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Transactional Documents for Mortgagees and Contractors
ICR 202008-2502-004 · OMB 2502-0605 · Object 103457601.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Transactional Documents for Mortgagees and Contractors |
| Author | Hendrich, Nicole M |
| Last Modified By | Calc |
| File Modified | 2018-03-19 |
| File Created | 2026-07-17 |
| Conversion State | failed_conversion |
Extracted Text
Initial Operating Deficit / Lease-up Tracking Worksheet Section 232 U.S. Department of Housing and Urban Development Office of Residential Care Facilities OMB Approval No. 2502-0605 (exp. 03/31/2018) Public reporting burden for this collection of information is estimated to average 1.5 hours. This includes the time for collecting, reviewing, and reporting the data. The information is being collected to obtain the supportive documentation which must be submitted to HUD for approval, and is necessary to ensure that viable projects are developed and maintained. The Department will use this information to determine if properties meet HUD requirements with respect to development, operation and/or asset management, as well as ensuring the continued marketability of the properties. This agency may not collect this information, and you are not required to complete this form unless it displays a currently valid OMB control number. Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions. Project Name: Date Prepared: Lender Name: Income & Occupancy Assumptions Unit Type Assisted Living Memory Care Skilled Nursing or Sub-Acute Independent Living Other Income Totals UW Eff. Gross Inc. per year Total # Beds UW Occupancy # Occupied Units 0.00 0.00 0.00 0.00 $0 0 0.00% 0.00 EGI per Occp'd Unit $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Per Res Day $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 POU per year $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 % of EGI UW 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% Number of Preleases Net Monthly Absorption 0.00 0.00 Expense Assumptions Ground Rent Marketing and Promotion Insurance (property & liability) Real Estate (Property) Taxes Management Fees Replacement Reserves TOTAL Total UW Total UW Exp. per year Exp. per Month $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Debt Service Assumptions Interest Only Principal Plus Interest MIP $ $ $ Category e.g. General & Administrative e.g. Payroll Taxes and Benefits e.g. Resident Care e.g. Food Services e.g. Activities e.g. Housekeeping & Laundry e.g. Maintenance e.g. Utilities e.g. Bad Debt Previous Versions Obsolete - per month per month per month Debt Service Calculator Mortgage Amount Term in Months Annual Interest Rate MIP Percentage DRAFT Percentage 100.00% 80.00% 30.00% 30.00% 30.00% 10.00% 30.00% 50.00% 0.00% 0.00% 100.00% 100.00% 100.00% 100.00% 80.00% 100.00% Expense Floor Yearly Floor Monthly Floor $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 0.77% form HUD-91128-ORCF (03/2018) U.S. Department of Housing and Urban Development Office of Residential Care Facilities Initial Operating Deficit Escrow Calculation Section 232 0 Period One Instructions: Use this tab to make draw request from IOD escrow. Only modify shaded blue cells. This worksheet is required to be updated on a cash basis only. Assisted Living Memory Care Skilled Nursing or Sub-Acute Independent Living Total Occupied Units Total Resident Days EGI e.g. General & Administrative e.g. Payroll Taxes and Benefits e.g. Resident Care e.g. Food Services e.g. Activities e.g. Housekeeping & Laundry e.g. Maintenance e.g. Utilities e.g. Bad Debt Ground Rent Marketing and Promotion Insurance (property & liability) Real Estate (Property) Taxes Management Fees Replacement Reserves Total Expenses NOI P+I MIP Income/Loss per Period Cumulative Loss (actual is blue) Expense Ratio % of UW Expense Occupancy Debt Service Coverage Ratio Period Two Month 1 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Month 1 Actual NA 0.0% 0.0% Draw Amount Requested Dollar Difference from Scheduled Draws Amount Approved (entered by HUD) Escrow Balance Month 2 Actual 0 0 Month 2 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NA 0.0% 0.0% NA 0.0% 0.0% 0.00 0 0 0 0 Period Three Month 3 Actual 0 0 Month 3 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NA 0.0% 0.0% 0.0% 0.0% 0.0% 0.00 0 0 0 0 OMB Approval No. 2502-0605 (exp. 06/30/2017) Month 4 Actual 0 0 Month 4 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.00 0 0 0 0.00 0 0 0 0 0 Month 5 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Month 5 Actual Month 6 Actual 0 0 Month 6 Forecasted 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 7 Actual 0 0 Month 7 Forecasted 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 8 Actual 0 0 Month 8 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 9 Actual 0 0 Month 9 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 10 Actual 0 0 Month 10 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 11 Actual 0 0 Month 11 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 12 Actual 0 0 Month 12 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 IOD Base Requirement $0 Actual Escrow IOD Amount $0 Previous Versions Obsolete DRAFT form HUD-91128-ORCF (mm/yyyy) U.S. Department of Housing and Urban Development Office of Residential Care Facilities Initial Operating Deficit Escrow Calculation Section 232 OMB Approval No. 2502-0605 (exp. 06/30/2017) 0 Instructions: Use this tab to make draw request from IOD escrow. Only modify shaded blue cells. This worksheet is required to be updated on a cash basis only. Month 13 Actual Ground Rent Marketing and Promotion Insurance (property & liability) Real Estate (Property) Taxes Management Fees Replacement Reserves Total Expenses NOI P+I MIP Income/Loss per Period Cumulative Loss (actual is blue) Month 13 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Expense Ratio % of UW Expense Occupancy Debt Service Coverage Ratio 0.0% 0.0% 0.0% #DIV/0! Assisted Living Memory Care Skilled Nursing or Sub-Acute Independent Living Total Occupied Units Total Resident Days EGI e.g. General & Administrative e.g. Payroll Taxes and Benefits e.g. Resident Care e.g. Food Services e.g. Activities e.g. Housekeeping & Laundry e.g. Maintenance e.g. Utilities e.g. Bad Debt Draw Amount Requested Dollar Difference from Scheduled Draws Amount Approved (entered by HUD) Escrow Balance Month 14 Actual 0 0 Month 14 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 15 Actual 0 0 Month 15 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 16 Actual 0 0 Month 16 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 17 Actual 0 0 Month 17 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 18 Actual 0 0 Month 18 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 19 Actual 0 0 Month 19 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 20 Actual 0 0 Month 20 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 21 Actual 0 0 Month 21 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 22 Actual 0 0 Month 22 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 23 Actual 0 0 Month 23 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 24 Actual 0 0 Month 24 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 IOD Base Requirement $0 Actual Escrow IOD Amount $0 Previous Versions Obsolete DRAFT form HUD-91128-ORCF (mm/yyyy) U.S. Department of Housing and Urban Development Office of Residential Care Facilities Initial Operating Deficit Escrow Calculation Section 232 OMB Approval No. 2502-0605 (exp. 06/30/2017) 0 Instructions: Use this tab to make draw request from IOD escrow. Only modify shaded blue cells. This worksheet is required to be updated on a cash basis only. Month 25 Actual Ground Rent Marketing and Promotion Insurance (property & liability) Real Estate (Property) Taxes Management Fees Replacement Reserves Total Expenses NOI P+I MIP Income/Loss per Period Cumulative Loss (actual is blue) Month 25 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Expense Ratio % of UW Expense Occupancy Debt Service Coverage Ratio 0.0% 0.0% 0.0% #DIV/0! Assisted Living Memory Care Skilled Nursing or Sub-Acute Independent Living Total Occupied Units Total Resident Days EGI e.g. General & Administrative e.g. Payroll Taxes and Benefits e.g. Resident Care e.g. Food Services e.g. Activities e.g. Housekeeping & Laundry e.g. Maintenance e.g. Utilities e.g. Bad Debt Draw Amount Requested Dollar Difference from Scheduled Draws Amount Approved (entered by HUD) Escrow Balance Month 26 Actual 0 0 Month 26 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 27 Actual 0 0 Month 27 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 28 Actual 0 0 Month 28 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 29 Actual 0 0 Month 29 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 30 Actual 0 0 Month 30 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 31 Actual 0 0 Month 31 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 32 Actual 0 0 Month 32 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 33 Actual 0 0 Month 33 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 34 Actual 0 0 Month 34 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 Month 35 Actual 0 0 Month 35 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Month 36 Forecast 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.0% 0.0% 0.0% #DIV/0! 0.00 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 IOD Base Requirement $0 Actual Escrow IOD Amount $0 Previous Versions Obsolete DRAFT form HUD-91128-ORCF (mm/yyyy) Initial Operating Deficit Escrow Calculation Section 232 Summary Exhibit 0 Prepared: 12/30/1899 Number of Preleases 0.00 0.00 0.00 0.00 0.00 Avg. Monthly Absorption 0.00 0.00 0.00 0.00 0.00 Rounded Operating Deficit Total: $0 Occupancy Assumptions Unit Type Assisted Living Memory Care Skilled Nursing or Sub-Acute Independent Living Totals Period Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12 Month 13 Month 14 Month 15 Month 16 Month 17 Month 18 Month 19 Month 20 Month 21 Month 22 Month 23 Month 24 Month 25 Month 26 Month 27 Month 28 Month 29 Month 30 Month 31 Month 32 Month 33 Month 34 Month 35 Month 36 Occupied Units 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 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 Previous versions obsolete Total # Beds 0 0 0 0 0 Occupied Percent #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! UW Occupancy 0.00% 0.00% 0.00% 0.00% 0.00% Income per Period $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Exp. & Mort. per Period $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Income/Loss per Period $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 form HUD-91128-OHP (03/2018)