HUD 52849 Capital Fund Financing Program Pooled Transaction List o

Capital Fund Financing Program Pooled
Transaction: List of Participating PHAs

OMB Approval No. 2577-0157

U.S. Department of Housing

(exp. 11/30/2023)

and Urban Development

Public Reporting Burden for this collection of information is estimated to average 1 hour 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. Response to this collection of information is mandatory to obtain a benefit. HUD may not conduct or sponsor, and an applicant is not
required to respond to a collection of information unless it displays a currently valid OMB control number. This collection of information is required for the approval of a Capital Fund Finance Proposal pursuant to
HUD regulations 24 CFR 905. Comments regarding the accuracy of this burden estimate and any suggestions for reducing this burden can be sent to the Reports Management Officer, Office of Policy Development
and Research, REE, Department of Housing and Urban Development, 451 7th St SW, Room 4176, Washington, DC 20410-5000. When providing comments, please refer to OMB Approval No. 2577-0157.
The information requested does not lend itself to confidentiality.

Name of Pool:______________________________________
(a)

(b)

(c)

(d)

Name of PHA

Amount of
Issuance

Percentage of
Pooled
Transaction

Annual Debt
Service

(e)

(f)

(g)
Debt Service
Debt Service
Current FY
as Percent of
as a Percent of
Capital Fund
Pooled Debt
Capital Fund
Service

(h)
Cost of
Issuance as a
Percent of
Issuance

(i)

(j)

Number of
Properities
Modernized

Current
PHAS
Score

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
TOTAL
Instructions:
1. Fill in the requested information for each PHA participating in the CFFP Pool. Cross-collateralization is not permitted.
2. Column (d) should include principal and interest payments, plus any other ongoing fees (e.g. trustee fees, rating agency fees, etc.).
3. Column (j) use PHAS rating name: High, Standard or Troubled.
4. If more that 17 PHAs are participating, use a second form for the remaining PHAS and provide a subtotal for the second form and grand total for the pool.

form HUD-52849 (11/2008)