N.Y. Comp. Codes R. & Regs. tit. 2, Appendices, app 6
Form A. C. 896 (1961)
_________
Annual or Supplemental STATEMENT*
OF
HOUSING AND URBAN RENEWAL INDEBTEDNESS
_______________
(Name of Municipality)
________ COUNTY, NEW YORK
PREPARED AS OF
________, 19________
*SEE INSTRUCTIONS, PAGE 2
(continued)
Form A. C. 896-1 (1961)
INSTRUCTIONS
If a city, town or village has any unpaid indebtedness which was contracted to effectuate any of the purposes of Article 18 of the New York State Constitution, as implemented by the Public Housing Law, the General Municipal Law or any other general or special law, within 60 days after the close of its fiscal year an annual verified statement of its housing and urban renewal debt-contracting power must be filed with the State Comptroller and the State Commissioner of Housing. In addition thereto, not more than 15 nor less than 3 days before any such municipality contracts any indebtedness for housing or urban renewal purposes, it shall file with the same officials a verified supplemental statement of its housing and urban renewal debt-contracting power, The annual statement shall contain the items of indebtedness enumerated in Section 135.00 of the Local Finance Law, which are contracted by the municipality for the purposes set forth in paragraph a of Section 150.00 of such law, and should be prepared as of the close of such fiscal year. The supplemental debt statement should indicate any additions to, omissions of or changes in the items or statements contained in its previous annual debt statement. (Local Finance Law, Section 151.00).
A duplicate copy of every annual or supplemental housing and urban renewal debt statement must be filed within the same respective period of time with the clerk or other corresponding officer of such municipality. However, in the case of a city containing more than one county, a copy of such statement shall, in addition thereto, be filed in the office of the chief fiscal officer thereof. (Local Finance Law, Section 151.00).
The term "housing authority", as used in the Local Finance Law, means "authorities" as that term is defined in Section 3 of the Public Housing Law, as amended from time to time. (See Local Finance Law, Section 2.00(13)).
In the appropriate spaces indicate whether the statement is annual or supplemental. The supplemental debt statement must also contain a statement as to the amount of the proposed housing or urban renewal debt to be contracted.
Form A. C. 896-2 (1961)
(Supplemental, Annual) STATEMENT OF HOUSING AND URBAN
RENEWAL INDEBTEDNESS
The following is a statement of the power of the ________ of ________, in the County of ________, New York, to contract indebtedness for housing and urban renewal purposes prepared as of ________, 19________, pursuant to Title 11 of Article 2 of the Local Finance Law:
AVERAGE ASSESSED VALUATION
Average Assessed Valuations (One-Fifth of Total of Column 4)............ $ ____________
NOTE: The Local Finance Law, Section 2.00(7), defines "Completed Assessment Roll" as one which has been "completed, verified and filed by the assessors". The amounts to be used in the columns above would be the amounts shown on such rolls as filed after the hearing of grievances, regardless of subsequent changes. Assessed valuation of "Pension Exempt Property" should be entered only by cities with a population of 125,000 or more.
HOUSING AND URBAN RENEWAL DEBT LIMIT
Multiply "Average Assessed Valuation" (Above) by.02 $ ________
NET MARGIN OF DEBT-CONTRACTING POWER
FOR HOUSING AND URBAN RENEWAL PURPOSES
Housing and Urban Debt Limit (Above) ............ $________
Less: Net Housing and Urban Renewal Indebtedness
(Page 4) ............ $________
Margin ............ $________
PERCENTAGE OF DEBT-CONTRACTING POWER OF MUNICIPALITY
EXHAUSTED FOR HOUSING AND URBAN RENEWAL
Divide "Net Housing Indebtedness" (Page 4) by "Housing
Debt Limit" (Above) and Enter Result Here ............ ________
PROPOSED HOUSING AND URBAN RENEWAL DEBT *
The Amount of the Proposed Housing and Urban Renewal
Debt to be Contracted in Connection with which this
Statement is Filed ............ $________
* Required only for Supplemental Statements.
Form A.C. 896-3 (1961)
HOUSING AND URBAN RENEWAL DEBT STATEMENT
INCLUSIONS
See Local Finance Law, Sections 135.00 (a, 1) and
151.00(b). $________
newal purposes.
See Local Finance Law, Sections 135.00 (a, 2) and
151.00(b).
purposes (other than at '4' and '5' below). Separate
according to Local Finance Law, Section 135.00 (a, 3). (b) ________
See Local Finance Law, Sections 135.00 (a, 3) and
151.00(b).
Separate according to Local Finance Law, Section
135.00(a, 4). (b)________
See Local Finance Law, Sections 135.00 (a, 4),
143.00 and 151.00(b).
nicipalities.
See Local Finance Law, Sections 135.00 (a, 5) and
151.00
ing out of or connected with housing and urban re- (a) ________
newal purposes. Separate according to Local Finance
Law, Section 135.00 (a, 6). (b)________
See Local Finance Law, Sections 135.00 (a, 6) and
151.00(b).
newal purposes.
See Local Finance Law, Sections 122.00, 135.00 (a, 8)
and 151.00(b).
EXCLUSIONS
newal debt.
See Local Finance Law, Sections 136.00(10) and
151.00(b, 3).
See Local Finance Law, Sections 136.00(11) and
151.00(b, 3).
See Local Finance Law, Sections 136.00(12) and
151.00(b, 3).
LESS THAN 5,000:
Indebtedness for housing and urban renewal pur-
poses arising from a guarantee, a loan by the State
to a housing authority acting as an instrumentality
of such town or village or a contract for a periodic
subsidy. (Compute according to subdivision 9 of Sec-
tion 136.00 of the Local Finance Law). ________
See Local Finance Law, Sections 151.00 (b, 1),
143.00.
OF 5,000 OR MORE:
The unpaid balances of any loan or loans by the
State to any housing authority acting as an instru-
mentality of the city or village. No exclusion is
permitted, if such housing authority is in default in
payment of such loan or loans. ________
See Local Finance Law, Section 151.00 [b, 2(a)].
5,000 OR MORE:
Indebtedness for self-liquidating housing projects ________
See Local Finance Law, Sections 151.00 [b, 2(b)],
152.00.
5,000 OR MORE:
Indebtedness for housing and urban renewal pur-
poses permitted to be deducted pursuant to Item (c)
of Subdivision 2 of Paragraph b, Section 151.00 of
the Local Finance Law. ________
See Local Finance Law, Section 151.00 [b, 2(c)].
5,000 OR MORE:
Indebtedness for urban renewal purposes permitted to
be deducted pursuant to Item (d) of Subdivision 2 of
Paragraph b, Section 151.00 of the Local Finance
Law. ________
See Local Finance Law, Section 151.00 [b, 2(d)].
Gross Housing and Urban Renewal Indebtedness ............ $ ________
Less: Exclusions ............ ________
Net Housing and Urban Renewal Indebtedness ............ $ ________
________
Form A.C. 896-4 (1961)
SCHEDULE A
This schedule should show the bonds, notes or other obligations which have been authorized to be issued for housing and urban renewal purposes to the extent to which obligations have not been issued.
The following symbols may be used above: Serial Bond--SB; Bond Anticipation Note or similar obligation--BAN; Capital Note--CN; Revenue Anticipation Notes-- RAN.
VERIFICATION BY CHIEF FISCAL OFFICER
STATE OF NEW YORK
SS:
COUNTY OF ________
________, being duly sworn, deposes and says:
That he is the duly (elected) (appointed), qualified, and acting chief fiscal officer of the ________ of ________ in the County of ________, New York; that he prepared and has read the foregoing (annual) (supplemental) debt statement of housing and urban renewal indebtedness and knows the contents thereof; that the same is true to (his) (her) own knowledge except as to the matters therein stated to be alleged upon information and belief; and that as to those matters he believes it to be true.
Sworn to before me this ________day of
____________
(Signature)
________, 19________
____________
(Title)
____________
(Mail Address)
____________
Notary Public
________
(The statement of housing and urban renewal indebtedness must be verified by the chief fiscal officer. In towns such officer will be the supervisor or presiding supervisor; in villages and counties, the treasurer, except in the County of Suffolk, the county auditor. For cities, see definition in Local Finance Law, Section 2.00(5). If a municipality has no chief fiscal officer, this statement must be verified by the finance board.)
N.Y. Comp. Codes R. & Regs. tit. 2, Appendices, app 6