Tribal Annual Performance Report (TAPR) Excel workbook

Bureau of Indian Affairs Housing Improvement Program

2019 Tribal Annual Performance Report v.1 PRA.xlsm

Tribal Annual Performance Report

OMB: 1076-0184

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Profile
Form
PriorityListForm
TribePartI
Tribe Part II
150 Per Cent
HIP Home


Sheet 1: Instructions


This workbook was created using Windows 7, Office Suite Excel 10. There may be some compatibility issues when trying to use this workbook with an earlier version of Excel.May not work with Microsoft Excel 5.0/95 Workbook version.

You are using the Electronic VBA Version of the 2019 HIP Tribal Annual Performance Report. This version shall only be used for FY 2019.

This workbook contains macros and formulas, to properly use this Excel Workbook, you must save as enabled Workbook or enable the security macros.

To save for use with an older version of Excel,choose Office,then Save As and select one of these options from the Save As Type dropdown list:1)Excel 97-2003 Workbook;2)Save as type:Excel Enabled Workbook;3)Save by adding your tribe name to file;(e.g. 2019 HIP Tribal Annual Performance Report - Your Tribe name)

The 2019 HIP Tribal Annual Performance Report is due to your respective region by COB December 31, 2018.

Before submitting this workbook to your respective Regional Office, please save as type: Excel Workbook.

Operating Systems: Windows 7 or recommended Windows Vista, or Windows xp Service pack 3


Profile

Item Number Instructions

To properly populate the combo box, please make selection in the regions dropdown box twice.
1 Select Region from Dropdown box, twice.
2 Select Tribe/Consortium from Dropdown box.
3 Press the continue button.
4 Select member Tribe of Consortia from Dropdown Box
5 Provide four digit fiscal year (FY) that identifies fiscal year in which work plan will be implemented. (Fiscal year beginning in October 1, of the current calendar year).
6 Provide name of preparer in the event we may need to contact you.
7 Select position that you are currently holding from Dropdown Box.
8 Provide phone number.
9 Provide fax number.
10 Provide email address.
11 Digital signature, will Autofill when cell "D10" is filled. (Cell is protected)
12 Will Autofill when cell "D9" is filled. (Cell is protected)




Form

Portions of this worksheet are protected and has formulas.
1 Provide District or Member Tribe of consortia, if applicable.
2 Provide Last Name of Applicant.
3 Provide First Name of Applicant.
4 Select Suffix Name from Dropdown Box ( i.e. Sr. Jr. III. IV)
5 Provide Tribal Enrollment number of applicant.
6 Select Category of service, applicant is requesting from Dropdown Box. (i.e. A, B, C-1, C-2, D)
7a Provide Last Name of Spouse
7b Provide year to be served
7c Provide date of when the application was signed
8 Provide First Name of Spouse.
9 Provide enrollment number of spouse.
10 Provide total amount of income for all family members.
11 Provide number of occupants in household.
12 Provide birthdate of 1st aged person. (i.e. 06/13/1950)
13 Provide degree of disability (i.e. 100%, 50%)
14 Provide number of dependents.
15 Select "Yes" if house is in dilapidated condition Select, "No" if house in in repairable condition.
16 Select "Yes" if applicant is a Native Veteran
17 Provide date when applicant signed application.
18 Select "Yes" if applicant received a letter of denial of service and is waiting list from Tribal Housing Authority. Select "Pending" if applicant will get a letter from Housing Authority at a later time. Select, "No" if applicant received housing assitance within the last 20 years. (Has Hyperlink)
19 Provide an Estimated Start Date. (i.e. 07/16/2013)
20 Provide an Estimated cost for project. (i.e. 130,000)
21 Click the "Transfer" button to print Priority Calculation sheet and transfer data to worksheets "Priority Calculation" and "Tribe Part I". Place printed calculation sheet in Applicant case file.
22 For extra sheets, Click the "Print" button to print the Calculation sheet .
23
24




*Program Category: (A) Interim Improvements; (B) Renovations; (C-1) Replacement Housing (replacement of existing, substandard dwelling); (C-2) Replacement Housing (housing provided, no existing dwelling)

Priority List Form

Portions of this worksheet are protected and has formulas.

Row "2", Cell "C2" will auto fill from information entered in worksheet "Form". (Cell is protected)
1 Row "2", Cell "M2" will auto fill from information entered in worksheet "Form". (Cell is protected)
2 Row "3", Cell "M3" will auto fill from information entered in worksheet "Form". (Cell is protected)
3 Row "4",Cell "M4" will auto fill from information entered in worksheet "Form". (Cell is protected)
4 Column B will auto fill from information entered in worksheet "Form".
5 Column C will auto fill from information entered in worksheet "Form".
6 Column D will auto fill from information entered in worksheet "Form".
7 Column E will auto fill from information entered in worksheet "Form".
8 Column F will auto fill from information entered in worksheet "Form".
9 Column G will auto fill from information entered in worksheet "Form".
10 Column H will auto fill from information entered in worksheet "Form".
11 Column I will auto fill from information entered in worksheet "Form".
12 Column J will auto fill from information entered in worksheet "Form".
13 Column K will auto fill from information entered in worksheet "Form".
14 Column L will auto fill from information entered in worksheet "Form".
15 Column M will auto fill from information entered in worksheet "Form".
16 Column N will auto fill from information entered in worksheet "Form".
17 Column O will auto fill from information entered in worksheet "Form".
18 Column P will auto fill from information entered in worksheet "Form".
19 Column Q will auto fill from information entered in worksheet "Form".
20 Column R will auto fill from information entered in worksheet "Form".
21 Column S will auto fill from information entered in worksheet "Form".
22 Column T will auto fill from information entered in worksheet "Form".
23 Column U will auto fill from information entered in worksheet "Form".
24 Column V will auto fill from information entered in worksheet "Form".
25 When printing Priority Calculation sheet, to prevent printing extra sheets, select file, select print, select active sheets and select the number of sheets you want to print.



Tribe Part I

Item Number Instructions



Row "2", Cell "E2" will auto fill from information entered in worksheet "Form". (Cell is protected)
1 Row "2", Cell "K2" will auto fill from information entered in worksheet "Form". (Cell is protected)

Row "3", Cell "E3" will auto fill from information entered in worksheet "Form". (Cell is protected)
2 Row "3", Cell "K3" will auto fill from information entered in worksheet "Form". (Cell is protected)

Row "4",Cell "E4" will auto fill from information entered in worksheet "Form". (Cell is protected)
3 Row "4", Cell "K4" will auto fill from information entered in worksheet "Form". (Cell is protected)

Row "5", Cell "E5" will auto fill from information entered in worksheet "Form". (Cell is protected)
4 Row "5", Cell "K5" will auto fill from information entered in worksheet "Form". (Cell is protected)

Column B will auto fill from information entered in worksheet "Form".
5 Column C will auto fill from information entered in worksheet "Form".

Column D will auto fill from information entered in worksheet "Form".

Column E will auto fill from information entered in worksheet "Form".
6 Column F will auto fill from information entered in worksheet "Form".
7 Column G will auto fill from information entered in worksheet "Form".

Column H will auto fill from information entered in worksheet "Form".

Column I will auto fill from information entered in worksheet "Form".

Column J will auto fill from information entered in worksheet "Form".
8a Column K will auto fill from information entered in worksheet "Form".
8b Column L will auto fill from information entered in worksheet "Form".
9a Column M will auto fill from information entered in worksheet "Form".

Column N will auto fill from information entered in worksheet "Form".
9b When printing Tribe Part I, to prevent printing extra sheets, select file, select print,select print active sheets and select the number of sheets you want to print.




Tribe Part II

Item Number Instructions

Portions of this worksheet areprotected and has formulas, it contains no macros.



Will autofill (Cells are protected)
1a Will autofill (Cells are protected)
1b Will autofill (Cells are protected)
2a Will autofill (Cells are protected)
2b Will autofill (Cells are protected)
2c For each recipient provided program service, within accomplishing reporting FY, enter last and first name of recipient.
3 Provide Name of the Tribe/Consortium for which information is being reported.
4 For each recipient listed in Item Number 3,enter the type of program assistance provided, by entering a digit (1) in the applicable Program Category column(s):
5 (A) Interim Improvements (Repairs)

(B) Renovations

(C-1) Replacement Housing (replacement of existing substandard housing).

(C-2) New Housing (provision of housing for families without a home).

(D) Down Payment Assistance (provision of housing in providing a grant for down payment).

For each recipient listed in Item 6a, enter the Actual Start Date (MM/YY) of the construction project.
6a For each recipient listed in Item 6, enter Actual Completion Date of the project.
6b For each recipient listed in Item Number 7a, enter Actual Administrative Cost of the project.
7a For each recipient listed in Item Number 7b, enter Actual Project Cost.
7b Will autofill. (Cell is Protected)
7c


Sheet 2: Profile

Housing Improvement Program
Tribal Annual Performance Report
Profile





1 Region


2 Tribe / Consortia




3 Agency


4 Fiscal Year


5 Name


6 Title


7 Phone #


8 Fax #


9 Email



I certify that the information given is true, complete and correct to the best of my knowledge, belief, and they are made in good faith.
10 Signature


11 Date























PRIVACY ACT STATEMENT
25 CFR 265 and 25 U.S.C. 13 authorize the collection of this information. This information is covered by the system of record notice “Indian Housing Improvement Program, Interior, BIA-10.” The primary use of this information is to determine eligibility for assistance under the Housing Improvement Program. The records contained therein may only be disclosed in accordance with the routine uses and may not otherwise be disclosed by any means of communication to any person, or to another agency, except pursuant to a written request by, or with prior written consent of the individual to whom the record pertains. If the BIA uses the information furnished on this form for purposes other than those indicated above, it may provide you with an additional statement reflecting those purposes. Executive Order 9397 authorizes the collection of your Social Security number. Furnishing the information is voluntary but failure to do so may result in disapproval of your application.






PAPERWORK REDUCTION ACT STATEMENT
This information is being collected to select eligible families or individuals to participate in the Housing Improvement Program. Response to this request is required to obtain a benefit in accordance with 25 CFR 256. You are not required to respond to this collection of information unless it displays a currently valid OMB control number. This information will be used to determine the eligibility and the ranking of the applicant. Public reporting burden for this form is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to Information Collection Clearance Officer – Indian Affairs, 1849 C Street, NW, MS-4141, Washington, DC 20240.



























































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 3: Form


See Instructions PRIORITY CALCULATION FORM








Region












1 ALASKA

Privacy Act Warning! Information on this sheet may pertain to the Privacy Act, all persons handing records must protect integrity, security and confidentiality!




Tribe of Consortia





2 Sitka Tribe Of Alaska












District, Agency, Member Tribe of Consortia



Fiscal Year
Date of Application



3





Enter the date when the applicant signed the application.





















Last Name of Applicant First Name
Suffix
Enrollment #
Category:





4
Enter Applicant's Last Name. Please ensure that Tribe name is selected in Cell B7 from dropdown box.

Please make selection from dropdown box.

Provide Enrollment #

Please make selection from Dropdown Box.
















Pts



5 Household Income:

Enter family size, then enter total income at right!

Enter the total income for all family members, the points for this factor will autocalulate to the right!

#N/A #N/A 0


















6 Aged Person:

Enter birthdate, e.g. 6/3/1954
0 0 0 0
0


















7 Disabled Individual:

Select "Yes or No" need only one document stating condition.

0
0 0 0


















8 Dependent Children: Under age 18
Enter the number of Dependents under 18 years of age

0
0 0 0


















9 Homeless/ Dilapidated

Select"Overcrowded or Dilapidated"

#VALUE! 0 Homeless
0


















10




#VALUE! 0 Dilapidated
0


















11 Overcrowded

Select"Yes or No"

0
0 0 0


















12 Veteran

Select "Yes or No"

0

0 0


















13 Have you applied for the Veterans Home Loan Program. Select "Yes or No"

No






















14






Subtotal 0 0


















15 DownPayment Assistance, must be provide a Certificate of Eligibility from Lender.
Select "Yes" if the applicant is seeking down payment assistance, otherwise select "No", Category selection must be "D".
0 0


















16 You are on the waiting list and have obtained a denial letter from the Local Housing Authority.
Select "Yes" if the applicant has a copy of a housing assistance application from the local Housing Authority. You may select "Pending", but the applicant must provide a copy before HIP assistance can be provided. Otherwise select "No".
0 0












17 You have received prior Federal Housing Assistance from HIP, NAHASDA, 1937 ACT, USDA
Select "Yes" if the applicant has received prior Federal Housing Assistance within the past Twenty Years, otherwise select "No".
0 0


















18

0 0


















19 HIP Eligibility requirements 25 CFR Part 256 effective after 12/10/15 Eligibility Status 0 0


















20 If known, please provide an estimated start date to renovate or build new!







21 If known, please provide an estimated cost to renovate or build new!























22 Date of Evaluation:



See instructions on printing

















23 Name of Evaluator:






















24 Contact Number:














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 4: PriorityListForm


























Regional Office:

Number of Tribes Submitting Workplans:

Number of Eligible Applicants:
0



Fiscal Year:

Number of Tribes In Region:

Number of Applications Considered:
0



















Privacy Act Warning! Information on this sheet may pertain to the Privacy Act, must protect integrity, security and confidentiality!


LAST NAME FIRST NAME SR. JR. III IV Suffix Enter format dd:mm:yy Tribe/ District Category B, C-1, C-2. Cat Family size See Table Page 711 25 CFR Part 256.14 Factor Number One, Annual Household Income. Income 1040 Form Income Pts See Table Page 711 25 CFR Part 256.14 Factor Number Two, Aged Person. Aged See Table Page 711 25 CFR Part 256.14 Factor Number Three, Disabled Individuals. Disabled See Table Page 711 25 CFR Part 256.14 Factor Number Four, Dependent Children. Dependent Children See Table Page 711 25 CFR Part 256.14 Factor Number Five, Overcrowded. Homeless See Table Page 711 25 CFR Part 256.14 Factor Number Five, Dilapidated. Dilapidated See Table Page 711 25 CFR Part 256.14 Factor Number Five, Homeless. Overcrowded No points assessed for this factor, for tracking data purposes only! Native Veteran Veteran Loan Down Payment Denial Letter Prior Assistance This field is linked to the Applicant Data form . Eligibility Status Total Points Notes
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Sheet 5: TribePartI

PART I - TRIBAL WORK PLAN Date:

1 Work Plan for Fiscal Year:
Name:
2 Name of Tribe / Consortium:
Title:
3 Number of Eligible Applicants:
Phone:
4 Number of Applications Received:
Fax:

See instructions for printing form
5. Name of Eligible Applicant (ranked in order of need) 6. Applicant's Servicing Tribe 7. Program Category (Enter One As Applicable) 8a. Estimated Start Date 8b. Estimated Project Costs
25 CFR 256.17(b))**
Eligibility Status 8c. Priority Ranking Points (ranked in order from highest to lowest)

Last First Suffix (A) (B) (C-1) (C-2) (D)
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Sheet 6: Tribe Part II

PART II - REPORT OF ACCOMPLISHMENTS
1 a. Number of Applicants Provided Service:


Name of Tribe / Consortium
b. Number of Projects Completed within Fiscal Year:


2 a. Amount of Total Administration Funds to Report:

REGION
b. Amount of Total Constuction Funds to Report:

AGENCY
c. Amount of Total HIP Funds to Report:

FISCAL YEAR

Type or Printed Name
Title




Telephone
Fax





3 Name of Applicant Provided Program Services 4. Applicant's Servicing Tribe 5. Program Category (Enter one, as applicable) 6. Construction Schedules 7. Construction Funds
Last First (A) (B) (C-1) (C-2) (D) a.Date of Construction Start b.Date of Construction Completion a. Admin cost b. Project cost c.Sum of 7(a) & 7(b)
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Sheet 7: 150 Per Cent

FACTOR NO. 1 - HIP ELIGIBILITY/SELECTION CRITERIA @ 150%
INCOME GUIDELINE POINT SCHEDULE FOR ALL STATES EXCEPT ALASKA & HAWAII
FAMILY SIZE 0% to 25% of PG
25 POINTS
26% to 50% of PG
20 POINTS
51% to 75% of PG
15 POINTS
76% to 100 of PG
10 POINTS
101% to 125% of PG
5 POINTS
125% to 150% of PG
0 POINTS
OVER 150% of FPIG
INELIGIBLE






















1 0 TO 3,035 3,036 TO 6,070 6,071 TO 9,105 9,106 TO 12,140 12,141 TO 15,175 15,176 TO 18,210 18,211 & HIGHER
2 0 TO 4,115 4,116 TO 8,230 8,231 TO 12,345 12,346 TO 16,460 16,461 TO 20,575 20,576 TO 24,690 24,691 & HIGHER
3 0 TO 5,195 5,196 TO 10,390 10,391 TO 15,585 15,586 TO 20,780 20,781 TO 25,975 25,976 TO 31,170 31,171 & HIGHER
4 0 TO 6,275 6,276 TO 12,550 12,551 TO 18,825 18,826 TO 25,100 25,101 TO 31,375 31,376 TO 37,650 37,651 & HIGHER
5 0 TO 7,355 7,356 TO 14,710 14,711 TO 22,065 22,066 TO 29,420 29,421 TO 36,775 36,776 TO 44,130 44,131 & HIGHER
6 0 TO 8,435 8,436 TO 16,870 16,871 TO 25,305 25,306 TO 33,740 33,741 TO 42,175 42,176 TO 50,610 50,611 & HIGHER
7 0 TO 9,515 9,516 TO 19,030 19,031 TO 28,545 28,546 TO 38,060 38,061 TO 47,575 47,576 TO 57,090 57,091 & HIGHER
8 0 TO 10,595 10,596 TO 21,190 21,191 TO 31,785 31,786 TO 42,380 42,381 TO 52,975 52,976 TO 63,570 63,571 & HIGHER
9 0 TO 11,675 11,676 TO 23,350 23,351 TO 35,025 35,026 TO 46,700 46,701 TO 58,375 58,376 TO 70,050 70,051 & HIGHER
10 0 TO 12,755 12,756 TO 25,510 25,511 TO 38,265 38,266 TO 51,020 51,021 TO 63,775 63,776 TO 76,530 76,531 & HIGHER
11 0 TO 13,835 13,836 TO 27,670 27,671 TO 41,505 41,506 TO 55,340 55,341 TO 69,175 69,176 TO 83,010 83,011 & HIGHER
12 0 TO 14,915 14,916 TO 29,830 29,831 TO 44,745 44,746 TO 59,660 59,661 TO 74,575 74,576 TO 89,490 89,491 & HIGHER
EACH PERSON OVER 12 ADD

1,080

2,160

3,240

4,320

5,400

6,480 6,481 & HIGHER

25%=
3,035 50%=
6,070 '75%=
9,105 100%=
12,140 125%=
15,175 150% =
18,210
-

@ Add'l: 810 @ Add'l: 2,160 @ Add'l: 3,240 @ Add'l: 4,320 @ Add'l: 5,400 @ Add'l: 6,480
-
PG = HHS Poverty Guidelines





















































































FACTOR NO. 1 - HIP ELIGIBILITY/SELECTION CRITERIA @ 150%
INCOME GUIDELINE POINT SCHEDULE FOR ALASKA
FAMILY SIZE 0% to 25% of PG
25 POINTS
26% to 50% of PG
20 POINTS
51% to 75% of PG
15 POINTS
76% to 100 of PG
10 POINTS
101% to 125% of PG
5 POINTS
126% to 150% of PG
0 POINTS
OVER 150% of FPIG
INELIGIBLE






















1 0 TO 3,795 3,796 TO 7,590 7,591 TO 11,385 11,386 TO 15,180 15,181 TO 18,975 18,976 TO 22,770 22,771 & HIGHER
2 0 TO 5,145 5,146 TO 10,290 10,291 TO 15,435 15,436 TO 20,580 20,581 TO 25,725 25,726 TO 30,870 30,871 & HIGHER
3 0 TO 6,495 6,496 TO 12,990 12,991 TO 19,485 19,486 TO 25,980 25,981 TO 32,475 32,476 TO 38,970 38,971 & HIGHER
4 0 TO 7,845 7,846 TO 15,690 15,691 TO 23,535 23,536 TO 31,380 31,381 TO 39,225 39,226 TO 47,070 47,071 & HIGHER
5 0 TO 9,195 9,196 TO 18,390 18,391 TO 27,585 27,586 TO 36,780 36,781 TO 45,975 45,976 TO 55,170 55,171 & HIGHER
6 0 TO 10,545 10,546 TO 21,090 21,091 TO 31,635 31,636 TO 42,180 42,181 TO 52,725 52,726 TO 63,270 63,271 & HIGHER
7 0 TO 11,895 11,896 TO 23,790 23,791 TO 35,685 35,686 TO 47,580 47,581 TO 59,475 59,476 TO 71,370 71,371 & HIGHER
8 0 TO 13,245 13,246 TO 26,490 26,491 TO 39,735 39,736 TO 52,980 52,981 TO 66,225 66,226 TO 79,470 79,471 & HIGHER
9 0 TO 14,595 14,596 TO 29,190 29,191 TO 43,785 43,786 TO 58,380 58,381 TO 72,975 72,976 TO 87,570 87,571 & HIGHER
10 0 TO 15,945 15,946 TO 31,890 31,891 TO 47,835 47,836 TO 63,780 63,781 TO 79,725 79,726 TO 95,670 95,671 & HIGHER
11 0 TO 17,295 17,296 TO 34,590 34,591 TO 51,885 51,886 TO 69,180 69,181 TO 86,475 86,476 TO 103,770 103,771 & HIGHER
12 0 TO 18,645 18,646 TO 37,290 37,291 TO 55,935 55,936 TO 74,580 74,581 TO 93,225 93,226 TO 111,870 111,871 & HIGHER
EACH PERSON OVER 12 ADD

1,350

2,700

4,050

5,400

6,750

8,100 8,101 & HIGHER

25%=
3,795 50%=
7,590 '75%=
11,385 100%=
15,180 125%=
18,975 150% =
22,770
-

@ Add'l: 1,350 @ Add'l: 2,700 @ Add'l: 4,050 @ Add'l: 5,400 @ Add'l: 6,750 @ Add'l: 8,100
-
PG = HHS Poverty Guidelines




















Sheet 8: HIP Home


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