2577-0282 Voucher Management System

52681-B Clean.docx

Voucher Management System (VMS) Section 8 Budget and Financial Form

2577-0282 Voucher Management System

OMB: 2577-0282

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Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Public reporting burden for this collection of information is estimated to average 1.50 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. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number. Assurances of confidentiality are not provided under this collection. Authority for this collection of information is the Housing and Community Development Act of 1987. Housing Agencies (HAs) required to maintain financial reports in accordance with accepted accounting standards to permit timely and effective audits. The financial records identify the amount of annual contributions that are received and disbursed by HAs. Responses to the collection of information are required to obtain a benefit or to retain a benefit. The information requested does not lend itself to confidentiality.

HA Number: HA Name: HA FYE:
Submission Type: Original Submission Revised Submission Special Submission
Housing Choice Voucher Program – Utilization and Administrative Fee and Expense Reporting


Vouchers under lease on the First Day of the Month:
UML:
Rental Assistance Demonstration 1– Public Housing Conversion
Rental Assistance Demonstration 2- Mod Rehab, Rent Supp, RAP Conversion
Rental Assistance Demonstration 3 –PRAC Conversion
Litigation
Homeownership
New This Month
Moving To Work
One Year Mainstream – MTW
Family Unification – Non MTW
Family Unification – Pre2008 - MTW
Family Unification – 2008/Forward - MTW
Non-Elderly Disabled – Non-MTW
Non-Elderly Disabled- 2008/Forward - MTW
Portable Vouchers Paid
Hope VI
Tenant Protection
Enhanced Vouchers
Veterans Affair Supported Housing (VASH) Voucher
DHAP to HCV Vouchers Leased
Foster Youth to Independence
Mobility Demonstration
Stability Vouchers
Emergency Transfer Vouchers for VAWA
All Other Vouchers
Total Vouchers

HAP Expenses:
Rental Assistance Demonstration 1– Public Housing Conversion
Rental Assistance Demonstration 2- Mod Rehab, Rent Supp, RAP Conversion
Rental Assistance Demonstration 3 – PRAC Conversion
Litigation
Homeownership
New This Month
Moving To Work
One Year Mainstream – MTW
Family Unification – Non MTW

Page 1 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

HAP Expenses (cont.):
Family Unification - 2008/Forward - MTW
Non-Elderly Disabled - Non-MTW
Non-Elderly Disabled 2008 Forward - MTW
Portable Vouchers Paid
Hope VI
Tenant Protection
Enhanced Vouchers
Veterans Affair Supported Housing (VASH) Voucher
DHAP to HCV Vouchers Leased
All Other Vouchers
MTW - Family Unification 2008/Forward HAP expenses after the First of the Month
MTW - Family Unification per-2008 HAP After the First of the Month
MTW - Non-Elderly Disabled 2008/Forward HAP Expenses after the First of the Month
MTW - VASH HAP Expenses after the First of the Month
MTW - One Year Mainstream HAP After the First of the Month
HCV - FSS Escrow Deposits
HCV - All Voucher HAP Expenses After the First of Month
Foster Youth to Independence
Mobility Demonstration
Stability Vouchers
Emergency Transfer Vouchers for VAWA
MTW - Foster Youth to Independence HAP Expenses After the First of the Month
MTW - Mobility Demonstration HAP Expenses After the First of the Month
MTW - Stability Vouchers HAP Expenses After the First of the Month
MTW - Emergency Transfer Vouchers for VAWA HAP Expenses After the First of the Month
Total Vouchers

Other Voucher Reporting Requirements:
UML:
HCV Number of Vouchers Under Lease (HAP Contract) on the last day of the month
HA Owned Units Leased - included in the units leased above
HCV New Vouchers Issued but not under HAP contract as of the last day of month
Portable Vouchers Administered (Port-In)
Mainstream
Number of PBVs under AHAP and not under HAP
Number of PBVs under HAP and Leased
Number of PBVs under HAP and not Leased
Number of PBVs under HAP and not Leased with vacancy payment and associated vacancy HAP expense

Page 2 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement Housing Assistance Payments Program Supplemental Reporting Form		US Department of Housing and Urban Development Office of Public and Indian Housing	OMB Approval No. 2577- 0282 (Exp. 03/31/2025)
	Mainstream - Number of New Vouchers Issued but not Under HAP Contract as of the last day of the month
	Stability Vouchers - Number of New Vouchers Issued but not Under H AP Contract as of the last day of the month

	HAP Expenses:
	Portable Vouchers Administered (Port-In)
	Mainstream
	HCV HAP Spent on Permissive Deductions
	Mainstream HAP Spent on Permissive Deductions
	Number of PBVs under HAP and not Leased with vacancy payment and associated vacancy HAP expense
	Project Based Vouchers - Total HAP Expenses
	Mainstream - HAP Expenses After the First of the Month
	Mainstream - FSS Escrow Deposits
	Adjustment Funding- Per Unit Cost
	Adjustment Funding- Shortfall
	Adjustment Funding- Per Unit Cost Increase MS Program
	Adjustment Funding- Shortfall MS Program

Page 3 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Memorandum Reporting:
UML:
Number of Hard to House Families Leased

HAP Expenses:
HCV – Fraud Recovery Total Collected this Month
Interest or other income earned this month from the investment of HAP funds and Net Restricted Assets
HCV – FSS Escrow Forfeitures
Portable HAP costs Billed and Unpaid – 90 Days or older
Mainstream – FSS Escrow Forfeitures this Month
Mainstream – Fraud Recovery Total Collected this Month
Non-HAP Spent on Permissive Deductions
Administrative Expenses:
HAP Expenses:
Non-MTW Administrative Expenses
Audit
Mainstream- Administrative Expenses
Mobility Demonstration Services Expenditures
Housing Mobility- Related Service Expenditures
Housing Mobility- Related Service Expenditures (MTW)
Financial
HAP Expenses:
HCV – Unrestricted Net Position Funds (UNP) as of the Last Day of the
HCV – Restricted Net Position Funds (RNP) as of the Last Day of the Month
HCV – Cash/Investment as of the Last Day of the Month
Mainstream - Unrestricted Net Position Funds (UNP) as of the Last Day of the Month
Mainstream – Restricted Net Position Funds (RNP) as of the Last Day of the Month
Mainstream – Cash/Investment as of the Last Day of the Month
MTW:
HAP Expenses:
MTW – Public Housing Operating Subsidy Eligible Expenses
MTW – Capital Fund Eligible Expenses
MTW – Local, Non-Traditional (LNT) Program
MTW – HCV Administrative Fee Expenses
MTW – HCV Administrative Expenses Using HAP

Page 4 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Other - Unspent Funds Fund Source 1
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 1
Type of Account – 1
Activity – 1
Funds Committed – 1
Type of Commitment – 1
Date of Commitment – 1 (MM/DD/YYYY)
Funds Obligated – 1
Type of Obligation – 1
Date of Obligation – 1 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 1
Projected Date of Full Expenditure – 1 (MM/DD/YYYY)

Other - Unspent Funds Fund Source 2
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 2
Type of Account – 2
Activity – 2
Funds Committed – 2
Type of Commitment – 2
Date of Commitment – 2 (MM/DD/YYYY)
Funds Obligated – 2
Type of Obligation – 2
Date of Obligation – 2 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 2
Projected Date of Full Expenditure – 2 (MM/DD/YYYY)

Shape1 Page 5 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Other - Unspent Funds Fund Source 3
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 3
Type of Account – 3
Activity – 3
Funds Committed – 3
Type of Commitment – 3
Date of Commitment – 3 (MM/DD/YYYY)
Funds Obligated – 3
Type of Obligation – 3
Date of Obligation – 3 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 3
Projected Date of Full Expenditure – 3 (MM/DD/YYYY)

Other - Unspent Funds Fund Source 4
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 4
Type of Account – 4
Activity – 4
Funds Committed – 4
Type of Commitment – 4
Date of Commitment – 4 (MM/DD/YYYY)
Funds Obligated – 4
Type of Obligation – 4
Date of Obligation – 4 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 4
Projected Date of Full Expenditure – 4 (MM/DD/YYYY)

Page 6 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Other - Unspent Funds Fund Source 5
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 5
Type of Account – 5
Activity – 5
Funds Committed – 5
Type of Commitment – 5
Date of Commitment – 5 (MM/DD/YYYY)
Funds Obligated – 5
Type of Obligation – 5
Date of Obligation – 5 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 5
Projected Date of Full Expenditure – 5 (MM/DD/YYYY)

Other - Unspent Funds Fund Source 6
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 6
Type of Account – 6
Activity – 6
Funds Committed – 6
Type of Commitment – 6
Date of Commitment – 6 (MM/DD/YYYY)
Funds Obligated – 6
Type of Obligation – 6
Date of Obligation – 6 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 6
Projected Date of Full Expenditure – 6 (MM/DD/YYYY)

Shape2 Page 7of 1 7 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Other - Unspent Funds Fund Source 7
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 7
Type of Account – 7
Activity – 7
Funds Committed – 7
Type of Commitment – 7
Date of Commitment – 7 (MM/DD/YYYY)
Funds Obligated – 7
Type of Obligation – 7
Date of Obligation – 7 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 7
Projected Date of Full Expenditure – 7 (MM/DD/YYYY)

Other - Unspent Funds Fund Source 8
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 8
Type of Account – 8
Activity – 8
Funds Committed – 8
Type of Commitment – 8
Date of Commitment – 8 (MM/DD/YYYY)
Funds Obligated – 8
Type of Obligation – 8
Date of Obligation – 8 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 8
Projected Date of Full Expenditure – 8 (MM/DD/YYYY)

Shape3 Page 8 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Other - Unspent Funds Fund Source 9
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 9
Type of Account – 9
Activity – 9
Funds Committed – 9
Type of Commitment – 9
Date of Commitment – 9 (MM/DD/YYYY)
Funds Obligated – 9
Type of Obligation – 9
Date of Obligation – 9 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 9
Projected Date of Full Expenditure – 9 (MM/DD/YYYY)

Other - Unspent Funds Fund Source 10
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) – 10
Type of Account – 10
Activity – 10
Funds Committed – 10
Type of Commitment – 10
Date of Commitment – 10 (MM/DD/YYYY)
Funds Obligated – 10
Type of Obligation – 10
Date of Obligation – 10 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation – 10
Projected Date of Full Expenditure – 10 (MM/DD/YYYY)

Shape4 Page 9 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Other - Unspent Funds Fund Source 11
Misc.:
Unspent Fund Source (HCV, CAP, OP or MTW) - 11
Type of Account - 11
Activity - 11
Funds Committed - 11
Type of Commitment - 11
Date of Commitment - 11 (MM/DD/YYYY)
Funds Obligated - 11
Type of Obligation - 11
Date of Obligation - 11 (MM/DD/YYYY)
Funds Expended from Commitment/Obligation - 11
Projected Date of Full Expenditure - 11 (MM/DD/YYYY)

Expenses:
HAP Expenses:
Expense Amount 1
Expense Amount 2
Expense Amount 3
Expense Amount 4
Expense Amount 5

Misc.:
Expense Amount 1 Comment
Expense Amount 2 Comment
Expense Amount 3 Comment
Expense Amount 4 Comment
Expense Amount 5 Comment

Page 10 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

MTW Other Expense Category

Shape5 Shape6 Shape7 Shape8 HAP Expenses:

Shape9 Shape10 Shape11 Shape12 6

MTW - Other PHA to identify the type of expense incurred Amount -

Shape13 Shape14 Shape15 Shape16 7

MTW - Other PHA to identify the type of expense incurred Amount -

Shape17 Shape18 Shape19 Shape20 8

MTW - Other PHA to identify the type of expense incurred Amount -

Misc.:

MTW - Other PHA to identify the type of expense incurred Amount - 6 Comment
MTW - Other PHA to identify the type of expense incurred Amount - 7 Comment
MTW - Other PHA to identify the type of expense incurred Amount - 8 Comment

Comments:

Misc.:

Comments

Disaster Voucher Program-1 (DVP):

Misc.

Disaster Comments - Mandatory when Other Fees are recorded

UML:

Disaster Name

Disaster Families Assisted

HAP Expenses:

Disaster Families Assisted

Disaster Security Deposit

Disaster Security Deposit Returned

Disaster Utility Deposit

Disaster Utility Deposit Returned

Disaster Administrative Expenditures

Disaster Broker Fee

Disaster Placement Fee

Disaster Service Connection Fee

Disaster Case Management Fee

Disaster Administrative Fee

Disaster Other Fees

Page 11 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Disaster Voucher Program-2 (DVP):

Misc.:

Shape97 Shape98 Shape99 Shape100 Disaster Comments- Mandatory when Other Fees are recorded

Shape101 Shape102 Shape103 Shape104 UML:

Shape105 Shape106 Shape107 Shape108 Disaster Name

Shape109 Shape110 Shape111 Shape112 Disaster Families Assisted

Shape113 Shape114 Shape115 Shape116 HAP Expenses:

Shape117 Shape118 Shape119 Shape120 Disaster Families Assisted

Shape121 Shape122 Shape123 Shape124 Disaster Security Deposit

Shape125 Shape126 Shape127 Shape128 Disaster Security Deposit Returned

Shape129 Shape130 Shape131 Shape132 Disaster Utility Deposit

Shape133 Shape134 Shape135 Shape136 Disaster Utility Deposit Returned

Shape137 Shape138 Shape139 Shape140 Disaster Administrative Expenditures

Shape141 Shape142 Shape143 Shape144 Disaster Broker Fee

Disaster Placement Fee

Disaster Service Connection Fee

Disaster Case Management Fee

Disaster Administrative Fee

Disaster Other Fees

Disaster Voucher Program-3 (DVP):

Shape165 Shape166 Shape167 Shape168 Misc.:

Shape169 Shape170 Shape171 Shape172 Disaster Comments Mandatory when Other Fees are recorded

Shape173 Shape174 Shape175 Shape176 UML:

Shape177 Shape178 Shape179 Shape180 Disaster Name

Shape181 Shape182 Shape183 Shape184 Disaster Families Assisted

Shape185 Shape186 Shape187 Shape188 HAP Expenses:

Shape189 Shape190 Shape191 Shape192 Disaster Families Assisted

Shape193 Shape194 Shape195 Shape196 Disaster Security Deposit

Shape197 Shape198 Shape199 Shape200 Disaster Security Deposit Returned

Shape201 Shape202 Shape203 Shape204 Disaster Utility Deposit

Shape205 Shape206 Shape207 Shape208 Disaster Utility Deposit Returned

Shape209 Shape210 Shape211 Shape212 Disaster Administrative Expenditures

Shape213 Shape214 Shape215 Shape216 Disaster Broker Fee

Shape217 Shape218 Shape219 Shape220 Disaster Placement Fee

Shape221 Shape222 Shape223 Shape224 Disaster Service Connection Fee

Shape225 Shape226 Shape227 Shape228 Disaster Case Management Fee

Shape229 Shape230 Shape231 Shape232 Disaster Administrative Fee

Shape233 Shape234 Shape235 Shape236 Disaster Other Fees

Page 12 of 17 Form HUD-52681-B (03/2023)

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

Disaster Voucher Program-4 (DVP):

Misc.:

Disaster Comments Mandatory when Other Fees are recorded

UML:

Disaster Name

Disaster Families Assisted

HAP Expenses:

Disaster Families Assisted

Disaster Security Deposit

Disaster Security Deposit Returned

Disaster Utility Deposit

Disaster Utility Deposit Returned

Disaster Administrative Expenditures

Disaster Broker Fee

Disaster Placement Fee

Disaster Service Connection Fee

Disaster Case Management Fee

Disaster Administrative Fee

Disaster Other Fees

Page 13 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Emergency Housing Voucher Program-1 (EHV):

Shape237 Shape238 Shape239 Shape240 UML:

Shape241 Shape242 Shape243 Shape244 Emergency Housing Vouchers

Shape245 Shape246 Shape247 Shape248 Emergency Housing Vouchers - Number of New Vouchers Issued but not Under HAP Contract as of the last day of the month

Shape249 Shape250 Shape251 Shape252 HAP Expenses:

Shape253 Shape254 Shape255 Shape256 Emergency Housing Vouchers

Shape257 Shape258 Shape259 Shape260 Emergency Housing Vouchers - HAP Expenses After the First of the Month

Shape261 Shape262 Shape263 Shape264 Emergency Housing Vouchers - Admin Fees - Preliminary Fee Expenses

Shape265 Shape266 Shape267 Shape268 Emergency Housing Vouchers - Admin Fees - Placement/Issuance Fee Expenses

Shape269 Shape270 Shape271 Shape272 Emergency Housing Vouchers - Admin Fees - Ongoing
Administrative Expenses

Shape273 Shape274 Shape275 Shape276 Emergency Housing Vouchers - Service Fee - Housing Search Assistance Expenses

Shape277 Shape278 Shape279 Shape280 Emergency Housing Vouchers - Service Fee - Security/Utility Deposit/ Rental Application/Holding Fee Expenses

Shape281 Shape282 Shape283 Shape284 Emergency Housing Vouchers - Service Fee - Owner Incentive Expenses

Emergency Housing Vouchers - Service Fee - Other Eligible Expenses

Shape285 Shape286 Shape287 Shape288 Emergency Housing Vouchers - FSS Escrow Deposits

Emergency Housing Vouchers - FSS Escrow Forfeitures this Month

Shape289 Shape290 Shape291 Shape292 Emergency Housing Vouchers - Fraud Recovery Total Collected this Month

Shape293 Shape294 Shape295 Shape296 Emergency Housing Vouchers - Unrestricted Net Position Funds (UNP) as of the Last Day of the Month

Shape297 Shape298 Shape299 Shape300 Emergency Housing Vouchers - Restricted Net Position Funds (RNP) as of the Last Day of the Month

Shape301 Shape302 Shape303 Shape304 Emergency Housing Vouchers - Cash/Investment as of the Last Day of the Month

Emergency Housing Vouchers HAP Spent on Permissive Deductions

Shape305 Shape306 Shape307 Emergency Housing Vouchers Unexpended Service Fees

Shape308

Page 14 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Emergency Housing Voucher Program-2 (EHV):

Shape309 Shape310 Shape311 Shape312 UML:

Shape313 Shape314 Shape315 Shape316 Emergency Housing Vouchers

Shape317 Shape318 Shape319 Shape320 Emergency Housing Vouchers - Number of New Vouchers Issued but not U nder HAP Contract as of the last day of the month

Shape321 Shape322 Shape323 Shape324 HAP Expenses:

Shape325 Shape326 Shape327 Shape328 Emergency Housing Vouchers

Shape329 Shape330 Shape331 Shape332 Emergency Housing Vouchers - HAP Expenses After the First of the Month

Shape333 Shape334 Shape335 Shape336 Emergency Housing Vouchers - Admin Fees - Preliminary Fee Expenses

Shape337 Shape338 Shape339 Shape340 Emergency Housing Vouchers - Admin Fees - Placement/Issuance Fee Expenses

Shape341 Shape342 Shape343 Shape344 Emergency Housing Vouchers - Admin Fees - Ongoing
Administrative Expenses

Shape345 Shape346 Shape347 Shape348 Emergency Housing Vouchers - Service Fee - Housing Search Assistance Expenses

Shape349 Shape350 Shape351 Shape352 Emergency Housing Vouchers - Service Fee - Security/Utility Deposit/ Rental Application/Holding Fee Expenses

Shape353 Shape354 Shape355 Shape356 Emergency Housing Vouchers - Service Fee - Owner Incentive Expenses

Shape357 Shape358 Shape359 Shape360 Emergency Housing Vouchers - Service Fee - Other Eligible Expenses

Shape361 Shape362 Shape363 Shape364 Emergency Housing Vouchers - FSS Escrow Deposits

Emergency Housing Vouchers - FSS Escrow Forfeitures this Month

Shape365 Shape366 Shape367 Shape368 Emergency Housing Vouchers - Fraud Recovery Total Collected this Month

Shape369 Shape370 Shape371 Shape372 Emergency Housing Vouchers - Unrestricted Net Position Funds (UNP) as of the Last Day of the Month

Shape373 Shape374 Shape375 Shape376 Emergency Housing Vouchers - Restricted Net Position Funds (RNP) as of the Last Day of the Month

Shape377 Shape378 Shape379 Shape380 Emergency Housing Vouchers - Cash/Investment as of the Last Day of the Month

Emergency Housing Vouchers HAP Spent on Permissive Deductions

Shape381 Shape382 Shape383 Emergency Housing Vouchers Unexpended Service Fees

Shape384

Page 15 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)

Emergency Housing Voucher Program-3 (EHV):

Shape385 Shape386 Shape387 Shape388 UML:

Shape389 Shape390 Shape391 Shape392 Emergency Housing Vouchers

Shape393 Shape394 Shape395 Shape396 Emergency Housing Vouchers - Number of New Vouchers Issued but not U nder HAP Contract as of the last day of the month

Shape397 Shape398 Shape399 Shape400 HAP Expenses:

Shape401 Shape402 Shape403 Shape404 Emergency Housing Vouchers

Shape405 Shape406 Shape407 Shape408 Emergency Housing Vouchers - HAP Expenses After the First of the Month

Shape409 Shape410 Shape411 Shape412 Emergency Housing Vouchers - Admin Fees - Preliminary Fee Expenses

Shape413 Shape414 Shape415 Shape416 Emergency Housing Vouchers - Admin Fees - Placement/Issuance Fee Expenses

Shape417 Shape418 Shape419 Shape420 Emergency Housing Vouchers - Admin Fees - Ongoing
Administrative Expenses

Shape421 Shape422 Shape423 Shape424 Emergency Housing Vouchers - Service Fee - Housing Search Assistance Expenses

Shape425 Shape426 Shape427 Shape428 Emergency Housing Vouchers - Service Fee - Security/Utility Deposit/ Rental Application/Holding Fee Expenses

Shape429 Shape430 Shape431 Shape432 Emergency Housing Vouchers - Service Fee - Owner Incentive Expenses

Shape433 Shape434 Shape435 Shape436 Emergency Housing Vouchers - Service Fee - Other Eligible Expenses

Shape437 Shape438 Shape439 Shape440 Emergency Housing Vouchers - FSS Escrow Deposits

Emergency Housing Vouchers - FSS Escrow Forfeitures this Month

Shape441 Shape442 Shape443 Shape444 Emergency Housing Vouchers - Fraud Recovery Total Collected this Month

Shape445 Shape446 Shape447 Shape448 Emergency Housing Vouchers - Unrestricted Net Position Funds (UNP) as of the Last Day of the Month

Shape449 Shape450 Shape451 Shape452 Emergency Housing Vouchers - Restricted Net Position Funds (RNP) as of the Last Day of the Month

Shape453 Shape454 Shape455 Shape456 Emergency Housing Vouchers - Cash/Investment as of the Last Day of the Month

Emergency Housing Vouchers HAP Spent on Permissive Deductions

Shape457 Shape458 Shape459 Emergency Housing Vouchers Unexpended Service Fees

Shape460

Page 16 of 17 Form HUD-52681-B (03/2023)

Voucher for Payment of Annual Contributions and Operating Statement

Housing Assistance Payments Program Supplemental Reporting Form

US Department of Housing and Urban Development

Office of Public and Indian Housing

OMB Approval No. 2577-0282 (Exp. 03/31/2025)


Comments:


Name of PHA Point of Contact:	POC Phone Number:	Ext:
Date Submitted:	Official HA Email Address:

Page 17 of 1 7 Form HUD-52681-B (03/2023 )

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	Microsoft Word - 52681-B v2 swjwg.docx
Author	SMA
File Modified	0000-00-00
File Created	2023-08-27