HCD 781 12/89
CALIFORNIA HOUSING REHABILITATION PROGRAM
RENTAL COMPONENT
ANNUAL REPORT
Sponsor: __________________________________________________
Project Name: ________________________________________
Project Address: _____________________________________________
Contract Number: ________________________________________
I hereby submit the following items for the fiscal year beginning __________ and ending __________.
[ ] CHRP Interest Payment in the amount of $ _______.
[ ] Principal Prepayment in the amount of $ _______.
[ ] Residual Receipts Payment in the amount of $ _______
[ ] Financial Statement.
[ ] Income & Expense Statements (plus attachments).
[ ] Report on Account Balances.
[ ] Management Report) plus attachments.
[ ] Copy of current Hazard Insurance Policy.
CERTIFICATION: I hereby certify that I am responsible for the above submittals and, furthermore, to the best of my knowledge, the information included is true and complete.
By: ___________________________
Signature
______________________________
Name and Title
___________________________ | ___________________________ | |
Date | Phone Number |
At: ___________________________
City
Contract No.: __________
Fiscal Year: __________
Residential Income | Non-Residential Income | Total Income | ||
a. Rental Income | $ __________ | $ __________ | $ __________ | |
b. Rent Subsidies | $ __________ | $ __________ | $ __________ | |
c. Laundry Income | $ __________ | $ __________ | $ __________ | |
d. Interest Income | $ __________ | $ __________ | $ __________ | |
e. Security Deposits Withheld | $ __________ | $ __________ | $ __________ | |
f. Other: __________ | $ __________ | $ __________ | $ __________ | |
g. Total Income: | $ __________ | $ __________ | $ __________ |
Residential + | Non- Residential = | Total | ||
1. MANAGEMENT | ||||
a. Sponsor's Overhead | $ __________ | $ __________ | __________ | |
b. Contracted Management fee | $ __________ | $ __________ | __________ | |
c. Total Management | $ __________ | $ __________ | $ ________ | |
2. ADMINISTRATION | ||||
a. Marketing Expense | $ __________ | $ __________ | __________ | |
b. Audit | $ __________ | $ __________ | __________ | |
c. Legal | $ __________ | $ __________ | __________ | |
d. Miscellaneous | $ __________ | $ __________ | __________ | |
e. TOTAL | $ __________ | $ __________ | $ ________ | |
3. SPONSORS SALARIES AND BENEFITS | ||||
(include value of rent discounts) | ||||
a. On-/Off Site Manager | $ __________ | $ __________ | __________ | |
b. Assistant Manager | $ __________ | $ __________ | __________ | |
c. Assistant Manager | $ __________ | $ __________ | __________ | |
d. Grounds & Maintenance Personnel | $ __________ | $ __________ | __________ | |
e. Janitorial Personnel | $ __________ | $ __________ | __________ | |
f. Housekeepers | $ __________ | $ __________ | __________ | |
g. Service Staff | $ __________ | $ __________ | __________ | |
h. Other (specify) | $ __________ | $ __________ | __________ | |
i. TOTAL SALARIES AND BENEFITS | $ __________ | $ __________ | $ ________ | |
4. MAINTENANCE | ||||
a. Supplies | $ __________ | $ __________ | __________ | |
b. Elevator Maintenance | $ __________ | $ __________ | __________ | |
c. Pest Control | $ __________ | $ __________ | __________ | |
d. Grounds Contract | $ __________ | $ __________ | __________ | |
e. Painting & Decorating (Interior Only) | $ __________ | $ __________ | __________ | |
f. Other: | $ __________ | $ __________ | __________ | |
g. TOTAL MAINTENANCE | $ __________ | $ __________ | $ ________ | |
5. UTILITIES (Not paid for by tenants) | ||||
a. Trash Removal | $ __________ | $ __________ | __________ | |
b. Electricity | $ __________ | $ __________ | __________ | |
c. Water and Sewer | $ __________ | $ __________ | __________ | |
d. Gas | $ __________ | $ __________ | __________ | |
e. TOTAL | $ __________ | $ __________ | $ ________ | |
6. INSURANCE | ||||
a. Property and Liability Insurance | $ __________ | $ __________ | $ ________ | |
7. TAXES | ||||
a. Real Estate Taxes | $ __________ | $ __________ | __________ | |
b. Business Licenses | $ __________ | $ __________ | __________ | |
c. TOTAL TAXES | $ __________ | $ __________ | $ ________ | |
8. OTHER | ||||
a. Food | $ __________ | $ __________ | __________ | |
b. Support Services | $ __________ | $ __________ | __________ | |
c. | $ __________ | $ __________ | __________ | |
d. | $ __________ | $ __________ | __________ | |
e. TOTAL OTHER | $ __________ | $ __________ | $ ________ | |
9. DEPOSITS TO RESERVE ACCOUNT | ||||
a. Replacement Reserve | $ __________ | $ __________ | __________ | |
b. Operating Reserves | $ __________ | $ __________ | __________ | |
c. Other | $ __________ | $ __________ | __________ | |
d. TOTAL | $ __________ | $ __________ | $ ________ | |
10. DEBT SERVICE | ||||
a. CHRP (Attached) | $ __________ | $ __________ | __________ | |
b. | $ __________ | $ __________ | __________ | |
c. | $ __________ | $ __________ | __________ | |
d. TOTAL DEBT SERVICE | $ __________ | $ __________ | $ ________ | |
11. TOTAL OPERATING, RESERVE & DEBT SERVICE EXPENSES | $ __________ | $ ________ | $ __________ | |
C. PROJECT SUMMARY | ||||
1. Total Income (from A.1.g.) | $ __________ | $ ________ | $ __________ | |
2. Less Total Operating, Reserve & Debt Service Expenses (from B.11.) | ($ _________) | ($ ________) | ($ _________) | |
3. Net Cash Available for Distributions or Payments | $ __________ | $ ________ | $ __________ | |
4. Less Distribution | ||||
5. Less Loan Prepayments (Attached) | ||||
6. Less Incentive Payments | ||||
7. Residual Receipts (Attached) |
(copies of Bank Statements should be attached.) Only complete the nonresidential summary if CHRP funds were used for any of the nonresidential rehabilitation. Copies of invoices or explanations supporting all withdrawals from the Replacement Reserve or Operating Reserve Accounts must be attached.
Residential | Beginning Balance | Budgeted Deposits | Actual Deposits * | Withdrawals | Interest Earned ** | Net Increase (Decrease) | Ending Balance | |
1. | Replacement Reserves: | $ ________ | $ ________ | $ ________ | $ ________ | $ ________ | $ ________ | $ ________ |
2. | Operating Reserves: | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
3. | Security Deposits: | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
4. | Operating Account: | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
5. | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
Residential | Beginning Balance | Budgeted Deposits | Actual Deposits * | Withdrawals | Interest Earned ** | Net Increase (Decrease) | Ending Balance | |
1. | Replacement Reserves: | $ ________ | $ ________ | $ ________ | $ ________ | $ ________ | $ ________ | $ ________ |
2. | Operating Reserves: | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
3. | Security Deposits: | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
4. | Operating Account: | __________ | __________ | __________ | __________ | __________ | __________ | __________ |
5. | __________ | __________ | __________ | __________ | __________ | __________ | __________ | |
* "Actual Deposits" should reflect the same amount as shown under Section B. Operating Expenses, item 9. | ||||||||
** "Interest Earned" should reflect the same amount as shown under Section A. Project Income, item 2.d. |
(1) Interest due on CHRP loan for this fiscal year | ___________________________$ |
(2) Less interest payment made on CHRP loan for this fiscal year (check attached) | ___________________________$ |
(3) Equals interest deferred for this fiscal year = | ___________________________$ |
(4) Plus interest deferred from previous fiscal years + | ___________________________$ |
(5) Less interest payment made on CHRP loan for prev. fiscal years (attached) - | ___________________________$ |
(6) Equals total outstanding CHRP interest owed HCD as of = | ___________________________$ |
(b) __________ x (c) __________ = __________ (d)
(d) __________ / (a) __________ = __________% vacancy rate
(A) | (B) | (C) | (D) | (E) | (F) | (G) | For CHRP Assisted Units | |||
Unit Number Unit Dsgntn | Unit Type | Market Rent (or Basic Rent) | Approved CHRP Rent | Subsidy (if any) over CHRP Rent | Tenant's Portion of Rent | No. of Months Occupd | Total Rent Rec'd (BxE) | Total Rent Sbsdy (CxE) | Gross Hsehld Income | No. of Occupants |
Cal. Code Regs. Tit. 25, § 7695
2. New section refiled 10-6-89 as an emergency pursuant to Health and Safety Code section 50668.5(g) and Government Code section 11346.1(h); operative 10-10-89 (Register 89, No. 42). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 2-7-90.
3. New section refiled 2-5-90 as an emergency pursuant to Health and Safety Code section 50668.5(g) and Government Code section 11346.1(h); operative 2-7-90 (Register 90, No. 6). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 6-7-90.
4. Amendment of subsections (a)-(c) filed 3-5-90 as an emergency pursuant to Health and Safety Code section 50668.5(g); operative 3-5-90 (Register 90, No. 12). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 7-3-90.
5. Certificate of Compliance as to 2-5-90 and 3-5-90 orders including amendment of subsections (a) and (b) transmitted to OAL 5-22-90 and filed 5-29-90 (Register 90, No. 29).
Note: Authority cited: Section 50668.5, Health and Safety Code. Reference: Section 50668.5, Health and Safety Code.
2. New section refiled 10-6-89 as an emergency pursuant to Health and Safety Code section 50668.5(g) and Government Code section 11346.1(h); operative 10-10-89 (Register 89, No. 42). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 2-7-90.
3. New section refiled 2-5-90 as an emergency pursuant to Health and Safety Code section 50668.5(g) and Government Code section 11346.1(h); operative 2-7-90 (Register 90, No. 6). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 6-7-90.
4. Amendment of subsections (a)-(c) filed 3-5-90 as an emergency pursuant to Health and Safety Code section 50668.5(g); operative 3-5-90 (Register 90, No. 12). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 7-3-90.
5. Certificate of Compliance as to 2-5-90 and 3-5-90 orders including amendment of subsections (a) and (b) transmitted to OAL 5-22-90 and filed 5-29-90 (Register 90, No. 29).