The URL can be used to link to this page

Home My WebLink About1996-08-21 - Minutes - Archive• • MINUTES OF THE REGULAR MEETING OF THE HOUSING AUTHORITY OF THE CITY OF FAYETTEVILLE, ARKANSAS The Housing Authority of the City of Fayettteville, Arkansas met in Regular Session at 8:00 A.M. Wednesday August 21, 1996, in the office of the Authority #1 North School, Fayetteville, Arkansas. Dan Hudspeth, Chairperson, Commissioners Present: Commissioners Absent: called the meeting to order. Hudspeth, Richardson, Childress, Clinehens Fries Others Present: Bromo Wilson, Fredia Sawin The Minutes of the July 17, 1996 Reuglar Meeting were approved by motion, seconded, and carried unanimously. The July Financial Statement was approved by motion, seconded, and carried unanimously. RESOLUTION FOR APPROVING OPERATING BUDGET FOR PUBLIC HOUSING FISCAL YEAR ENDING 9/30/97. Resolution No. 589 was approved by motion, seconded, and carried unanimously. RESOLUTION AMENDING PUBLIC HOUSING STATEMENT OF POLICIES AND SECTION 8 RENTAL ASSISTANCE ADMINISTRATIVE PLAN ON ADMISSION TO AND CONTINUED OCCUPANCY ACCORDING TO HUD REGULATIONS ON RESTRICTIONS ON ASSISTANCE TO NON CITIZENS. Resolution No. 590 was approved by motion, seconded and carried unanimously. • Motion for purchase of a Seciton 8 vehicle for $16,000 was approved, seconded and carried unanimously. There being no further business, the meeting was adjourned. THE HOUSING AUTHORITY OF THE CITY OF FAYETTEVILLE, ARKANSAS CHAIRPERSON RESOLUTION NO. 590 RESOLUTION AMENDING THE STATEMENT OF POLICIES GOVERNING ADMISSION TO, AND CONTINUED OCCUPANCY OF, THE HUD -AIDED PUBLIC HOSING PROGRAM AND THE ADMINISTRATIVE PLAN OF THE SECTION 8 RENTAL ASSISTANCE PROGRAM BY INCORPORATING THE HUD REGULATIONS ON RESTRICTIONS ON ASSISTANCE TO NON CITIZENS BE IT RESOLVED BY THE BOARD OF COMMISSIONERS OF THE FAYETTEVILLE HOUSING AUTHORITY THAT: The following amendments to the Statement of Policies Governing Admission to and Continued Occupancy of HUD -Aided Public (housing Programs and the Administrative Plan of Section 8 Rertal Assistance Program are hereby approved: 1.: Add (ha following to Section 2.0, Definitions end renumber as necessary: • 2.4: Qbili A member of the family, other than the family head or a spouse, who Is under 18 years of age 2.0: Citizen A citizen or national of the United States 1 2 12: EvUnce of cllizenslt r el.'gliaimui(gr ioir n $tato& The documents which must be submitted to evidence citizenship or eligible Immigration status. 2,19: ±tad.sIJiousehtzti (adding to definition already there) , and who is the head of household for purpose", of determining Income eligibility and rent. 2.21 JN The U S. Immigration and Naturalization Service. 2.20: mixedfamily A family whose members Include those with cilirn::chip or eligible immigration status, and those without citizenship or eligible l nr .dration status. 2.31: Mational A person who owes permanent allegiance to the United States, for example, as a result of birth In a United States territory or possession, • 2.34: Mariam A person who Is neither a citizen nor national of the United States. • 2.38: aA .Uou 2,14 Section 214 011ie Housing and Community development Aut of 1980, as amended. (42 U.S.0 14JOa). Section 214 restricts HUA from making financial assistance available for noncitizens unless they meet one of the categories of eligible Immigration status specified In Section 214. 2 39' $ns tion 214 .overed..Ptoprams Programs to which the restrictions Imposed by Section 214 apply are programs that make available financial assistance pursuant to the United States Housing Act of 1937 (42 U S,C. 1437 - 1440), Section 235 or Section 236 of the National Housing Act (1Z U.S.C. 1710z and 1715±-1) and Section 101 of the Housing and Urban Development Act of 1906 (12 U S.0 1701s), • • • • • • 4.1 2. Under 4.3, Eligibility for Admission, change first paragraph A to 8, end add peregreph A es follows: A. B,6stl giSuisSE.Ig N4 t itIZeeS Housing Assistance may be provided only to (a) Citizens, or (b) Noncitizens who have eligible immigration status In one of the following six categories 1. Lawfully admitted for permanent residence as an Immigrant, Including special agricultural workers. 2 Entered the U.S. before January 1, 1972 and Is deemed lawfully admitted for permanent residence. 3. Lawfully present in the U.S. pursuant to the granting of asylum (refugee statue) 4. Lawfully present in the U.S on parole status. • 0. Lawfully present in the U.S as result of withheld deportation. O. Lawfully admitted under amnesty granted by the INS. 3. Under 4.0, Admission and Selection Criteria, add Sections 4.9, 4.10, 4.11, end 4.12 to read es follows end renumber following paragraphs: 4.9 n .Ill Veriflcatlo roc A. The housing authority shall request and review original documents of eligible immigration status Photocopies shall be retained of all documents for Its own records and return originals to the family. B. aubminigi • •i - ' • • e Irani jgggn Status: Each family member, regardless of age, must submit the following evidence: For citizens: a signed declaration of U.8 citizenship; For noncitizens who are or will be 62 years of age or older on June 19, 1995: (a) a signed declaration of eligible Immigration status, and (b) proof of age document; and For all other noncitizens: (a) a signed declaration of U.S. citizenship, (b) specified Immigration and Naturalization Service (INS) documents of eligible immigration status, and (c) a signed certification consent form. C. Primary venfication is conducted by a PHA through the INS automatod Systematic Allen. Verification for Entitlements (SAVE) system. If the INS SAVE system fails to verily eligible Immigration status, secondary verification is performed through a manual search by INS of Its records. 0 the secondary verification fads to confirm eligible immigration status, the fancily is notified of the right of appeal to INS, The INS will Issue a decision within 30 days of Its receipt of documentation concerning the appeal. If unable to issue a decision within 30 days, the INS will inforrn the family and the PHA of the reasons for the delay. When the PHA receives a copy of the INS decision, it notifies the family of its right to request en informal hearing with the PHA. 4.10 4.11 • Assistance to an applicant may not be delayed, denied, or terminated until (a) all immigration documents were timely submitted, (b) the family member requiring evidence has moved, (c) the INS or PHA appeals processes have not been concluded, (d) assistance Is prorated, or (e) assistance for a mixed family Is continued. Following completion of the appeals and informal hearing procedures, three types of assistance my be available to the family (a) continued assistance, (b) temporary deferral of termination of assistance, or (c) prorated assistance. 4.12 J?rphfbition of Assistance to NonCitizen Students The prohibition on providing assistance to a noncltizen student also extends to the noncltizen spouse and minor children of any noncltizen student accompanying or following to Join such student The prohibition does not extend to the citizen spouse and the children of the citizen spouse and noncltizen student, 4. Under 7. o, Methods of Administration, add 7.1 to reed as follows: 7.1 CampJj=ric The restrictions on use of assisted housing by noncitizens with ineligible immigration status in conformity with the nondiscrimination requirements of, including, but not limited to, title VI of the Civil Rights Act of 1964 and the rrnptementing regulations of 243 CFR part 1, section 504 of the Rehabilitation Act 0 1973, and the implementing regulations of 24 CFR part 0, the Fair Housing Act and the implementing regulations of 24 CFR part 100, and other civil rights statutes cited in the applicable program regulations. These statutes prohibit, among other things, discriminatory practices on the basis of race, color, national origin, sex, religion, age, disability and familial status in the provision of housing. SECTION 2. That the following regulations are effective retroactive to June 19, 1995. PASSED AND APPROVED THIS A7037i DAY OF X4fia(ent 1996 THE HOUSING AUTHORITY OF THE CITY OF FAYETTEVILLE,,.:KANSAS CHAIRPERSON 1 PHA/IHA Board Resolution Approving Operating Budget or -Calculation of Recto/mance Funding System Operating Subsidy RESOLUTION NO. 589 OMB Approval No. 2577-0026 (Exp. 10/31/97) Public Reporting Burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing sources, gathering and maintaining the data needed, and completing and reviewing the collection o1 information. Send comments regarding this burden estimate y other aspect of this collection of information, including suggestions for reducing this burden, to the Repo;ts Management Officer, Office of Information Policies and Systems, U.S. Department of Housing and Urban Development, Washington, U.C. 20410-3600 and to the Office of Management and Budget, Paperwork Reduction Project (2577-0026), Washington, D.C. 20503. Do not send this completed form to either of the above addressees. U.S. Department of Housing and Urban Development Office of Public and Indian Housing Acting on behalf of the Board of Cunuuissioners of the below -maned Public Housing Agency (PI IA)/Indian Housing Authority (IIIA). as its Chairmam,1 hiiake the following certifications and agreements to the DepauUnen( of I lousing and Urban Development (IIUD) regarding the Board's approval of (cheek one or 111010 as applicable): x Operating Budget Submitted on: Operating Budget Revision Submitted on: Calculation of Perfonuauce Funding System Submitted un: Revised Calculation of Perforulance Funding System Submitted on: (date) 8/21/96 R/21/g6 I certify on behalf of the: (FHA/u-IA Nane) Fayetteville Housing Authority Mat 1. All regulatory and statutory requirements have been met; 2. The PITA has sufficient operating reserves to meet the working capital needs of its developments; • Proposed budget expenditures are necessary in tlie efficient and economical operation of the housing for the purpose of serving low-income residents; 4. The budget indicates a source of funds adequate to cover all proposed expenditures; 5. The calculation of eligibility for Federal funding is in accordance with the provisions of the regulations; 6. All proposed rental changes and expenditures will be consistent with provisions of law; 7. The P11A/IHA will comply with the wage rate requirements under 24 CFR 968.110(e) auul (1) or 24 CFR 905.120(e) and (d); 8. The PHA/11-1A will comply with the requirements for access to records and audits under 24 CFR 968.110(i) or 24 CFR 905.I20(8); and 9. The 1311A/IFIA willCOMply with the felillitellICIIIS for Ote reextunination of fluidly income and composition under 24 CFR 960.209.990.115 and 905.315. IherebycertifythatallUteinformationstatedwithin,aswellasanyiukrrmationprovidedintheaccoiiij a inientherewith,istrueandaccurate.. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802) *ad Chairman's Name (type) signal Date: Dan Hudspeth 4frISfAr— 8/21/96 Previous edition is obsolete 'U.S. Govarnmem Print Office: 1995. 404.925/20274 form HUD -52574 (10(95) ref. Handbook 7575.1 Calculation of Performance Funding System Operating Subsidy PHAIIHA-Owned Rental Housing Public Repo! ting Burden for this collection of information is estimated to average 2.5 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. Send comments regarding this burden estimate or any other aspect of this collection of information, Including suggestions for reducing this burden, to the Reports Management Of icer, Paperwork Reduction Project 7-0029), 011ice of Information Policies and Systems, U.S. Department oI Housing and Urban Development, Washington, D.C. 20410-3600. -tot send this form to the above address. U.S. Department of Housing and Urban Development Office of Public and Indian Housing OMB Approval No. 2577-0029 (exp. 7/31/96) Name and Address of Public Housing Agency/ Indian Housing Authority: (PHMHA) Fayetteville Housing Authority #1 North School Avenue Fayetteville, AR 72701 ▪ Budget submission to HUD required Type of Submission: ® Original Revision No: Number of HA Units 252 Unit Months Available: (UMAs) 3,024 Suaect Fiscal Year 10/1/96 9/30/97 ACC Number: FW 7031 PAS/LOCCS P reject No: Line No. Descr Allen Submission Dale: Aj RI 0[ 91 71 0] 0111 91 31 5 8/21/96 Rogues sd by PHAAHA HUD Modifications (PUM) (PUM) Part A Alrewaore tapanaaa al u r,w•a•.••o 12 01 Previous allowable expense level (line 07 of form HUD -52723 (o previous fiscal year) (Ell) 210.87 e i � �� O//// ��✓/�j�/�j� 108 R3 1. — 02 a line 01 multiplied by .005 of occupied units as of rent roll date 1.05 14 Average monthly dwelling rental charge per unit (line 12 divided by line 13) 02 b Delta from form HUD -52720-B, if applicable (see instructions) 16 Projected average monthly dwelling rental charge per unit (line 14 unit times line 15) (line 16 times line 17) 03 -Requested' year units from latest form HUD-52720-A(see Instructions) f//J/l��//Z Projected occupancy percentage (see Instructions) Z A 04 Add-ons to allowable expense level from previous fiscal year (see Instructions) 111 Non -dwelling units 67 Long-term vacant units 9 05 Total of lines 01, 02a, 02b, and 04 211.92 150.23 jA//j/lj��iU/ 06 Inflation factor • HUD Whole dollars) Modifications 1.024 ///%!('//!C%///i�j��44% 454,296 24 07 Revised allowable expense level (AEL)(line 05 limes line 06) 217.01 07a Transition Funding 07b Increase to AEI. 08 Allowable utilities expense level from form HUD -52722-A 44.76 fiscal . 13 Actual or n Estimated PUM cost of Independent Audit (IA) during subject year Costs attributable to deprogrammed units 1 Total Allowable Expenses and Additions (sum of lines 07 thru 10) 261.90 amMi Pall is invening Werner nreume 12 Total Number rent roll (as of // ) 7 01 moo_ (Ell) 6 2 1 r e i � �� O//// ��✓/�j�/�j� 108 R3 1. — ��/, � �� // � / 4 1. 13 of occupied units as of rent roll date 249 14 Average monthly dwelling rental charge per unit (line 12 divided by line 13) 15 Change factor n/a 16 Projected average monthly dwelling rental charge per unit (line 14 unit times line 15) (line 16 times line 17) Ins R3 97 % 1 flIi c,7 �O 17 Projected occupancy percentage (see Instructions) 18 Projected average monthly dwelling rental income per 111 Non -dwelling units 67 Part U non-aweumg racoma 19 Estimated Investment Income (Ell) 5. 11 Unemployment compensation 20 Otherincome Excess Ut '99 28 Total Otter (specify in Remarks section) 21 Total non -dwelling Income (line 19 plus line 20) 28a Add-on for Family Sell Sufficiency Program 6. 10 8c 22 Total operating receipts (line 18 plus line 21) 111 Non -dwelling units 67 Long-term vacant units 9 23 PUM deficit or (Innccoome) (line line 22) Total add-ons (sum of lines 25 thru 28) 150.23 jA//j/lj��iU/ �1111��minus �� %/l/!/!/!/i%//ijj/jjjj�!!!!/!/�'�////�j�jj�j�j�/ Requested dollars) IHA • HUD Whole dollars) Modifications ///%!('//!C%///i�j��44% 454,296 24 Deficit or (Income) before add-ons (line 23 times UMAs shown In heading) Pall U. Add-ons for cnanges m raver or rev w roya•a••-•• .•••- -•••-•-••o•-^•-s 25 FICA contributions 26 Unemployment compensation 27 Flood insurance premiums 28 Total Otter (specify in Remarks section) j// /2,///�jj� j� j/j� j/ j// // �/ ,..� , �,, ice,; ,� �, '�// "' moi/ /////% 28a Add-on for Family Sell Sufficiency Program 28b Other Add-ons for Federal law or regulations 8c Unit reconfiguration 288e Non -dwelling units 28e Long-term vacant units 9 29 Total add-ons (sum of lines 25 thru 28) Previous edition is obsolete for PHMHA Fiscal Years beginn ng 1/1/95 and thereafter Page 1 orm nuu- ref. Handbook 7475.13 • Description -End Adiuslments Requested by PHA/IHA (PUM) HUD Modifications (PUM) epayment Schedules ....... .................. --....-----_ --- .---- - ._._ 0 - ---. _ 'IOW��'/i��l.,<7 r6/ 12E ;/.,� .//�; ��- ��// y%'%%%x/i /� // /r i gr/'/' // /��/�/�� 6 / // ,/ 30 Deficit or (incomm)belore year-end adjustments (total of lines 24 and 29) 47 454 (identify Individual amounts under 'Remarks") ,946 400 • 454 , 696 . ( ) 31 n Actual or ) Estimated cost of Independent Audit (IA) during subject fiscal year 32 PFS operating subsidy eligibility before year-end adjustments of line 30 or line 31) (11 less than zero, enter zero (0)) �(greater F. Calculation of Operating Subsidy Approvable for Subject Fiscal Year (Note: Do not revise after the end of the subject FY) 51 33 Prior years' net year-end adjustments (identity Individual FYs and amounts under "Remarks"j_ 34 Additional subject fiscal year operating subsidy eligibilityjspedly)__ 54 Utility adjustment (line 22, Iorm HUD -52722-B) ( ) Combined utility and Til adjustment (total of lines 53 and 54) ( Deficit or (Income) after year-end adjustments (total of lines 30 and 55) 35 Overobligations from prior fiscal years to be recovered In subject fiscal year 3s.. Unfunded eligibility in prior fiscal years to be obligated In subject Ilscal year 58 37 Other (spedy) 61 Net year-end adjustment 38 Other (specify) 62 Unfunded portion 39 other (spedy) 63 Prorated net year-end adjustment 40 Unfunded portion due to proration • 41 Operating subsidy approvable for subject fiscal year (total of lines 32 thru 40) HUD Use Only (Note: Do not revise after the end of the subject FY) 43 Amount of operating subsidY-PProvable for subject fiscal year not funded iSrii( ii "%%: j. ) /jr.ri'!/i -'. 44 Amount of funds obligated in excess of operating subsidy approvable for subject fiscal year 45 Funds obligated In subject fiscal year (total of lines 41 thru 44) for the (Must be the sane as line 690 of the Operating Budget, form HUD -52564, subjectyear) fiscal ear ' -': -:c.<C /:: vss<:�:r%-.": - ( �G%% � C%;" r,ri epayment Schedules ....... .................. --....-----_ --- .---- - ._._ 0 - ---. _ 'IOW��'/i��l.,<7 r6/ 12E ;/.,� .//�; ��- ��// y%'%%%x/i /� // /r i gr/'/' // /��/�/�� 6 / // ,/ 46 Total amount due in previous fiscal year (line 49 of form HUD -52723 for previous fiscal year) 47 Total amount to be collected In subject fiscal year (identify Individual amounts under 'Remarks") ( ) ( ) 48 Total additional amount due HUD (include any amount entered on line 44) (Identify individual amounts under 'Remarks') Adjustment of Independent Audit (IA)Cost Add-ons 9 49 Total amount due HUD to be collected In Iuture fiscal year(s) (Total of lines 46 thru 48) (Identity Individual amounts under 'Remarks') 51 Estimated Investment Income (Ell) 52 Target Investment Income (TII) Part H Calculation of Year-end Adjustment for Subject Fiscal Year I hereby certify Thal all the information staled herein, as well as any information provided in the accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and statements. Conviction may result In criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012: 31 U.S.C. 3729, 3802) Signalure off- mired HA Representative 8 rate: i/i %I �/ :••• 411 X AV./ / Signature of Authorized Field 011ice Representative & Dale: X Previous edition Is obsolete for PHAAHA Fiscal Years beginning 1/1/95 and thereafter Page 2 form HUD -52723 (12/94) rel. Handbook 7475.13 'IOW��'/i��l.,<7 r6/ 12E ;/.,� .//�; ��- ��// y%'%%%x/i /� // /r i gr/'/' // /��/�/�� 6 / // ,/ �� .��// �- -M7 ////j j/ ij/�//� //%/�///j/0 • %. Si / ' ��% %/j//// ndicate the types of that have been reflected on this form: adjustmentsr/i Utility Adjustment � Unit Months Available (UMAs) Target Investment Income (TII) Adjustment ❑ Dwelling Rental Income Adjustment of Independent Audit (IA)Cost Add-ons 9 Other (specify under "Remarks") 51 Estimated Investment Income (Ell) 52 Target Investment Income (TII) 53 Til adjusbnent (line 51 minus line 52) 54 Utility adjustment (line 22, Iorm HUD -52722-B) 55 Combined utility and Til adjustment (total of lines 53 and 54) 56 Deficit or (Income) after year-end adjustments (total of lines 30 and 55) 57 PFS operating subsidy eligibility alter year-end adjustments (greater of line 31 or line 56) 58 line 32 of latest Iorm HUD -52723 approved during subject FY (Do not use line 32 of This revision) 61 Net year-end adjustment for subject fiscal year (line 57 minus line 58) 62 Unfunded portion due to proration 63 Prorated net year-end adjustment for subject fiscal year • I hereby certify Thal all the information staled herein, as well as any information provided in the accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and statements. Conviction may result In criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012: 31 U.S.C. 3729, 3802) Signalure off- mired HA Representative 8 rate: i/i %I �/ :••• 411 X AV./ / Signature of Authorized Field 011ice Representative & Dale: X Previous edition Is obsolete for PHAAHA Fiscal Years beginning 1/1/95 and thereafter Page 2 form HUD -52723 (12/94) rel. Handbook 7475.13 .Calculation of Performance Funding System Operating Subsidy PHA/IHA-Owned Rental Housing Public Reporting Burden for this collection of Information Is estimated to average 2.5 hours per response, Including the tine for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of Information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management Officer, Paperwork Reduction Project �7-0029), Office of Information Polities and Systems, U.S. Department of Housing and Urban Development, Washington, D.C. 20410-3600. not send this form to the above address. U.S. Department of Housing and Urban Development Office of Public and Indian Housing OMB Approval No. 2577-0029 (exp. 7/31/96) Name and Address 01 Public Housing Agency / Indian Housing Authority: (PHMHA) Fayetteville Housing Authority #1 North School Avenue Fayetteville, AR 72701 ▪ Budget submission to HUD required Type of Submission: ® Odglnal 0 Revision No: Number al HA Units 252 UM Months Available: (UMAs) 3,024 Subject Fiscal Year: 10/1/96 9/30/97 ACC Number: FW 7031 PAS/LOCCS P oleo No: AI RI01917i Line No. Dour pilon Submission Date: Of 01 11 91 31 5 Requested by PHMHA (PUM) 8/21/96 HUD Modifications (PUM) enses and Additions 01 Previous allowable expense level (line 07 of form HUD -52723 fo previous fiscal year) 210.87 S , 7 , 20 Otherincome Excess Ut 02a Line Ol multiplied by .005 Flood insurance premiums 1.05 13 02 b Delta from form HUD -52720-B, If applicable (see instructions) 1�� (line 12 divided by line 13) 22 108 03 'Requested' year units from latest form HUD 52720-A(see instructions) // // 15 Z ��/�� 04 Add-ons to allowable expense level from previous fiscal year (see instructions) 1. PUM deficit or (Income) (line 11 minus line 22) 16 Projected 05 Total of lines 01, 02a, 02b, and 04 211.92 24 1 08 83 06 Inflation tactor 17 1.024 occupancy percentage (see instructions) 07 Revised allowable expense level (AEL)(line 05 times line 06) 217.01 18 Projected average monthly dwelling rental Income per unit (line 16 times line 17) 07a Transition Funding 1 0R 27 07b Increase to AEL 08 Allowable utilities expense level from form HUD -52722-A 44.76 .13 Actual or n Estimated PUM cost of Independent Audit (IA) during subject fiscal year I Costs attributable to deprogrammed units 11 Total Allowable Expenses end Additions (sum of lines 07 thru 10) 261,90 e 12 Total 5.11 S , 7 , 20 Otherincome Excess Ut .99 Flood insurance premiums 21 13 Numbertof occupied units of rent roll date 249 14 Average monthly dwelling rental charge per unit (line 12 divided by line 13) 22 108 83 / 28b 15 Change factor n/ a 1. - 1. PUM deficit or (Income) (line 11 minus line 22) 16 Projected average monthly dwelling rental charge per unit (line 14 times line 15) Total add-ons (sum of lines 25 thru 28) 24 1 08 83 j� j j� 17 Projected occupancy percentage (see instructions) 454,296 97% % 18 Projected average monthly dwelling rental Income per unit (line 16 times line 17) 1 0R 27 19 Estimated Investment Income (Ell) 5.11 26 20 Otherincome Excess Ut .99 Flood insurance premiums 21 Total non -dwelling income (line 19 plus line 20) Total Other (specify in Remarks section) 6.10 28a 22 Total operating receipts (line 18 plus line 21) / 28b 111.67 c iration 288e 23 PUM deficit or (Income) (line 11 minus line 22) 150.23 29 Total add-ons (sum of lines 25 thru 28) 24 Deficit or (income) j� j j� Requested dHA (Whole dollars) HUD Modifications (Whole before add-ons (line 23 times UMAs shown In heading) 454,296 • ulation and other el !bill 25 FICA contributions 26 Unemployment compensation 27 Flood insurance premiums 28 Total Other (specify in Remarks section) 28a Selld Add-ontherfor ons j/ / / ' / 28b ral tawncy gugram forly Other Add-ons for Federal taw or regulations c iration 288e Lond g -term -t rmfNon-dwellinvacanunitsunits 29 Total add-ons (sum of lines 25 thru 28) Previous edition Is obsolete for PHA/IHA Fiscal Years beginn ng 1/1/95 and thereafter Page 1 form HUD -52723 (5/96) ref. Handbook 7475.13 Part O. Memorandum of Amounts Due HUD, Including Amounts on Repayment Scnedules 46 Total amount due in previous fiscal year (line 49 of form HUD -52723 for previous fiscal year) 47 Total amount to be collected in subject fiscal year (identity individual amounts under 'Remarks") 48 Total additional amount due HUD (Include any amount entered on line 44) (Identify individual amounts under Remarks") 49 Total amount due HUD to be collected In future fiscal year(e) (Total of lines 46 thru 48) (Identify individual amounts under "Remarks") Part 11 Calculation of Year-end Adjustment for Subject Fiscal Year This part Is to be completed only after the subject Ilscal year has ended Iodinate the types of adjus(rnents that have been reflected No D • escrlptlon Requested by PHA/IHA (RUM) HUD Moodi�, tions Part E Calculation of Operating Subsidy Eligibility Before Year -End Adjustments /%i . / / // Income lines 24 and 29) 4R4„ 2QF TargetInvestment(TB) iA�jAdjustment 30 Deficit or (incom9),before year-end adjustments (total of 31 n Actual or Estimated cost of Independent Audit (IA) during subject fiscal year 400 32 PFS operating subsidy (greater at line 30 or eligibility before year-end adjustments ine 31) (11 less than zero, enter zero (0)) 454,696 (specily under �F. Subsidy Approvable for Subject Fiscal Year (Note: Do not revise after the end of the subject FY) Calculation of Operating 52 Target Investment Income(T11) Individual FYs and amounts under "Remarks") TII adjustment (line 51 minus line 52) 33 Pdor years' net year-end adjustments (Identity Utility adjustment (line 22, form HUD -52722-B) 55 Combined utility and TII adjustment total of lines 53 and 54) 34 Additional subject fiscal year operating subsidy eligibilityjspeclfy) 56 ) Overobligations Irom prior fiscal years to be recovered in subject fiscal year alter adiustmenls (greater of tine 31 or line 56) ) ( PFS operating subsidy eligibility year-end 35 36 Unfunded eligibility in prior fiscal years to be obligated In subject fiscal year Une 32 of latest form HUD -52723 approved during subject FY (Do not use line 32 of this revision) 37 Other (specify) 61 Net year-end adjustment for subject 38 Other (specify) 62 Unfunded portion due to proration Other 63 Prorated net year-end adjustment for subject 39 (specify) 40 Unfunded portion due to proration approvobie for subject fiscal year (total of lines 32 thru 40) 41 Operating subsidy Do not revise after the end of the subject FY) HUD Use Only (Note: ,, ) i for subject fiscalyear not funded't{2.2."' c -"I -1j : tom / '222222 ( 43 Amount of operating subsidy approvable P 9 Y PD '42' // � ; for subject fiscal year / - 22 44 Amount of funds obligated in excess of operating subsidy approvable „ / 45 Funds obligated In subject fiscal year (total of lines 41 thru 44) (Must be to same as line 690 of the Operating Budget, form HUD -52564, for Ute subject fiscal year) / ;: ii -� i��- ,1./�%%j !%/,y%! Part O. Memorandum of Amounts Due HUD, Including Amounts on Repayment Scnedules 46 Total amount due in previous fiscal year (line 49 of form HUD -52723 for previous fiscal year) 47 Total amount to be collected in subject fiscal year (identity individual amounts under 'Remarks") 48 Total additional amount due HUD (Include any amount entered on line 44) (Identify individual amounts under Remarks") 49 Total amount due HUD to be collected In future fiscal year(e) (Total of lines 46 thru 48) (Identify individual amounts under "Remarks") Part 11 Calculation of Year-end Adjustment for Subject Fiscal Year This part Is to be completed only after the subject Ilscal year has ended I hereby certify Thal all the information slated herein, true and accurate. Warning: HUD will prosecute false claims and statements. (18 U.S.C. 1001,1010, 1012; 31 U.S.C. 3729, 3802) Signature of A orized HA Represent... as well as any iufonnalion provided in the accompaniment herew1Ui, IS Conviction may result In criminal and/or civil penalties. Signature of Authorized Field Office Representative 8 Dale: X • Previous edition is obsolete for PHA/IHA Fiscal Years beginning 1/1/95 and thereafter Page 2 form HUD -52723 (1294) rel. Handbook 7475.13 Iodinate the types of adjus(rnents that have been reflected on this loan: " .2 z2:.2'21.12#'�%idem // �? jy/p P/ /. 2;1..07 , 7/i j Utility Adjustment 9 Unit Months Available (UMAs) /%i . / / // Income TargetInvestment(TB) iA�jAdjustment j�%„%/ / / �/i/%%" Adjustment ol Independent Audit Cost Add-ons "Remarks) (specily under ty.,.r*o%'Y/i��222/�/////%24 ��/Other 51 Estimated Investment Income (Ell) 52 Target Investment Income(T11) 53 TII adjustment (line 51 minus line 52) 54 Utility adjustment (line 22, form HUD -52722-B) 55 Combined utility and TII adjustment total of lines 53 and 54) 56 Deficit or (Income) alter year-end adjustments (total of lines 30 and 55) 57 alter adiustmenls (greater of tine 31 or line 56) PFS operating subsidy eligibility year-end 58 Une 32 of latest form HUD -52723 approved during subject FY (Do not use line 32 of this revision) 61 Net year-end adjustment for subject fiscal year (line 57 minus line 58) 62 Unfunded portion due to proration 63 Prorated net year-end adjustment for subject fiscal year I hereby certify Thal all the information slated herein, true and accurate. Warning: HUD will prosecute false claims and statements. (18 U.S.C. 1001,1010, 1012; 31 U.S.C. 3729, 3802) Signature of A orized HA Represent... as well as any iufonnalion provided in the accompaniment herew1Ui, IS Conviction may result In criminal and/or civil penalties. Signature of Authorized Field Office Representative 8 Dale: X • Previous edition is obsolete for PHA/IHA Fiscal Years beginning 1/1/95 and thereafter Page 2 form HUD -52723 (1294) rel. Handbook 7475.13 HA Calculation of Occupancy Percentage for a Requested Budget Year (RBY) PHNIHA-Owned Rental Housing Performance ndjng System (PFS) la. Name of PHA/IHA: Fayetteville Housing Authority 1b. Street Address: #1 North School Avenue U.S. Department of Housing and Urban Development Office of Public and Indian Housing OMB Approval No. 2577-0066 (Exp. 8/31/98) 2a. Contact: (Person who can best answer questions about this submission) Bromo Wilson lc. City: Fayetteville 3. RBY Beginning Date: (ma/day/yr) 10/1/96 Id. State AR le. Zip Code: 72701 4. Type of Submission: Original Revision No. IT 5. PAS/LOCCS Project No: AR09001935 2.b Contacrs Phone No: (Include area code) 501) 521-3850 i 6. Report Date: (check one box) (mo/day/yr) (1) Actual Day Average for 3/31/96 Actual Month 7. Data Source: form HUD -51234 Rent Roll Records Part A. Actual Occupancy Data as of Report Date B. Units Occupied 9. Units Available 10. Actual Occupancy Percentage (Divide line 8 by line 9; multiply by 100 and round to nearest whole) 25,0 252 99 Stop 11. If the HA -wide occupancy percentage shown on line 10 Is 97% or greater andthe HA believes that an average occupancy rate of Note at least 97% Is sustainabletor the RBY, then check the box below. You have completed the form and do not need 0 proceed further. High Occupancy HA: Occupancy Percentage Is 4 Use 97% as the Projected Occupancy 97% or higher and Is sustainable for the RBY Percentage on line 17 of form HUD -52723 XX 12. Units vacant as of Report Date (subtract line 8 from line 9 and enter result) Stop 13. If the result on line 12 is five or fewer vacant units and the HA believes that during the RBY: 1) the Inventory (line 9) will not change; & and, 2) the number of vacant units on line 12 will be vacant for the lull RBY, then check the box below. You have completed Ilse Note form and do not need to proceed further. • High Occupancy HA with flue or 4 Use line 10 for the Projected Occupancy fewer vacant units Percentage on line 17 of form HUD -52723 Part B. Distribution of Actual Vacancies By Major Cause Given below are circumstances and actions recognized by HUD as possible causes of vacancies that are beyond 111e control of the HA to correct. If appropriate, please distribute the number of vacant units reported on line 12 among these causes. Attach sheet identified with HA name and address, the RBY beginning date, and ACC number. Use the sheet to describe, for each circumstance; when the circumstance occurred; the location of the units Involved; why the circumstance Is preventing the HA from occupying, selling, demolishing, rehabilitating, reconstructing, consolidating or modernizing the vacant units; and ih Ilk Iihood that these circumstances will be mitigated or eliminated in the RBY. e e 14. Units vacant because of litigation (e.g., units that are being held vacant as part of court-ordered or HUD -approved desegregation plan) 15. Units they vacant do not meet because of minimum Federal, construction Tribal, or habitability or State standards laws of general ) applicability. (Note: do not Include units vacant only because 16. Units vacant due to changing market conditions 17. Units vacant because of natural disaster 18. Units vacant because of insufficient funding for otherwise approvable CIAP application 19. RMC (This -managed units vacant because of line for use only by RMCs) failure of HA to fund approvable request for Federal modernization funding 20. Units vacant because of casualty loss and need to settle Insurance claims 21. Total Units Vacant Due To Circumstances Beyond The HA's Control (Enter sum of lines 14 - 20) - 22. Units vacant after adfustIng for circumstances beyond the HA's control (Subtract line 21 from line 12) Stop 23. If the result on fine 22 is five or fewer vacant units andthe HA believes that during the RBY: 1) the Inventory (line 9) will not change; & and, 2) the number of vacant units on both lines 21 and 22 will be vacant for the full RBY, then check the box below. You have completed Note he form and do not need to proceed further. High Occupancy HA with live or fewer vacant units 4 Use line 10 for the Projected Occupancy after adjustment for vacancies beyond its control Percentage on line 17 of form HUD -52723 24. Vacancy Percentage after adjusting for beyond control circumstances (Divide line 22 by line 9, multiply by 100, and round to nearest whole) 25. If the result on line 24 is 3% or less andthe HA believes that during the RBY: 1) the Inventory (line 9) will not change; and, 2) the number of vacant units on lines 21 and 22 will be vacant for the lull RBY, then check the box below. You have completed the form and do not need to proceed further. ❑High Occupancy HA: 3% or less vacancy rate -) Use line 10 for the Projected Occupancy afteradjustment for vacancies beyond control Percentage on line 17 of form HUD -52723 Stop •tote This form replaces forms HUD -52728-A thru -C which have been canceled. Page 1 of 3 form HUD -52728 (5/96) ref Handbook 7475.13 HA Calculation of Occupancy Percentage for a Requested Budget Year (RBY) PHAIIHA-Owned Rental Housing Performance "finding System (PFS) Th. Name of PHA/HA: Fayetteville Housing Authority U.S. Department of Housing and Urban Development Office of Public and Indian Housing OMB Approval No. 2577-0066 (Exp. 8/31198) Ib. Street Address: #1 North School Avenue lc. City: Fayetteville 3. RBY Beginning Date: (mofdayyr) 10/1/96 ld. State* AR 10 Zip Code: 72701 4. Type el Submission: ▪ Original ▪ Revision No. 5. PAS/LOCCS Project No: AR09001935 2a. Contact: (Person who can best answer questions about This submission) Bromo Wilson 2.b Contacts Phone No: (Indude area code) (501) 521-3850 6. Report Date: (check one box) (mo/day/yr) fl Actual Day Average for 3/31/96 — Actual Month 7. Data Source' form HUD -51234 Rent Roll Records Part A. Actual Occupancy Data as of Report Date 8. Units Occupied 9. Units Available 10. Actual Occupancy Percentage (Divide line 8 by line 9; multiply by 100 and round to nearest whole) 2511 752 99 Stop & Note 11. If the HA -wide occupancy percentage shown on line 10 is 97% or greater and the HA believes that an average occupancy rate of at least 97% is sustainable for the RBY, then check the box below. You have completed the f orm and do not need o proceed further. High Occupancy HA: Occupancy Percentage Is 4 Use 97% as the Projected Occupancy PI 97% or higher and is sustainable for the RBY Percentage on line 17 of form HUD -52723 12. Units vacant as of Report Dale (subtract line 8 from line 9 and enter result) Stop Note • 13. If the result on line 12 is live or fewer vacant units and the HA believes that during the RBY: 1) the inventory (line 9) will not change: and, 2) the number of vacant units on line 12 will be vacant for the lull RBY, then check the box below. You have completed the form and do not need to proceed further. High Occupancy HA with five or 9 Use line 10 for the Projected Occupancy fewer vacant units Percentage on line 17 of form HUD -52723 Part B. Distribution of Actual Vacancies By Major Cause Given below are circumstances and actions recognized by HUD as possible causes of vacancies that are beyond the control of the HA to correct. If appropriate, please distribute the number of vacant units reported on line 12 among these causes. Attach sheet Identified with HA name and address, the RBY beginning date, and ACC number. Use the sheet to describe, for each circumstance; when the circumstance occurred; the location of the units involved; why the circumstance Is preventing the HA from occupying, selling, demolishing, rehabilitating, reconstructing, consolidating or modernizing the vacant units; and Ih Ilk Ilh d that these circumstances will be mlligaled or ellminated in the RBY. e e o0 14. Units vacant because of litigation (e.g., units that are being held vacant as part of court-ordered or HUD -approved desegregation plan) 15. Units they vacant do not meet because of minimum Federal, construction Tribal, or habitability or State standards laws of general ) applicability. (Note: do not include units vacant only because 16. Units vacant due to changing market conditions 17. Units vacant because of natural disaster 18. Units vacant because of insufficient funding for otherwise approvable CIAP application 19. RMC (This -managed line for use units vacant because of only by RMCs) failure of HA to fund approvable request for Federal modernization funding 20. Units vacant because of casualty loss and need to settle Insurance claims 21. Total Units Vacant Due To Circumstances Beyond The HA's Control (Enter sum of tines 14 - 20) 22. Units vacant after adjusting for circumstances beyond the HA's control (Subtract line 21 from Ilne 12) III t h Stop Note 23. If the result on line 22 is five or fewer vacant units and the HA believes that during the RBY: 1) the Inventory (Ilne 9) w no c ange, and, 2) the number of vacant units on both lines 21 and 22 will be vacant for the full RBY, then checkthe box below. You have completed the form and do not need to proceed further. High Occupancy HA with five or fewer vacant units 9 Use line 10 for the Protected Occupancy after adjustment for vacancies beyond its control Percentage on line 17 of form HUD -52723 24. Vacancy Pe centage after adjusting for beyond control circumstances (Divide line 22 by line 9, multiply by 100, and round to nearest whole) Stop 25. If the result on line 24 is 3% or less and the HA believes that during the RBY: 1) the inventory (line 9) will not change; and, 2) the & number of vacant units on lines 21 and 22 will be vacant for the full RBY, then check the box below. You have completed the form dote and do not need to proceed further. ❑High Occupancy HA: 3% or less vacancy rate 4 Use line 10 for the Projected Occupancy • atteradjustment for vacancies beyond control Percentage on Zine 17 of form HUD -52723 This form replaces forms HUD -52728-A thru -C which have been canceled. Page 1 of 3 form HUD -52728 (5/96) ret Handbook 7475.13 1 9 0' N 0 8 8 S 8:8 & II rot R UIItIkIji••.< s rii7 .�id& , I 8 a a: I R a aha_ <lq•<• �9&�N.• '41 I 2 a' Fi£ i ... c I. ntoc H.aq Aq.,q/ Y,a., ltv*q Mt lq Fayetteville Housing Autht #1 North School Ave Fave++m,4lla. AQ 7071, Fc �Q. i-� p{{ :wit 11 �8. i A a a; 11 €iIjfl q i _ll' 5 tq 3R g a ill ,.£�..ir• FT `:YiJ 'Yyky�� i'k i20 J'$... , t [a:k.A .', fl .', .3 a. • V• Ol cb.r 135,352 W ,. O N A W ,. O N A I. 9,072 3,024 3,024 3,024 .0 iii. E6 nam A O V O op 0 0IN3 9 i ��r L il • CO im V O .18392 npr1 hun gal e:' `:{$: L'':4::::::.:::44.,“ `ki%< \.M.::; :C°:?.i::k:: ::k:::>:.*::::::: ; iiji' ;nv_�iY::v •.r ki: s744VY'•• #>. ;$ 2 ':: WW::.::: :,.,. : :'tR'.':�'.;::iN •¢ : 4f k Zk:ki: kJ. &*.:iY:TI Y)•:N CO• co -. v) .. co ol V • 010 0 O [-+ cn . cn 00 V 0 O:ii:Sa 3E y{i>.;. k.;:»>; :ti •::::.:„.rc i:sr-4.0 {., .k:.i:.: Ci"ec• ' is i i'i'[{;?!i .:V'n. ,. E v.,.tn'P3; ; j? Si s.3:i:;�:.;;:: 47,062,500 II'I [-+ A .. cO Cr) A O 0 y-+ cn .. r-• CO 0 0 1E-1 V W V 0 O 0 = 77A[[ X 858,108 aa04r 092kwh .5. :.C:. fi:'t{Ys' +iY.} M1: Ji4 ii:i' .k:. f^:'' i i:.i C 858,108 858,108 6,318,200 ..k k ;•„•,• v,:: o: tY:•::i:s"'goII [;.. y ti.kv: :. ^Y':. Y):YYY: q::�2i�{s 4:k: $:'a`.k:i :<g R.<: \:' ?4,(.0:::c..*:*:::::.tt:' s8 :s:%::• :.Y;3;' . N • V) A 0• C o [+ CI CT1 N N 0• 796,772 __-1 6,472,200 1 926,532 5,959,800 11 1 r S O. CTI F. CO N ".+Y:,'sis L-: c ::a {-4:::..+.:. :i�.v�;i:k:i 3::::ii .`5`s',.:''k;,i;; 5'i':.:: { .a te;, °•�3 :�Si:Yk';::.'::#: N V O 01 '. r 03 na o 9 756 F • kx..< kkk:::a:Su kik:::ii }:).t::::...*:'* iyY::S::i::i :2 k:\jt::ki gq.Li a:: iii ):: 3a:i.:)'Y" j•5.i <:i M N 0 8 0 �$ a 18 810 Wi Q 2 a 44 71a spa spa a� 11111111 11 1 ts sf 8!Id (hclitticirt J ppy 11V pp pp sa a ~ .P 0 a a E i 6 yI a 515151 71 CD C 1 CO CO 01 W O V1 A N W 01 N CO : S W O N A LO 0 V N CO 01 CO O O T w w 1-r 0 if 0 ;1 4. OI XIUN3ddb Certification for a Drug -Free Workplace Public Housing Agency / Indian Housing Authority F ublic Reporting Burden for this collection of information is estimated to average 0.25 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. Send comments garding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management 'ker. Office of Information Policies and Systems. U.S. Departrnent of Housing and Urban Development, Washington, D.C. 20410-3600: and to the Office of anagement and Budget, Paperwork Reduction Project (2577-0044) Washington, D.C. 20503. U.S. Department of Housing and Urban Development Office of Public and Indian Housing OMB No. 2577-0044 (exp. 10/31/92) PHNIHA Name: Fayetteville Housing Authority ProgranvActiviry Receiving Federal Grant Funding: (mark one) Development nCIAP X Operating Subsidy nSec.23 Leased Housing 11 Development or CIAP, enter the Federal Fiscal Year in which the funds are expected to be reserved : If Operating Subsidy or Section 23, enter die PI-A'sJIHA's FiscafYear Ending date in which funds are expected to be obligated : Acting on behalf of the above named PHA/IHA as its Authorized Official, I make the following certifications and agreements to the Departmen of Housing and Urban Development (HUD) regarding the sites listed below: 1. I certify that the above narned PHA/111A wilt provide a drug-free workplace by: • a. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the PHA's/IHA's workplace and specifying the actions that will be taken against employees for violation of such prohibition. b. Establishing a drug-free awareness program to inform employ- ees about the following: (1) The dangers of drug abuse in the workplace; (2) The PHA's/IHA'spolicy ofmain tainingadrug-Gee workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace. c. Making it a requirement that each employee of the PHA/IHA be given a copy of the statement required by paragraph a.; d. Notifying the employee in the statement required by paragraph a. that, as a condition of employment with the PHA/111A, the employee will do the following: (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute convicticr for a violation occurring in the workplace no later than fivt days after such conviction; e. Notifying the HUD Field Office within ten days after receivint notice under subparagraph d. (2) from an employee or otherwise receiving actual notice of such conviction; f. Taking one of the following actions within 30 days of receivin) notice under subparagraph d. (2) with respect to any employe/ who is so convicted: (1) Taking appropriate personnel action against such an em ployee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in drug abuse assistance or rehabilitation program approved fe such purposes by a Federal, State, or local health, law en forcement, or other appropriate agency; g. Making a good faith effort to continue to maintain a drug-fre workplace through implementation of paragraphs a. thru f. WA RNING: 18 U.S.C. 1001 provides, among other things. that whoever knowingly and willingly makes or uses a document or writing containing any false, fic itiou: or fraudulent statement or aridly, in any matter within the jurisdiction of any department or agency of the United States, shall be fined not more than 510,000 c imprisoned for not more than five years. or both. 2. Sites for Work Performance. 711ePliA/IHA shalllist in the space provided below the site(s) for the performance of work done in connectic with the HUD funding of the program/activity shown above: Place of Performance shall include the street address, city, county, State, an zip code. (If more space is needed, attach additional page(s) the same size as this form. Identify each sheet with the PHA/IHA name and addre: and the program/activity receiving grant funding.) Site A• 4111 S Iewis / Sito B' 10 S Willow Ave / Site C• 12th4 14th Streets Site ,j• #1 North School AvpnllP Signed by: (Name, Title & Signature of Authorized PHNIHA 011idal) Name & Tide: Bromo Wilson / Executive Director • Signature & D X 8/21/96 form HUD -50070 (1218' ref. Handbooks 7417.1, 7475.13. 7485 Gertifloation for Contracts, Grants, Loans & Cooperative Agreements Public Housing Agency / Indian Housing Authority rat Here: Fayetteville Housing Authority #1 North School Avenue Fayetteville, AR 72701 U.A. Department of Housing and Urban Office of Pub& =It Housing ■ .ter than cosseting Ru slay or Section 23, war to Fidwel Find Yaw In Mit M Arida an wgeasd to M maned: ■ Operating tuSldy a feeder' 23. waw PHAYfHA's Fiscal Yew 6ddng On institch knelt an exposes is be obapassd 9/30/97 Plogranaolvity FarcelvIng Federal Grant as 6103Ae0: (mirk one Operating Subsidy ■ CGP ■MP ■ktRoP ■ Other. tailings) Development Drug Eininatcn Giants Sr -23 Lased Mouth; Adjustments • Acting on betulf of the above named PHAAHA as its Authorized Official, I make the following certifications so the Department of Housing and Urban Development (HUD): (1) No Federal appopriated ftmds have been paid or will be paid, by or on behalf of the undersigned, to any person for bdluendng or attempting to influence an officer or employee of any agency, a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, wtttbtuation, renewal, amealmeot, a modification of any Federal contract, pant, loan, or cooperative agreement. (2) lf any ftmds other dust Federal appropriated funds have been paid or will bepaidtoanyperson for influencing or attempting to influence an offica or employee of any agency, a Member of Congress, an office- or employee of Congress, or any employee of a Member of Congress in connection with this Federal contract, pant, loan, or 000paacve agreanent, the under- signed shall complete and submit Standard Fano-111, Disclosure of Lobbying Activities, in acwrdance with is instructions. (3) The tmdenigned shall require that the language of this certification be included in the award documents for all subawuels at all den (including subcontracts, abgranu, and oontracs under grants, loans. and cooperative agreements) and that all wSt ipiens shall certify and disclose ax 'tingly. 'This certification is a material repirsenurion of fact upon which telianae wn pima! when this transaction was made or entered into. Submission of this cntiflution is a prerequisite for making a entering into this transaction imposed by Section 1332. Title, 31, US. Code. Any pan who fails to file the required certification shall be abject to a civil penalty of tsar less than $10,020 and not more than $100,000 fa each such failure. I certify under penalty of perjury that the foregoing is true and correct Authorized PHAAHA Oficial. nn ant : Bromo Wilson Executive Director auresn a oar • f A eafrii/rk gl/te /one HUD 10e71 (MI ,u& Hande000b 4717.1.7476.13. a 7413 1 Certification for • Contracts, Grants, Loans & Cooperative Agreements Public Housing Agency / Indian Housing Authority Ilittrau tress: Fayetteville Housing Authority #1 North School Avenue Fayetteville, AR 72701 u.3. Department of Housing and Urban Offs. of PuMRc°i rd vNepn Ydlw Housing ■ Mor than Opining flbidy or Section 23, ens err. F.dwat Meg Yes fn .4irh M Inds an egt.asd tots nnrwt M Operating Subsidy a Section 33. .ran PHAYAHA's End Yaw Ending elan In which Inds en ap.asd b W 9/30/97 P mtim'Af *y R.l *'g Federal &wt ov r 1100,00: Pratt err) Operating Subsidy Devebpmert Drug Elknkudion Grants S.e.23 Lased Housirg Adjustments ■ ■ ■ ■ CGP CIAP MROP Other. tarwren • • AcdnganbehalfoftheabovenamedPHMHAasItsAuthorvedOdkial,tmakethefolowingcertifatiau to the Dcpmunent of Housing and Urban Development (HUD): (1) No Federal appropriated Rinds have been paid or will be paid, by a on bebalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress in Connection with the awarding of any Federal contract, the making of any Federal gem the making of any Federal lan, the entering into of any inoperative sgreanem, and the extension, continuation, renewal amendment, or modification of any Federal contract, pant, loan, or cooperative gramma. (2) If any funds other than Federal appropriated hmdshave been paidvwillbepaidtoanyperson for influencing a attempting to influence an officer or employee of any agency. a Member of Congress, an officer or employee of Congress, or any employee of a Member of Congress in connection with this Federal contact, pant, loan, a cooperative agreement, the under- signed shall complete and submit Standard Forint I I DHrclaatae of Lobbying Activities, in accordance with hs instruction (3) The undersigned shall require that the language of this certification be included in the award documenu for all subawuds at all tiers (including subcontracts, subgrants, and w. encu under pane, buts, and cooperative agreements) aryl that all subredpieats shall msify and disclose accordingly. This mention is a material representation of fact upon which reliane was pissed when this transaction was made or entered into. Submission of this certification is a prerequisite for nuking a enuring into this transaction imposed by Section 1352. Title 31, US. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $ I0,000 and not mac than S100,003 for each such (slime. I certify under penalty of perjury dist the foregoing is true and corrects Authorized PHMHA Official. tela anis : Bromo Wilson Executive Director rutin a 0a.: Ian HND 60071 (1/02) sal Hret000ks 4717.1. 747E.13, a 7415.1 CO J 0 S O c c n a 0 c X ma nc O 0 co C m U O n Eoa m c mao d 0 o. 2577-0029 (exp. 8/31/89) O 0. 0. m 0 O l9 0 _N .D d L v c E co a fp T bm 5- Ey 0. V)a c 7 7 co N c O 0 ._ • V!`0 V 010 CL Oa a - c w 0m YO oO ca 0 x N m EC s 4 x Subject Year Eligibility • 40.1-1 Other Eligibility Prior Year Adjustment Total Eligibility 0 cc m0 0 E ua N me U F; 0 O E Q ▪ a m c .0 ci =n E 0 161 dolom 4110 MOM WEIR 111 im III - MI= .mo im 11110•1111 EOM i- m .mo im MEM MEM IWO Evil. PHA/IHA Req. HUD Modif. PHA/IHA Req. • WIVE HUD Modif. PHA/IHA Re HUD Modif. N 0 N ca f • 1- PHA/IHA Req. form HUD -52721 (4/88 co 'et in co 0 0 O 0 CO • CO COO 0) On) O O O O O O O O r u 0 0 0 O ww 0 6 man 0 z 0 0 • Program (PGM) Code: Manual Entry (Go to Part VI) System Calculation with Equal Monthly Payments System Calculation with Unequal Monthly Payments DED OD g Type of Payment Entry (Check one): 0 0 ulatlon of P re U E 0 Tl Y m Payments Within Month Zp >❑ PHAIIHA Req. e o 0 0 ❑ 1 a1 0 0 ❑ C Q • o 6 O = 0 = 0 _ • _ 2 a 2 a a 0. 0. C O To Q2 Wo 4m.. y C 00 O m U m t m ao HUD Modif. Pay Dates Within Month: Payment Percentages Within Month: Monthly Payment Allocation Percentage Payment for Each Month: L. N a 1n to CO .0 CO CO form HUD -52721 (4/88) 1 10 o .; w r O 0 a mINIEMEI Y 0 M U r a N ro o o. 'm N '0 Q c D o a) N N o CO ¢ < m E o 0) c2 co y 01 ❑ ❑ ❑ Percent Distribution of Remaining Balance (Use Parts 11 and III) a c u N 0 E a. 0 D m Q E 0 Y Add/Change (Use lines 19-20c) N N N 0 0 N 0 0 0 ❑ ❑ Type of Payment Revision (Check one): Add/Change Revisions: from (choose one): Payment # 1 11 I to Payment # I 1 1 1 0 N N 0- a Source of Funds: Unscheduled Funds to (choose one): Payment # L_L_LJ Payment #'s I I I I thru 1 1 1 1 (Equal Spread) Delete Revisions: Payment # L1L 1 PGM Codes 11 1 1 I Delete (choose i 0 0 0 0 00 0) 0) 00)) O CO 0 O N r r r r CO N CO N N N form HUD -52721 (4/88) 9 m sm m C =a= fr PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. aaaa a a a a a a aThT.a alga PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. HUD Modif. PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. PHAIIHA Req. HUD Modif. p1 amdl mmini Total/Subtotal PHAIIHA Req. TotallSubtotal 1 Project Nothedene._ f Fiscal Year End (FYE) Part VIII — Certification of Public Housing Agencyllndian Housing Authority I certify that all applicable provisions of the Annual Contr buttons Contract covering the above numbered pro ect(s) have been compiled with by this PHAIIHA and that this Form HUD -52721 and all supporting forms and documentation have been examined by me and to the best of my knowledge and belief are true, correct and complete and in accordance with all applicable HUD regulations and requirements including those relating to cash management. Name of PH�w,r9i/ty n %9aP-574✓d Signature and Title o Ictal Authorized to Certify d Ate CA 04. P70e PHARM Comments BaCto,P) 9 Date HUD Use Only Field Office Approval Field Office Name Signature and Title of Field Of lice Official Date Field Office Comments Regional Accounting Division Comments Entered Into LOCOS By Date Time . form HUD -52721 (4/88) • CO c Cri 0 x c y c O C xEc o om • 0 m'n E oo3 L C na 0 0 0 90 E (12 s28 ECD y a N c_ Na,O 0 c V - V aOa 9 (exp. 8/31/89 O 4 0 Z 2 Q 0 m 0 O To 0) O Revision No. or a 0 0 2 0 to 0. N 0 0 U ' 0" o f 0 • Subject Year Eligibility amidi w O Prior Year Adjustment C To n cnE 0 Q momdi orm HUD•52721 (4/88 0 O D x PHA/IHA Req. HUD Modif. N 0 PHA/IHA Req. 0 0 x N ]• O O CI a • m 0 0 0 0 0 0 0 0 0 0 0 .0 a Previous Edition Obsolete • N 0 0 • • 0 c a cc v 0 N of E a 0 c 0 L Manual Revision (Use Part VI) c N C a 1) N m o (71 m a 0 a) c N N E c a) o cc N o aa)) c R o a N 0 a N N y a 0 o v 'LI N m 0. ❑ ❑ ❑ b 0 0 0 N 0 E a a H a E 0 N 0) 0 c N N N N N 0 c 0 0 CO c L J a7.1 °) ❑ ❑ Type of Payment Revision (Check one): AddlChenge Revisions: PGM Code LJ N c 0 E a c M w a li 0 0 0 1- 0 N from (choose one): Payment # 1 1 to Payment p I 1 I I 0 c N 0 is 0 a 0 h c 0 m a 0 a) a) U 00 L 5 v a Source of Funds: Unscheduled Funds • Transfer LI Delete Revisions: Delete (choose on i a 0 a c J 1CD CD CD OD m a CO a 0 0 N 0 0 N N form HUD -52721 (4/88) • 9 driml d a as a a aRaaaaaaaaa aaaa.1 PHA/IHA Req. 0 0 0 PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. PHA/IHA Req. HUD Modif. 3M tittiot Total/Subtotal PHA/IHA Req. TotallSubtotal HUD Modlf. 0 e e 3 c Project No. ALL_. .sect/e3r.. Fiscal Year End (FYE) 191i3145f1 Part VIII — Certification of Public Housing Agencylindian Housing Authority I certify that all applicable provisions of the Annual Contr butions Contract covering the above numbered pro ect(s) have been complied with by this PHAIIHA and that this Form HUD -52721 and all supporting forms and documentation have been examined by me and to the best of my knowledge and belief are true, correct and complete and in accordance with all applicable HUD regulations and requirements including those relating to cash management. Name of rYt /!i 011,6 A1/4/514/i /! 2*o/r ry Signature and Title ofA/Ilciel Authorized to PHARHAommenls fit- lxiev ✓,e-/)jgW-erae Date HUD Use Only Field Office Approval Field Office Name Signature end Title of Field Office Ofliclal Dale Field Ot lice Comments Regional Accounting Division Comments • Entered Into LOCCS By Date Time form HUD -52721 (4/89)