Fund
$
N/A
1381
Management Improvement and Operating Plan
$
N/A
Total Deposits
$
N/A
1410
Land
$
N/A
1420
Buildings
$
N/A
1440
Building Equipment (Portable)
$
N/A
1450
Furniture for Project/Tenant Use
$
N/A
1460
Furnishings
$
N/A
1465
Office Furniture and Equipment
$
N/A
1470
Maintenance Equipment
$
N/A
1480
Motor Vehicles
$
N/A
1490
Miscellaneous Fixed Assets
$
N/A
Total Fixed Assets
$
N/A
Accumulated Depreciation
$
N/A
Net Fixed Assets
$
N/A
1510
Investments - Operations
$
N/A
1515
Investments - Entity
$
N/A
1520
Intangible Assets
$
N/A
1590
Miscellaneous Other Assets
$
[Details]
Total Other Assets
$
N/A
1300T
1400T
1495
1400N
1500T
AFS Submission
1000T
Page 3 of 5
Total Assets
$
N/A
2105
Bank Overdraft - Operations
$
N/A
2110
Accounts Payable - Operations
$
N/A
2111
Accounts Payable - Construction/ Development
$
N/A
2112
Accounts Payable - Project Improvement Items
$
N/A
2113
Accounts Payable - Entity
$
N/A
2115
Accounts Payable - 236 Excess Income due HUD
$
N/A
2116
Accounts Payable - Section 8 & Other
$
N/A
2120
Accrued Wages Payable
$
N/A
2121
Accrued Payroll Taxes Payable
$
N/A
2123
Accrued Management Fee Payable
$
N/A
2130
Accrued Interest Payable - Section 236
$
N/A
2131
Accrued Interest Payable - First Mortgage (or Bonds)
$
N/A
2132
Accrued Interest Payable - Other Mortgages
$
[Details]
2133
Accrued Interest Payable - Other Loans and Notes
(Surplus Cash)
$
N/A
2134
Accrued Interest Payable - Other Loans and Notes
$
N/A
2135
Accrued Interest Payable - Flexible Subsidy Loan
$
N/A
2136
Accrued Interest Payable - Capital Improvements Loan
$
N/A
2137
Accrued Interest Payable - Operating Loss Loan
$
N/A
2150
Accrued Property Taxes
$
N/A
2160
Notes Payable (Short-term)
$
N/A
2170
Mortgage (or Bonds) Payable - First Mortgage (Bonds)
(Short Term)
$
N/A
2172
Other Mortgages Payable (Short Term)
$
[Details]
2173
Other Loans and Notes Payable - Surplus Cash (Short
Term)
$
N/A
2174
Other Loans and Notes (Short Term)
$
N/A
2175
Flexible Subsidy Loan Payable (Short Term)
$
N/A
Liabilities
AFS Submission
Page 4 of 5
2176
Capital Improvement Loan Payable (Short Term)
$
N/A
2177
Operating Loss Loan Payable (Short Term)
$
N/A
2180
Utility Allowances
$
N/A
2190
Miscellaneous Current Liabilities
$
[Details]
2210
Prepaid Revenue
$
N/A
Total Current Liabilities
$
N/A
2191
Tenant/Patient Deposits Held In Trust (Contra)
$
N/A
2305
Accounts Payable - Entity (Long-Term)
$
N/A
2310
Notes Payable (Long-Term)
$
N/A
2311
Notes Payable - Surplus Cash
$
N/A
2320
Mortgage (or Bonds) Payable - First Mortgage (or Bonds)
$
N/A
2322
Other Mortgages Payable (Long Term)
$
[Details]
2323
Other Loans and Notes Payable - Surplus Cash
$
N/A
2324
Other Loans and Notes Payable
$
N/A
2325
Flexible Subsidy Loan Payable
$
N/A
2326
Capital Improvement Loan Payable
$
N/A
2327
Operating Loss Loan Payable
$
N/A
2330
Interest on Loans or Notes Payable (Long Term)
$
N/A
2390
Miscellaneous Long Term Liabilities
$
[Details]
2300T
Total Long Term Liabilities
$
N/A
2000T
Total Liabilities
$
N/A
Total Equity
$
N/A
Total Liabilities and Equity
$
N/A
2122T
Equity Data - Entities other than Corporations
3130
2033T
Equity Data - Corporations
3161
Common Stock (Corporations)
$
N/A
3162
Paid-in Surplus (Corporations)
$
N/A
3163
Retained Earnings (Corporations)
N/A
AFS Submission
Page 5 of 5
$
3164
Other Equity (Corporations)
$
N/A
3160
Total Equity (Corporations)
$
N/A
Total Liabilities and Equity/Retained Earnings
(Corporations)
$
N/A
Equity Data
Cash Flow Data
2036T
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Profit and Loss Data
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Statement Data
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Supplemental
Data
AFS Submission
Page 1 of 5
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Balance Sheet Data
Profit and Loss Data
Date From
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Equity Data
Description
Account
Supplemental
Data
Cash Flow Data
Value
Details
Rent Revenue
5120
Rent Revenue - Gross Potential
$
N/A
5121
Tenant Assistance Payments
$
N/A
5140
Rent Revenue - Stores and Commercial
$
N/A
5170
Garage and Parking Spaces
$
N/A
5180
Flexible Subsidy Revenue
$
N/A
5190
Miscellaneous Rent Revenue
$
[Details]
5191
Excess Rent
$
N/A
5192
Rent Revenue/ Insurance
$
N/A
5193
Special Claims Revenue
$
N/A
5194
Retained Excess Income
$
N/A
5195
Lease Revenue (Nursing Home or Section 232 - B&C or
AL)
$
N/A
Total Rent Revenue
$
N/A
5220
Apartments
$
N/A
5240
Stores and Commercial
$
N/A
5250
Rental Concessions
$
N/A
5270
Garage and Parking Space
$
N/A
5100T
Vacancies
AFS Submission
5290
Page 2 of 5
Miscellaneous
$
[Details]
5200T
Total Vacancies
$
N/A
5152N
Net Rental Revenue (Rent Revenue Less Vacancies)
$
N/A
$
N/A
5300 Revenue
5300
Nursing Homes/ Assisted Living/Board & Care/Other
Elderly Care/Coop/ and Other Revenues
Financial Revenue
5410
Financial Revenue - Project Operations
$
N/A
5430
Revenue from Investments - Residual Receipts
$
N/A
5440
Revenue from Investments - Replacement Reserve
$
N/A
5490
Revenue from Investments - Miscellaneous
$
[Details]
Total Financial Revenue
$
N/A
5400T
Other Revenue
5910
Laundry and Vending Revenue
$
N/A
5920
Tenant Charges
$
N/A
5945
Interest Reduction Payments Revenue
$
N/A
5990
Miscellaneous Revenue
$
[Details]
5900T
Total Other Revenue
$
N/A
5000T
Total Revenue
$
N/A
Administrative Expenses
6203
Conventions and Meetings
$
N/A
6204
Management Consultants
$
N/A
6210
Advertising and Marketing
$
N/A
6250
Other Renting Expenses
$
N/A
6310
Office Salaries
$
N/A
6311
Office Expenses
$
N/A
6312
Office or Model Apartment Rent
$
N/A
6320
Management Fee
$
N/A
6330
Manager or Superintendent Salaries
$
N/A
AFS Submission
Page 3 of 5
6331
Administrative Rent Free Unit
$
N/A
6340
Legal Expense - Project
$
N/A
6350
Audit Expense
$
N/A
6351
Bookkeeping Fees/Accounting Services
$
N/A
6370
Bad Debts
$
N/A
6390
Miscellaneous Administrative Expenses
$
[Details]
Total Administrative Expenses
$
N/A
6263T
Utilities Expenses
6420
Fuel Oil/Coal
$
N/A
6450
Electricity
$
N/A
6451
Water
$
N/A
6452
Gas
$
N/A
6453
Sewer
$
N/A
Total Utilities Expense
$
N/A
6400T
Operating & Maintenance Expenses
6510
Payroll
$
N/A
6515
Supplies
$
N/A
6520
Contracts
$
N/A
6521
Operating and Maintenance Rent Free Unit
$
N/A
6525
Garbage and Trash Removal
$
N/A
6530
Security Payroll/Contract
$
N/A
6531
Security Rent Free Unit
$
N/A
6546
Heating/Cooling Repairs and Maintenance
$
N/A
6548
Snow Removal
$
N/A
6570
Vehicle and Maintenance Equipment Operation and
Repairs
$
N/A
6590
Miscellaneous Operating and Maintenance Expenses
$
[Details]
Total Operating and Maintenance Expenses
$
N/A
6500T
AFS Submission
Page 4 of 5
Taxes & Insurance
6710
Real Estate Taxes
$
N/A
6711
Payroll Taxes (Project's Share)
$
N/A
6720
Property & Liability Insurance (Hazard)
$
N/A
6721
Fidelity Bond Insurance
$
N/A
6722
Workmen's Compensation
$
N/A
6723
Health Insurance and Other Employee Benefits
$
N/A
6790
Miscellaneous Taxes, Licenses, Permits and Insurance
$
[Details]
Total Taxes and Insurance
$
N/A
6700T
Financial Expenses
6820
Interest on First Mortgage (or Bonds) Payable
$
N/A
6825
Interest on Other Mortgages
$
N/A
6830
Interest on Notes Payable (Long Term)
$
N/A
6840
Interest on Notes Payable (Short Term)
$
N/A
6850
Mortgage Insurance Premium/ Service Charge
$
N/A
6890
Miscellaneous Financial Expenses
$
[Details]
Total Financial Expenses
$
N/A
$
N/A
6800T
6900 Expenses
6900
Nursing Homes/Assisted Living/ Board & Care/Other
Elderly Care Expenses
Operating Results
6000T
Total Cost of Operations before Depreciation
$
N/A
5060T
Profit (Loss) before Depreciation
$
N/A
6600
Depreciation Expenses
$
N/A
6610
Amortization Expense
$
N/A
Operating Profit or (Loss)
$
N/A
5060N
Corporate or Mortgagor Revenue/Expenses
7105
Entity Revenue
$
N/A
7110
Officer's Salaries
$
N/A
AFS Submission
Page 5 of 5
7120
Legal Expenses
$
N/A
7130
Federal, State, and Other Income Taxes
$
N/A
7141
Interest on Notes Payable
$
N/A
7142
Interest on Mortgage Payable
$
N/A
7190
Other Expenses
$
[Details]
Net Entity Expenses
$
N/A
Profit or Loss (Net Income or Loss)
$
N/A
S1000010
Total first mortgage (or bond) principal payments required
during the audit year [12 monthly payments]. This applies
to all direct loans, amortizing HUD-helds, and fully insured
first mortgages.
$
N/A
S1000020
Total of 12 monthly deposits in the audit year into the
Replacement Reserve account, as required by the
Regulatory Agreement even if payments may be
temporarily suspended or reduced.
$
N/A
S1000030
Replacement Reserves, or Residual Receipts and
Releases which are included as expense items on this
Profit and Loss statement.
$
N/A
S1000040
Project Improvement Reserve releases under the Flexible
Subsidy Program that are included as expense items on
this Profit and Loss statement.
$
N/A
7100T
Profit or Loss
3250
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Balance Sheet Data
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FASSUB Main Menu
Comments or Questions
Supplemental
Data
AFS Submission
Page 1 of 2
Project Name
FHA/Contract Number
Date From
Date To
010TC111
01/01/2004
12/31/2004
WONDERFUL MANOR
Supplemental Schedules with Financial
Statement Data
Balance Sheet Data
Profit and Loss Data
Notes & Auditor
Reports
Equity Data
Description
Account
Supplemental
Data
Cash Flow Data
Value
Details
Equity Data - Entities other than Corporations
S1100010
Beginning of Year Balance
$
N/A
Net Income or Loss
$
N/A
S1200420
Distributions
$
N/A
S1200430
Contributions
$
N/A
S3100030
Prior Period Adjustment
$
N/A
S1100020
Other Changes in Equity
$
[Details]
End of Year - 3130
$
N/A
3250
3130
Equity Data - Corporations
S1100300
Beginning Balance - Common Stock (Corporations)
$
N/A
S1100310
Change in Common Stock
$
N/A
Common Stock (Corporations)
$
N/A
S1100400
Beginning Balance - Paid-in Surplus (Corporations)
$
N/A
S1100410
Change in Paid-in Surplus (Corporations)
$
N/A
Paid-in Surplus (Corporations)
$
N/A
Beginning Balance - Retained Earnings (Corporations)
$
N/A
3161
3162
S1100500
AFS Submission
S1100510
Page 2 of 2
Change in Retained Earnings (Corporations)
$
N/A
Retained Earnings (Corporations)
$
N/A
S1100600
Beginning Balance - Other Equity (Corporations)
$
N/A
S1100610
Change in Other Equity (Corporations)
$
N/A
Other Equity (Corporations)
$
N/A
S1100700
Beginning of Year Balance/Prior Year Total Equity
(Corporations)
$
N/A
S1100710
Change in Total Equity (Corporations)
$
N/A
Total Equity (Corporations)
$
N/A
Equity Data
Cash Flow Data
3163
3164
3160
Save Your Work
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Balance Sheet Data
Profit and Loss Data
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Statement Data
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Comments or Questions
Supplemental
Data
AFS Submission
Page 1 of 5
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Balance Sheet Data
Profit and Loss Data
Description
Account
Date From
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Equity Data
Value
Supplemental
Data
Cash Flow Data
Details
Cash Flow from Operating Activities
S1200010
Rental Receipts
$
N/A
S1200020
Interest Receipts
$
N/A
S1200030
Other Operating Receipts
$
N/A
S1200035
Entity/Construction Receipts
$
[Details]
S1200040
Total Receipts
$
N/A
S1200050
Administrative
$
N/A
S1200070
Management Fee
$
N/A
S1200090
Utilities
$
N/A
S1200100
Salaries and Wages
$
N/A
S1200110
Operating and Maintenance
$
N/A
S1200120
Real Estate Taxes
$
N/A
S1200140
Property Insurance
$
N/A
S1200150
Miscellaneous Taxes and Insurance
$
N/A
S1200160
Tenant Security Deposits
$
N/A
AFS Submission
Page 2 of 5
S1200170
Other Operating Expenses
$
N/A
S1200180
Interest on First Mortgage
$
N/A
S1200181
Interest Payments - Second Mortgage
$
N/A
S1200182
Interest Payments - Third Mortgage
$
N/A
S1200190
Interest on Notes Payable
$
N/A
S1200210
Mortgage Insurance Premium (MIP)
$
N/A
S1200220
Miscellaneous Financial
$
N/A
S1200225
Entity/Construction Disbursements
$
[Details]
S1200230
Total Disbursements
$
N/A
S1200240
Net Cash provided by (used in) Operating
Activities
$
N/A
Cash Flow from Investing Activities
S1200245
Net Deposits to the Mortgage Escrow account
$
N/A
S1200250
Net Deposits to the Reserve for Replacement
account
$
N/A
S1200255
Net Deposits to Other Reserves
$
N/A
S1200260
Net Deposits to the Residual Receipts account
$
N/A
S1200300
Net Deposits to the Management Improvement
and Operating Plan account
$
N/A
S1200310
Net Deposits to the Long Term Investment
account
$
N/A
S1200330
Net Purchase of Fixed Assets
$
N/A
S1200340
Other Investing Activities
$
[Details]
S1200345
Entity/Construction Investing Activities
$
[Details]
S1200350
Net Cash used in Investing Activities
$
N/A
$
N/A
Cash Flow from Financing Activities
S1200360
Principal Payments - First Mortgage (or
Bonds)
AFS Submission
Page 3 of 5
S1200361
Principal Payments - Second Mortgage
$
N/A
S1200362
Principal Payments - Third Mortgage
$
N/A
S1200365
Proceeds from Mortgages, Loans, or Notes
Payable
$
N/A
S1200370
Principal Payments on Loans or Notes
Payable
$
N/A
S1200385
Proceeds from Flexible Subsidy Loans
$
N/A
S1200390
Flexible Subsidy Loan principal payments
$
N/A
S1200395
Proceeds from Capital Improvement Loans
$
N/A
S1200400
Principal payments on Capital Improvement
Loan Payable
$
N/A
S1200405
Proceeds from Operating Loss Loans
$
N/A
S1200410
Principal payments on Operating Loss Loan
Payable
$
N/A
S1200420
Distributions
$
N/A
S1200430
Contributions
$
N/A
S1200450
Other Financing Activities
$
[Details]
S1200455
Entity/Construction Financing Activities
$
[Details]
S1200460
Net Cash used in Financing Activities
$
N/A
S1200470
Net increase (decrease) in Cash and Cash
Equivalents
$
N/A
Cash and Cash Equivalents
S1200480
Beginning of Period Cash
$
N/A
S1200T
End of Period Cash
$
N/A
Reconciliation of Net Profit (Loss) to Net Cash Provided by (Used in) Operating Activities
3250
Profit or Loss (Net Income or Loss)
$
N/A
Adjustments to Reconcile Net Profit (Loss) to Net Cash Provided by (Used in) Operating
Activities
6600
Depreciation Expenses
$
N/A
6610
Amortization Expense
$
N/A
AFS Submission
Page 4 of 5
S1200490
Decrease (increase) in Tenant/Member
Accounts Receivable
$
N/A
S1200500
Decrease (increase) in Accounts Receivable Other
$
N/A
S1200510
Decrease (increase) in Accrued Receivable
$
N/A
S1200520
Decrease (increase) in Prepaid Expenses
$
N/A
S1200530
Decrease (increase) in Cash Restricted for
Tenant Security Deposits
$
N/A
S1200535
Decrease (increase) in Entity/ Construction
Asset accounts
$
[Details]
S1200540
Increase (decrease) in Accounts Payable
$
N/A
S1200550
Increase (decrease) in Accounts Payable HUD Excess Rents
$
N/A
S1200560
Increase (decrease) in Accrued Liabilities
$
N/A
S1200570
Increase (decrease) in Accrued Interest
Payable
$
N/A
S1200580
Increase (decrease) in Tenant Security
Deposits held in trust
$
N/A
S1200590
Increase (decrease) in Prepaid Revenue
$
N/A
S1200600
Other adjustments to reconcile net profit (loss)
to Net Cash provided by (used in) Operating
Activities
$
[Details]
S1200605
Increase (decrease) in Entity/Construction
Liability accounts
$
[Details]
$
N/A
Net Cash provided by (used in) Operating Activities
S1200610
Net Cash provided by (used in) Operating
Activities
S1200620
Comments
N/A
Save Your Work
Reset
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Balance Sheet Data
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FASSUB Main Menu
Cash Flow Data
Supplemental
Data
AFS Submission
Page 5 of 5
Comments or Questions
AFS Submission
Page 1 of 2
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Account
Description
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Auditor's Reports
Notes
Date From
Supplemental
Data
Findings & Prior Audits
Value
Details
S3100010
Organization and Presentation Note
N/A
S3100020
Prior Period Adjustment Note
N/A
S3100030
Prior Period Adjustment
S3100040
Summary of Significant Accounting
Policies Note
N/A
S3100050
Mortgages (or Bond) Payable Note
N/A
$
[Details]
Please enter the Mortgages Payable:
S3100120
Interest Reduction Payments from
Subsidy
S3100130
Notes/Loans Payable Note
Please Enter the Notes/Loans Payable
N/A
$
N/A
N/A
[Details]
AFS Submission
Page 2 of 2
S3100190
Total of Notes/Loans Payable
S3100200
Related Party Transactions Note
S3100230
Management Fee Note
$
N/A
[Details]
N/A
[Details]
Please enter the additional notes:
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Notes
Auditor's Reports
Supplemental Schedules with Financial
Statement Data
Findings & Prior Audits
Notes & Auditor
Reports
FASSUB Main Menu
Comments or Questions
Supplemental
Data
AFS Submission
Page 1 of 2
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Notes
Account
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Auditor's Reports
Description
Date From
Supplemental
Data
Findings & Prior Audits
Value
Details
Report on the Financial Statement
S2100-020 Opinion
None
N/A
None
S2100-050 Going Concern Issue
S2100-030 Opinion Explanation
N/A
N/A
Report on Supplemental Data
S2100-100 Opinion
None
N/A
S2100-110 Opinion Explanation
N/A
Report on Internal Controls
S2200-020 Reportable Conditions Indicator
None
N/A
S2200-030 Material Weaknesses Indicator
None
N/A
S2200-040 Comments on Internal Controls
N/A
Report on Compliance - Major Programs
S2300-020 Opinion
S2300-030 Material Non-Compliance Indicator
None
N/A
None
N/A
AFS Submission
Page 2 of 2
S2300-040 Comments on Non-compliance
N/A
Report on Compliance - Non-Major Programs
None
S2400-020 Material Non-Compliance Indicator
S2400-040 Comments on Non-compliance
N/A
N/A
Report on Compliance - Affirmative Fair Housing
None
S2500-020 Material Non-Compliance Indicator
S2500-040 Comments on Non-compliance
N/A
N/A
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Notes
Auditor's Reports
Supplemental Schedules with Financial
Statement Data
Findings & Prior Audits
Notes & Auditor
Reports
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Comments or Questions
Supplemental
Data
AFS Submission
Page 1 of 1
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Notes
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Auditor's Reports
Supplemental
Data
Findings & Prior Audits
Description
Account
Date From
Value
Details
Schedule of Findings and Questioned Costs
[Details]
Please enter the findings associated with this audit:
S2700-110
Contact Person First Name
N/A
S2700-120
Contact Person Middle Initial
N/A
S2700-130
Contact Person Last Name
N/A
Auditee's Comments on Audit Resolution Matters
Please enter the Prior Audit Matters for which there are comments:
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Notes
Auditor's Reports
Supplemental Schedules with Financial
Statement Data
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Comments or Questions
Supplemental
Data
AFS Submission
Page 1 of 2
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
Date From
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
NH/Assisted Living
Data
Certification/Federal Awards
Data
Description
Account
Supplemental
Data
Value
Details
Schedule of Reserve for Replacement
1320P
Balance at Beginning of Year
$
N/A
Total Monthly Deposits
$
N/A
1320ODT
Other Deposits
$
[Details]
1320INT
Interest on Replacement Reserve Accounts
$
N/A
1320RGL
Realized Gain or (Loss)
$
N/A
1320UGL
Unrealized Gain or (Loss)
$
N/A
1320WT
Approved Withdrawals
$
N/A
Other Withdrawals
$
[Details]
Balance at End of Year, Confirmed by Mortgagee
$
N/A
1320DT
1320OWT
1320
1320R
None
Deposits Suspended or Waived Indicator
N/A
Schedule of Residual Receipts
1340P
Balance at Beginning of Year
$
N/A
1340DT
Total Deposits
$
N/A
1340ODT
Other Deposits
$
[Details]
1340INT
Interest on Residual Receipt Accounts
$
N/A
1340RGL
Realized Gain or (Loss)
$
N/A
1340UGL
Unrealized Gain or (Loss)
$
N/A
AFS Submission
1340WT
1340OWT
1340
Page 2 of 2
Approved Withdrawals
$
N/A
Other Withdrawals
$
[Details]
Balance at Current Fiscal Year End
$
N/A
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Asset Data
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Data
Supplemental Schedules with Financial
Statement Data
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Data
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Reports
Supplemental
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FASSUB Main Menu
Comments or Questions
AFS Submission
Page 1 of 5
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
NH/Assisted Living
Data
Description
Account
Date From
Supplemental
Data
Certification/Federal Awards
Data
Value
Details
Computation of Surplus Cash, Distributions, and Residual Receipts (Annual)
S1300010
Cash
$
N/A
Accounts Receivable - HUD
$
N/A
S1300030
Other
$
[Details]
S1300040
Total Cash
$
N/A
S1300050
Accrued Mortgage (or Bond) Interest
Payable
$
N/A
S1300060
Delinquent Mortgage (or Bond) Principal
Payments
$
N/A
S1300070
Delinquent Deposits to Reserve for
Replacements
$
N/A
S1300075
Accounts Payable - 30 days
$
N/A
S1300080
Loans and Notes Payable [due within 30
days]
$
N/A
S1300090
Deficient Tax Insurance or MIP Escrow
Deposits
$
N/A
S1300100
Accrued Expenses [not escrowed]
$
N/A
2210
Prepaid Revenue
$
N/A
2191
Tenant/Patient Deposits Held In Trust
(Contra)
$
N/A
Other Current Obligations
$
[Details]
1135
S1300110
AFS Submission
Page 2 of 5
S1300140
Total Current Obligations
$
N/A
S1300150
Surplus Cash (Deficiency)
$
N/A
S1300160
Annual Distribution earned during fiscal
period covered by the statement
$
N/A
S1300170
Distribution Accrued and Unpaid as of the
end of the prior fiscal period
$
N/A
S1300180
Distributions and Entity Expenses paid
during fiscal period covered by statement
$
N/A
S1300190
Distribution Earned but Unpaid
$
N/A
S1300200
Amount Available for distribution during next
fiscal period
$
N/A
S1300210
Deposit Due Residual Receipts
$
N/A
Computation of Surplus Cash, Distributions, and Residual Receipts (Mid-year)
ex:
S1400010
Semi-Annual Period Ended
S1400020
Cash
$
N/A
S1400030
Tenant Subsidy due for semi-annual period
$
N/A
S1400040
Other
$
[Details]
S1400050
Total Cash
$
N/A
S1400060
Accrued Mortgage Interest Payable
$
N/A
S1400070
Delinquent Mortgage Principal Payments
$
N/A
S1400080
Delinquent Deposits to Reserve for
Replacements
$
N/A
S1400090
Accounts Payable [due within 30 days]
$
N/A
S1400100
Loans and Notes Payable [due within 30
days]
$
N/A
S1400110
Deficient Tax Insurance or MIP Escrow
Deposits
$
N/A
S1400120
Accrued Expenses [not escrowed]
$
N/A
S1400130
Prepaid Revenue
$
N/A
S1400-
Tenant Security Deposits Liability
$
N/A
12/31/1999
N/A
AFS Submission
Page 3 of 5
140
S1400150
Other Current Obligations
$
[Details]
S1400180
Total Current Obligations
$
N/A
S1400190
Surplus Cash (Deficiency)
$
N/A
S1400200
Distribution earned during semi-annual
period
$
N/A
S1400210
Distribution Accrued and Unpaid as of the
end of the semi-annual period
$
N/A
S1400220
Distributions and Entity Expenses paid
during semi-annual period
$
N/A
S1400230
Distribution Earned but Unpaid
$
N/A
S1400240
Amount Available for Distribution during next
fiscal period
$
N/A
S1400250
Deposit Due Residual Receipts
$
N/A
Beginning Balance for 1410
$
N/A
1410AT
Additions for 1410
$
[Details]
1410DT
Deductions for 1410
$
[Details]
Land
$
N/A
Beginning Balance for 1420
$
N/A
1420AT
Additions for 1420
$
[Details]
1420DT
Deductions for 1420
$
[Details]
Buildings
$
N/A
Beginning Balance for 1440
$
N/A
1440AT
Additions for 1440
$
[Details]
1440DT
Deductions for 1440
$
[Details]
Building Equipment (Portable)
$
N/A
Beginning Balance for 1450
$
N/A
1450AT
Additions for 1450
$
[Details]
1450DT
Deductions for 1450
$
[Details]
Schedule of Changes in Fixed Asset Accounts
1410P
1410
1420P
1420
1440P
1440
1450P
AFS Submission
1450
Page 4 of 5
Furniture for Project/Tenant Use
$
N/A
Beginning Balance for 1460
$
N/A
1460AT
Additions for 1460
$
[Details]
1460DT
Deductions for 1460
$
[Details]
Furnishings
$
N/A
Beginning Balance for 1465
$
N/A
1465AT
Additions for 1465
$
[Details]
1465DT
Deductions for 1465
$
[Details]
Office Furniture and Equipment
$
N/A
Beginning Balance for 1470
$
N/A
1470AT
Additions for 1470
$
[Details]
1470DT
Deductions for 1470
$
[Details]
Maintenance Equipment
$
N/A
Beginning Balance for 1480
$
N/A
1480AT
Additions for 1480
$
[Details]
1480DT
Deductions for 1480
$
[Details]
Motor Vehicles
$
N/A
Beginning Balance for 1490
$
N/A
1490AT
Additions for 1490
$
[Details]
1490DT
Deductions for 1490
$
[Details]
Miscellaneous Fixed Assets
$
N/A
1400PT
Total Beginning Balance for Fixed Assets
$
N/A
1400AT
Total Asset Additions
$
N/A
1400DT
Total Asset Deductions
$
N/A
1400T
Total Fixed Assets
$
N/A
1495P
Beginning Balance for 1495
$
N/A
Total Provisions
$
N/A
1460P
1460
1465P
1465
1470P
1470
1480P
1480
1490P
1490
6600
AFS Submission
1400ADT
1495
1400N
Page 5 of 5
Total Accumulated Depreciation from
Disposed Assets
$
N/A
Ending Balance for Accumulated
Depreciation
$
N/A
Total Net Book Value
$
N/A
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Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
NH/Assisted Living
Data
Supplemental Schedules with Financial
Statement Data
Certification/Federal Awards
Data
Notes & Auditor
Reports
Supplemental
Data
FASSUB Main Menu
Comments or Questions
AFS Submission
Page 1 of 5
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
Date From
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
NH/Assisted Living
Data
Certification/Federal Awards
Data
Description
Account
Supplemental
Data
Value
Details
Schedule of 5300 Accounts
5301
Private Pay Room & Board
$
N/A
5302
Private Pay Ancillary
$
N/A
5303
Contractual Adjustments
$
N/A
5305
Medicare Room & Board
$
N/A
5306
Medicare Ancillary
$
N/A
5307
Medicare Contractual Adjustments
$
N/A
5309
Medicaid Room & Board
$
N/A
5310
Medicaid Ancillary
$
N/A
5311
Swimming Pool Maintenance Expense
$
N/A
5312
Medicaid Contractual Adjustments
$
N/A
5315
VA Room & Board
$
N/A
5316
VA Ancillary
$
N/A
5317
VA Contractual Adjustments
$
N/A
5321
Hospice
$
N/A
5325
Other Public Room & Board
$
N/A
5326
Other Public Ancillary
$
N/A
AFS Submission
Page 2 of 5
5327
Other Public Adjustment
$
N/A
5330
Dietary Salaries
$
N/A
5331
Contributions and Gifts
$
N/A
5332
Food
$
N/A
5333
Dietary Supplies
$
N/A
5340
Registered Nurses Payroll
$
N/A
5341
Licensed Practical Nurses Payroll
$
N/A
5342
Other Nursing Salaries
$
N/A
5350
Housekeeping Salaries
$
N/A
5351
Housekeeping Supplies
$
N/A
5352
Other Housekeeping
$
N/A
5360
Drugs/Medical Supplies and Pharmaceuticals
$
N/A
5361
Medical Salaries
$
N/A
5362
Other Medical
$
N/A
5365
Food Servicing
$
N/A
5370
Laundry and Linen
$
N/A
5375
Housekeeping
$
N/A
5376
Health/Medical Services
$
N/A
5380
Recreation (Activities) and Rehabilitation
$
N/A
5385
Rehabilitation
$
N/A
5390
Other Service Revenue
$
N/A
5395
Adult Day Care
$
N/A
5396
Child Day Care
$
N/A
Schedule of 6900 Accounts
6930
Dietary Salaries
$
N/A
6931
Dietary Purchased Services
$
N/A
6932
Food
$
N/A
AFS Submission
Page 3 of 5
6933
Dietary Supplies
$
N/A
6940
Registered Nurses Payroll
$
N/A
6941
Licensed Practical Nurses Payroll
$
N/A
6942
Other Nursing Salaries
$
N/A
6943
Director of Nurses Salaries
$
N/A
6944
Nursing Purchase Services
$
N/A
6950
Housekeeping Salaries
$
N/A
6951
Housekeeping Supplies
$
N/A
6952
Other Housekeeping
$
N/A
6953
Housekeeping Purchased Services
$
N/A
6960
Drugs and Pharmaceuticals
$
N/A
6961
Medical Salaries
$
N/A
6962
Other Medical
$
N/A
6963
Medical Supplies
$
N/A
6964
Medical Purchased Services
$
N/A
6965
Pharmacy Salaries
$
N/A
6966
Pharmacy Supplies
$
N/A
6967
Pharmacy Purchased Services
$
N/A
6970
Laundry and Linen
$
N/A
6971
Laundry Salaries
$
N/A
6972
Laundry, Linen, Bedding, Disposables, Purchased
Services
$
N/A
6973
Laundry Supplies
$
N/A
6975
Medical Records Salaries
$
N/A
6976
Medical Records Supplies
$
N/A
6977
Medical Records Purchased Services
$
N/A
6980
Recreation and Rehabilitation
$
N/A
6981
Activities Supplies
$
N/A
AFS Submission
Page 4 of 5
6982
Activities Purchased Services
$
N/A
6983
Rehabilitation Salaries
$
N/A
6984
Rehabilitation Supplies
$
N/A
6985
Rehabilitation Purchased Services
$
N/A
6990
Other Service Expenses
$
N/A
Nursing Home Supplemental Data
S1900-010 Total Licensed Beds
N/A
S1900-020 Capacity
N/A
S1900-030 Medicare Pay Patient Days
N/A
S1900-040 Medicare Pay Patient Days Percentage
N/A
S1900-050 Medicaid Pay Patient Days
N/A
S1900-060 Medicaid Pay Patient Days Percentage
N/A
S1900-070 Private Pay Patient Days
N/A
S1900-080 Private Pay Patient Days Percentage
N/A
S1900-090 VA Pay Patient Days
N/A
S1900-100 VA Pay Patient Days Percentage
N/A
S1900-110 Other Pay Patient Days
N/A
S1900-120 Other Pay Patient Days Percentage
N/A
S1900-130 Actual Patient Days
N/A
S1900-140 Utilization
N/A
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Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
NH/Assisted Living
Data
Supplemental Schedules with Financial
Statement Data
Certification/Federal Awards
Data
Notes & Auditor
Reports
FASSUB Main Menu
Supplemental
Data
AFS Submission
Page 5 of 5
Comments or Questions
AFS Submission
Page 1 of 2
Project Name
FHA/Contract Number
WONDERFUL MANOR
010TC111
Supplemental Schedules with Financial
Statement Data
Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
Description
Account
Date From
Date To
01/01/2004
12/31/2004
Notes & Auditor
Reports
Supplemental
Data
NH/Assisted Living Certification/Federal Awards
Data
Data
Value
Details
Mortgagor's Certification
S2900010
Narrative
N/A
S2900020
Name of Signatory #1
N/A
S2900025
Title of Certifying Official
N/A
S2900030
Name of Signatory #2
N/A
S2900040
Auditee Telephone Number
N/A
S2900050
Date of Certification
ex: 12/31/1999
N/A
Managing Agent's Certification
S3000010
Narrative
N/A
S3000020
Name of Managing Agent
N/A
S3000030
Name of Signatory
N/A
S3000040
Managing Agent TIN
N/A
S3000-
Name of Individual (i.e., Property
AFS Submission
050
Page 2 of 2
Manager)
N/A
Auditor's Transmittal Letter
S3200005
Audit Firm ID (UII)
S3200010
Audit Firm
N/A
S3200020
Lead Auditor First Name
N/A
S3200030
Lead Auditor Middle Name
N/A
S3200040
Lead Auditor Last Name
N/A
S3200050
Auditor Street Address Line 1
N/A
S3200060
Auditor Street Address Line 2
N/A
S3200070
Auditor City
N/A
S3200080
Auditor State
N/A
S3200090
Auditor Zip Code
N/A
S3200100
Auditor Zip Code Extension
N/A
S3200110
Telephone Number
N/A
S3200120
Audit Firm TIN
N/A
S3200130
Date of Independent Auditor's
Report
N/A
ex: 12/31/1999
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Reserve Accounts
Data
Surplus Cash & Fixed
Asset Data
NH/Assisted Living Certification/Federal Awards
Data
Data
Supplemental Schedules with Financial
Statement Data
Notes & Auditor
Reports
Supplemental
Data
FASSUB Main Menu
Comments or Questions
File Type | application/pdf |
File Title | https://webt.hud.gov/HUD_Systems/fassub/afsprep.cfm?page_title= |
Author | c20798 |
File Modified | 2015-06-02 |
File Created | 2015-06-02 |