NOTE: Below is a completed example of Chart A. Complete the blank version that follows. NOTE: Entering an "x" indicates a "Yes" response. | ||||||||||||||||||||||||
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O1 | O2 | O3 | P | S | T | U | V | |||
Name of Applicant, and the Branches and Subgrantees that Applicant proposes to Fund with this NOFO | Location City/State | Agency's HUD Housing Counseling System (HCS) Number | Branch of an Intermediary, MSO, or SHFA | Subgrantee of an Intermediary, MSO, or SHFA | # of Housing Counselor Full-Time Equivalents | # of HUD HECM Roster Reverse Mortgage Counselors Full-Time Equivalents | # of Default Counselors to Provide Reverse Mortgage/ HECM Default Counseling during Grant Period | Formal Housing Counseling Training | HUD-certified Housing Counselors On Staff | Adopted National Industry Standards | Issued Client Exit Surveys | Issued Follow-up Client Surveys | Pulled Credit Reports Prior to Termination of Counseling | Opportunity Zones - Census Tract Number (preference points) | Promise Zones (preference points) | HBCU (preference points) | % of Award Applicant Intends to Allocate to Each Branch or Subgrantee | Counseling/Group Education to be Provided In Person | Counseling/Group Education to be Provided Via Telephone or Video (Interactive) | Counseling/Group Education to be Provided Over the Internet | Counseling/Group Education to be Available in Multiple Languages | |||
Applicant | ABC Intermediary | Alexandria, VA | 12345 | |||||||||||||||||||||
Branches and/or Sub-grantees |
ABC Intermediary | Alexandria, VA | 12346 | x | 2 | x | x | x | x | 51510201900 | x | x | 30 | x | x | x | x | |||||||
Housing Resources | Alamosa, CO | 56789 | x | 3 | 1 | 2 | x | x | x | x | x | 08003960200 | x | x | 35 | x | x | x | x | |||||
Housing Affiliate | Erie, PA | 98765 | x | 8 | x | x | x | x | 42049000100 | x | x | 20 | x | x | x | x | ||||||||
TOTAL | 1 | 2 | 13 | 1 | 2 | 3 | 1 | 2 | 3 | 3 | 1 | 3 | 3 | 3 | 85 | 3 | 3 | 3 | 3 | |||||
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O1 | O2 | O3 | P | S | T | U | V | |||
Applicant | These fields are not applicable for the Applicant's main office / headquarters. Applicants that provide housing counseling services at their main office must include this office in the list of Subgrantees and Branches below. | |||||||||||||||||||||||
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Not Applicable for FY 22 CHC NOFO |
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TOTAL | 0 | 0 | 0.00 | 0.00 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0.00% | 0 | 0 | 0 | 0 |
OMB Approval #2502-0621 | ||||||||
Exp Date 07/31/2026 | ||||||||
Public reporting burden for this collection of information is estimated to average 40 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. The information is being collected for a housing counseling agency to participate in HUD’s Housing Counseling program. The information will be used by HUD to ensure that Counselors provide guidance and advice to help families and individuals improve their housing conditions and meet the responsibilities of tenancy and homeownership. Counselors also help borrowers avoid predatory lending practices, such as inflated appraisals, unreasonably high interest rates, unaffordable repayment terms, and other conditions that can result in a loss of equity, increased debt, default, and foreclosure. This agency may not collect this information, and you are not required to complete this form, unless it displays a valid OMB control number. |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |