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HomeMy WebLinkAboutAgenda - 04-19-2005-8aORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: April 19, 2005 Action Agenda Item No. ~j-Q SUBJECT: Five-Year Public Housing Agency (PHA) Plan -Section 8 Housing Program DEPARTMENT: Housing/Comm. Development PUBLIC HEARING: (Y/N) Yes ATTACHMENT(S): Status Report Draft Five-Year PHA Plan Draft Certifications of Compliance/Board Resolution INFORMATION CONTACT: Tara L. Fikes, ext 2490 TELEPHONE NUMBERS: Hillsborough Chapel Hill Durham Mebane 732-8181 968-4501 688-7331 336-227-2031 PURPOSE: To conduct a public hearing and approve submission of the Five-Year Public Housing Agency (PHA) Plan for the Orange County Housing Authority, BACKGROUND: The U.S. Department of Housing and Urban Development Department (HUD) requires all agencies operating the Section 8 Existing Housing Assistance Program to prepare a Five (5) Year Public Housing Agency (PHA) Plan and an Annual Plan. The County's Department of Housing and Community Development administers the Section 8 Program that provides rent subsidies to low income families in the County. The PHA Plan is a 5-year plan that describes the mission of the Agency and the Agency's long- range goals and objectives far achieving its mission over the next five (5) years -Fiscal Years 2005-2010, The last plan was approved by the Board of Commissioners on January 18, 2001. Currently, the Section 8 Housing Program serves approximately 600 families throughout the County including the Towns of Carrboro, Chapel Hill and Hillsborough. The program currently has a waiting list of approximately 900 applicants, A complete status report for the program is attached to this abstract. HUD provides a template for the plan and the County's proposed Five-Year PHA Plan is provided with this abstract. The plan will be made available for public comment for the period April 8, 2005 to May 23, 2005 as advertised in the Chapel Hill Herald. All public comment received will be incorporated into the PHA Plan. There are substantive changes proposed in the new Five Year PHA Plan. This plan must be filed with HUD and must contain the attached draft Certifications of Compliance/Board Resolution signed by the Chair of the Board of Commissioners in order to continue to administer the Section 8 Existing Housing Assistance Program, 2 FINANCIAL IMPACT: There is na immediate impact, RECOMMENDATION(S): The Manager recommends that the Board conduct a public hearing and approve submission of the Annual Public Housing Agency (PHA) Plan for the Orange County Housing Authority and authorize the Chair to sign the Certifications of Compliance/Board Resolution on behalf of the Board following final completion by staff. Orange Count Section Eight Housing Voucher Choice Pragram Status Report Background The Section 8 Hausing Choice Voucher Program is a federally funded rental assistance program administered by public housing authorities (PHAs) or other government agencies, The programs' primary purpose is to provide rental assistance to low-income families with affordable decent, safe, and sanitary housing.. Tenants take the voucher and use it to rent homes in the private market. Families interested in the program apply to a local housing authority or other government agency for a Section 8 tenant-based voucher- a voucher that "stays" with the tenant. Currently, Section 8 helps mare than 1.4 million households in the United States by paying private landlords the difference between what the household can afford and the rent far the unit, In Orange County, the program is administered by the Orange County Hausing and Community Development Department and serves approximately 623 families countywide. The administering housing authority ar government agency is also responsible for inspecting the selected housing unit to make sure it complies with the Housing and Urban Development's (HUD) Hausing Quality Standards and ensuring that the rent charged is reasonable for the local housing market. The fallowing information provides summary information regarding the current status of the Section 8 Program in Orange County, Funding Capacity The U,S, Department of Hausing and Urban Development provides funding for the Section 8 Pragram. The approved Section 8 budget for Fiscal Year 2004-2005 is $4,410,531. Given HUD's funding scheme, this amount should allow us to fund approximately 623 vouchers, however, that number might decrease in coming months to keep actual expenses in line with current revenue. Increasing rental rates and the bedroom composition of our participants our actual costs are being monitored closely to ensure that actual program expenses da not exceed budget authority. Thus the total number of units financed by the program may be reduced in the naming months. Current Program Characteristics ~ Approximately 269 property owners lease property to 623 on average. ~ Of the 623 units, 599 are designated as tenant based vouchers and 24 vouchers are designated as project based vouchers for the Club Nova Apartments only., ~ The majority of the rental units are in the Carrbaro/Chapel Hill area (Southern Orange County), ~ Racial family composition: approx60% African-American; 37% Caucasian; 3% Other.. ~ Most non-elderly heads of households are working families. ~ Most families lease two-bedroom units, 4 ~ Current waiting list totals 964 families and applications are presently be accepted in the office on Tuesdays and Thursdays only. (Approximately 700 of these families have applied since the waiting list was reopened in August 2004.) Waiting List Selection Selections are made from the waiting list according to date and time of application and preference ranking. The program presently has maintained the following Waiting List Preferences for the applicants that are: a Involuntary displaced; b. Living in substandard housing to include homeless families; c. Paying more than 50% of their income for rent and utilities; and d. Elderly and/or Disabled. Additionally, the program has the following Local Preferences for: a. Families who live, work, or have been hired to work in the jurisdiction. b. Families who are graduates or participants in an education and training program to prepare for self-sufficiency.. c. Graduates of transitional housing programs for homeless persons; substance abusers; and victims of domestic abuse. Upcoming Issues Administrative Plan amendments will be proposed during Fiscal Year 2005 - 2006 to recommend the following.. 1. Provision to allow group home residents to decline the offer of a Section 8 voucher apre-determined number of times without losing their waiting list position,. 2, Section 8 Homeownership Program Guidelines PHA Plans Streamlined 5-Year/Annual Version U.S. Department of Housing and Urban Development Office of Public and Indian Housing OMB No. 2577-0226 (exp 05/31/2006) This information cotleetion is authorized by Section 51 I of the Quality Flousing and Work Responsibility Act, which added a new section SA to the U.S Housing Act of 1937 that introduced 5-year and annual PHA Plans The full PHA plan provides a ready source for interested parties to locate basic PFIA policies, rules, and requirements concerning the Pt1A's operations, programs, and services, and informs HUD, families served by the PHA, and members of the public of the PFIA's mission and strategics for serving the needs o(tow-income and very low-income families This form allows eligible PHAs to make a streamlined annual Plan submission to FIUU consistent with HUD's efforts to provide regulatory relief to certain PI1A5 Public reporting burden for this information collection is estimated to average I 1 7 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and mainmining the data needed, and completing and reviewing the cotleetion of information HUD may not collec(this information and respondents are no( reyuired to complete this (ortn, unless it displays a currently valid OMB Control Number Privacy Act Notice. The United States Department of Housing and Urban Development, Pcdemi Housing Administration, is authorized to solicit the information requested in this form by virtue of Title 12, U 5. Code, Section 1701 et seq ,and regulations promulgated thereunder at Title 12, Code of Federal Regulations In(orrnation in PHA plans is publicly available Streamlined 5-Year Plan for Fiscal Years 2005 - 2010 NOTE: This PHA Plan template (HUD-50095-SA) is to be completed in accordance with instructions contained in previous Notices PIH 99-3.3 (HA), 99-51 (HA), 2000-22 (HA), 2000-36 (HA), 2000-4.3 (HA), 2001- 4 (HA), 2001-26 (HA), 200.3-7 (HA), and any related notices HUD may subsequently issue. Full reporting for each component listed in the streamlined Annual Plan submitted with the 5-year plan is required. 5 form HUD-50075-SF (04/30/2003) (D PHA Name: Orange County 5-Year Plan for fiscal Years: 2005 - 2010 Annuat Plan for PY 2005 HA Code: NC104 Streamlined Five-Year PHA Plan Agency Identification PHA Name: Orange County PHA Number: NC104 PHA Fiscal Year Beginning: (mm/yyyy) 07/2005 PHA Programs Administered: ^Public Housing and Section 8 ®Section 8 Only ^Public Housing Only Number of public housing units: Number ofSB units: 623 Number of public housing units: Number of S8 units: ^PHA Consortia: (check box if submitting a joint PHA Plan and complete table) Participating PHAs PHA Code Program(s) Included in the Consortium Programs Not in the Consortium # of Units Each Program Participating PHA 1: Participating PHA 2: Participating P}IA 3: Public Access to Information Information regarding any activities outlined in this plan can be obtained by contacting: (select all that apply) ® Main administrative office of the PHA ^ PHA development management offices ^ PHA local offices Display Locations For PHA Plans and Supporting Documents The PHA Plans and attachments (if any) az'e available for' public inspection at: (select all that apply) ® Main administrative off ce of the PHA ^ PHA development management offices ^ PHA local offices ^ Main administrative office of the local government ^ Main administrative office of the County government ^ Main administrative office of the State government ^ Public library ^ PHA website ^ Other (list below) PHA Plan Supporting Documents are available for inspection at: (select all that apply) ® Main business office of the PHA ^ PHA development management offices ^ Other (list below) Page 2 of 38 form HUD•50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan (or Fiscal Years: 2005 - 2010 Annual Plan for f•Y 2005 HA Code: NC104 Streamlined Five-Year PHA Plan PHA FISCAL YEARS 2005 - 2010 [2A CFR Part 903.12] A. Mission State the PHA's mission for serving the needs oflow-income, very low income, and extremely low-income families in [he PHA's,jurisdiction. (select one of the choices below) ® The mission of the PHA is the same as that of the Depaztment of Housing and Urban Development: To promote adequate and affordable housing, economic opportunity and a suitable living environment free from discrimination.. ^ The PHA's mission is: (state mission here) B. Goals The goals and objectives listed below are derived from HUD's strategic Goals and Objectives and those emphasized in recent legislation. PHAS may select any of these goals and objectives as their own, or identify other goals and/or objectives. Whether selecting the HUD-suggested objectives or their own, PHAS ARE STRONGLY ENCOURAGED TO IDENTIFY QUANTIFIABLE MEASURES OF SUCCESS IN REACHING THEIR OBJECTIVES OVER THE COURSE OF THE 5 YEARS. (Quantifiable measures would include targets such as: numbers of families served or PHAS scores achieved.) PHAS should identify these measures in the spaces to the right of or below the stated objectives. HUD Strategic Goal: Increase the availability of decent, safe, and affordable housing. ® PHA Goal: Expand the supply of assisted housing Objectives: ® Apply for additional rental vouchers: ^ Reduce public housing vacancies: ^ Leverage private or other public funds to create additional housing opportunities: ^ Acquire or build units or developments ® Other (list below) Encourage local landlord participation in the Section 8 Program ® PHA Goal: Improve the quality of assisted housing Objectives: ^ Improve public housing management: (PHAS score) ® Improve voucher management: (SEMAP score) 85 ® Increase customer satisfaction: ^ Concentrate on efforts to improve specific management functions: (list; e.g., public housing finance; voucher unit inspections) ^ Renovate or modernize public housing units: ^ Demolish or dispose of obsolete public housing: ^ Provide replacement public housing: ^ Provide replacement vouchers: ® Other: (list below) Continuously review and modify Housing Oualit}~ Standm'ds to ensure an inventory of quality rental housing in the program Page 3 of 38 form HUD-50075SF (D4/30/2003) PHA Name: Orange County 5-Year Plan for Fiscal Years: 2005 - 2010 Annual Plan for r•Y 2005 FIA Codc: NC104 ® PHA Goal: Increase assisted housing choices Objectives: ^ Provide voucher mobility counseling: ® Conduct outreach efforts to potential voucher landlords ^ Increase voucher payment standards ® Implement voucher homeownership program: ^ Implement public housing or other homeownership programs: ^ Implement public housing site-based waiting lists: ^ Convert public housing to vouchers: ^ Other: (list below) HUD Strategic Goal: Improve community quality of life and economic vitality ^ PHA Goal: Provide an improved living environment Objectives: ^ Implement measures to deconcentrate poverty by bringing higher income public housing households into lower income developments: ^ Implement measures to promote income mixing in public housing by assuring access for lower income families into higher income developments: ^ Implement public housing security improvements: ^ Designate developments or buildings for pazticulaz resident groups (elderly, persons with disabilities) ^ Other: (list below) HUD Strategic Goal: Promote self-sufficiency and asset development of families and individuals ^ PHA Goal: Promote self-sufficiency and asset development of assisted households Objectives: ^ Increase the number and percentage of employed persons in assisted families: ^ Provide or attract supportive services to improve assistance recipients' employability: ^ Provide or attract supportive services to increase independence for the elderly or families with disabilities, ^ Other: (list below) HUD Strategic Goal: Ensure Equal Opportunity in Housing for all Americans ® PHA Goal: Ensure equal opportunity and affirmatively further fair housing Objectives: ® Undertake affirnative measures to ensure access to assisted housing regardless of race, color, religion national origin, sex, familial status, and disability: ^ Undertake affirmative measures to provide a suitable living environment for Page 4 of 38 form HUD-50075•SF (04/30/2003) q PHA Name: Omnge County 5-Year Plan 1'or Fiscal Years: 2005 - 2010 Annual Plan (or FY 2005 FIA Code: NC104 families living in assisted housing, regardless of race, color, religion national origin, sex, familial status, and disability: ® Undertake affirmative measures to ensure accessible housing to persons with all vazieties of disabilities regardless of unit size required: ^ Other: (list below) Other PFIA Goals and Objectives: (list below) To create positive awareness attd expmrd the level of fmnily, owner°, mul contmuni(y support in accomplishing the HA's mission. 2, To administer alt efficient, high pet forming agency tln•ough continuous improvement of the HA's support systems and conuttitment to our employees and their development. Page 5 of 38 form HUD-50075•SF (04/30/2003) )o PI1A Name: Orange County 5-Year Plan for risca) Years: 2005 - 2010 Annoal Plan for FY 2005 HA Code: NC104 Streamlined Annual PHA Plan PHA Fiscal Year 2005 [24 CFR Patt 90.3.12(b)] Table of Contents Provide the following table of contents for the streamlined Annual Plan submitted with the Five-Year Plan, including all streamlined plan components, and additional requirements, together with the list of supporting documents available for public inspection. A. ANNUAL STREAMLINED PHA PLAN COMPONENTS ® 1. Housing Needs ® 2. Financial Resources ® 3. Policies on Eligibility, Selection and Admissions ® 4. Rent Determination Policies ^ 5. Capital Improvements Needs ^ 6. Demolition and Disposition ^ 7. Homeownership ® 8. Civil Rights Certifications (included with PHA Certifications of Compliance) ® 9. Additional information a. PHA Progress on Meeting 5-Year Mission and Goals b. Criteria for Substantial Deviations and Significant Amendments c. Other Information Requested by IlUD i. Resident Advisory Board Membership and Consultation Process ii. Resident Membership on the PHA Governing Board iii. PHA Statement of Consistency with Consolidated Plan iv. (Reserved) ® 10. Project-Based Voucher Program ® 11. Supporting Documents Available for Review ^ 12. FY 20 Capital Fund Program and Capital Fund Program Replacement Housing Factor, Annual Statement/Performance and Evaluation Report ^ 13. Capital Fund Progratn 5-Year Action Plan ^ 14. Other (List below, providing name for each item) B. SEPARATE HARD COPY SUBMISSIONS TO LOCAL HUD FIELD OFFICE Form HUD-50077, PHA Certi tcations of Compliance with the PHA Plmts and Related Reeulatiotis: Bom•d Resolution to Accomaanv the Standard Annual. Stat:dmzl Five-Yeat". and Slreatnlitted Fn~e-Year/Annual Platts; Certification by State or' Local Official o1'PHA Plm: Consistency with Cotsolidated Plan. For PHAs APPLYING FOR CAPITAL Fi.JNZ) PROGRAM (CFP) GRANTS Form HUD-50070, Certification,for a Drug-Ft~ee Workplace; Form HUD-50071, Certi tcation ofPa,yntents to Lt)2uence Federal Ti mtsactiotts; Form SF-LLL & SF-LLLa, Disclosure o Lobbying Activities. Page 6 of 30 form HUD-50075-SP (04/30/2003) PF1A Name: Orange County 5-Year Plan for fiscal Years: 2005 - 2010 Annual Plan for FY 2005 ' l FIA Codc: NC104 Executive Summary (optional) [903.7(x)] If desired, provide a brief overview of the contents of the streamlined 5-Year/Annual Plan. 1. Statement of"Housing Needs [24 CFR Part 903,12 (b), 903,7(a)] A. Housing Needs of Families on the Public Housing and Section 8 Tenant- Based Assistance Waiting Lists State the housing needs of the families on the PHA's waiting IisUs. Complete one table for each type of PHA-wide waiting list administered by the PHA. PHAs may provide separate tables for site-based or subyurisdictional public housing waiting lists at their option. Housin Needs of Families on the PHA's Waitin Lists Waiting list type: (select one) ® Section 8 tenant-based assistance ^ Public Housing ^ Combined Section 8 and Public Housing ^ Public IIousing Site-Based or sub-jurisdictional waiting list (optional) If used, identi which develo menUsub'urisdiction: # of families % of total families Annual Turnover Waiting list total 909 Extremely low income <=30% AMI 364 40% Very low income (>30% but <=50% AMI) 545 60% Low income (>50% but <80% AMI) 0 0 Families with children 682 Elderly families Families with Disabilities Race/ethnicity Race/ethnicity Race/ethnicity Raee/ethnieity Characteristics by Bedroom Size (Public IIousin pnl ) 1BR 2 BR 3 BR 4 BR SBR 51- BR Is dre waiting list closed (select one)'? ®No ^ Yes If yes: IIow long has it been closed (# of months)? Does the PIIA expect to reopen the list in the PHA Plan year? ^ No ^ Yes Does Che PHA permit specific categories of families onto the waiting list, even if' generally closed? ^ No ^ Yes Page 7 of 38 form HUD-50075SF (04/30/2003) PtiA Name: Orange County 5-Year Ptan for Fiscal Years: 2005 - 2010 Annuat I'lart far FY 2005 ' HA Code: NC104 B. Strategy for Addressing Needs Provide a brief description of the PHA's strategy for addressing the housing needs of families on the PHA's public housing and Section 8 waiting lists IN THE UPCOMING YEAR, and the Agency's reasons for choosing this strategy. (I) Strategies Need: Shortage of affordable housing for all eligible populations Strategy 1. Maximize the number of affordable units available to the PHA within its current resources by: Select all that apply ^ Employ effective maintenance and management policies to minimize the number of public housing units off-line ^ Reduce turnover time for vacated public housing units ^ Reduce time to renovate public housing units ^ Seek replacement of public housing units lost to the inventory through mixed finance development ^ Seek replacement of public housing units lost to the inventory through section 8 replacement housing resources ® Maintain or increase section Slease-up rates by establishing payment standards that will enable families to rent throughout the jurisdiction ^ Undertake measures to ensure access to affordable housing among families assisted by the PHA, regardless of unit size required ® Maintain or increase section 8 lease-up rates by marketing the program to owners, particularly those outside of areas of minority and poverty concentration ® Maintain or increase section 8 lease-up rates by effectively screening Section 8 applicants to increase owner acceptance of program ® Participate in the Consolidated Plan development process to ensure coordination with broader community strategies ^ Other (list below) Strategy 2: Increase the number of affordable housing units by: Select all that apply ® Apply for additional section 8 units should they become available ^ Leverage affordable housing resources in the community through the creation of mixed - finance housing ® Pursue housing resources other than public housing or Section 8 tenant-based assistance. ^ Other: (list below) Need: Specific Family Types: Families at or below :30% of median Strategy 1: Target available assistance to families at or below 30 % of AMI Select all that apply Page 8 of 38 form HUD-50075-SF (04/30/2003) 13 PHA Name: Orange County 5-Year Plan for fiscal Ycars: 2005 - 2010 Annual ['tan for FY 2005 HA Code: NCI04 ^ Exceed I-ii_7D federal targeting requirements for families at or below .30% of AMI in public housing ^ Exceed HUD federal targeting requirements for families at or below .30% of AMI in tenant-based section 8 assistance ^ Employ admissions preferences aimed at families with economic hardships ^ Adopt rent policies to support and encourage work ^ Other: (list below) Need: Specific Family Types: Families at or below 50% of median Strategy is Target available assistance to families at or below 50% of AMI Select all that apply ^ Employ admissions preferences aimed at families who are working ® Adopt rent policies to support and encourage work ^ Other: (list below) Need: Specific Family Types: The Elderly Strategy l: Target available assistance to the elderly: Select all that apply ^ Seek designation ofpublic housing for the elderly ® Apply for special-purpose vouchers targeted to the elderly, should they become available ^ Other: (list below) Need: Specific Family Types: Families with Disabilities Strategy 1: Target available assistance to Families with Disabilities: Select all that apply ^ Seek designation ofpublic housing for families with disabilities ^ Carry out the modifications needed in public housing based on the section 504 Needs Assessment for Public Housing ® Apply for special-purpose vouchers targeted to families with disabilities, should they become available ^ Affirmatively market to local non-profit agencies that assist families with disabilities ^ Other: (list below) Need: Specific Family Types: Races or etlrnicities with disproportionate housing needs Strategy is Increase awareness of PIIA resources among families of races and ethnicities with disproportionate needs: Select if applicable Page 9 of 38 form HUD-50075-SF (04/30/2003) PIiA Name: Orange County 5-Year plan for Fiscal Years: 2005 - 2010 Annual Plan for r•Y 2005 I~ HA Code: NC104 ® Affirmatively market to races/etlmicities shown to have disproportionate housing needs ^ Other: (list below) Strategy 2: Conduct activities to affirmatively further fair housing Select all that apply ® Counsel section 8 tenants as to location of units outside of areas ofpoverty or minority concentration and assist them to locate those units ® Market the section 8 program to owners outside of aeeas ofpoverty /minority concentrations ^ Other: (list below) Other Housing Needs & Strategies: (list needs and strategies below) j2) Reasons for Selecting Strategies Of the factors listed below, select all that influenced the PHA's selection of the strategies it will pursue: ® Funding constraints ® Staffing constraints ^ Limited availability of sites for assisted housing ^ Extent to which particular housing needs are met by other organizations in the community ® Evidence of housing needs as demonstrated in the Consolidated Plan and other information available to the PHA ® Influence of the housing market on PHA programs ® Community priorities regarding housing assistance ® Results of consultation with local or state government ^ Results of consultation with residents and the Resident Advisory Board ® Results of consultation with advocacy groups ® Other: (list below) Affor°dable Flouring Advisory Bom~d Di-scussions Consolidated Housing Plan Community Meeti/:gs/Comments 1001 Affordable Housing Tas/c Fw-ce Reconunendations Page t0 of 38 form HUD-50075-SF (04/30!2003) PI{A Name: Orange Cuunry 5-Year Pian (ar fiscal Years: 2005 - 2010 Annual Pian for FY 2005 15 I1A Codc: NCt04 2. Statement of Financial Resources [24 CFR Part 903.12 (b), 903.7 (c)] List on the following table the financial resources that are anticipated to be available to the PIIA for the support of Federal public housing and tenant-based Section 8 assistance programs administered by the PHA during the Plan year. Note: the table assumes that Federal public housing or tenant based Section 8 assistance grant funds are expended on eligible purposes; therefore, uses of these funds need not be stated.. For other funds, indicate the use for those funds as one of the following categories: public housing operations, public housing capital improvements, public housing safety/security, public housing supportive services, Section 8 tenant-based assistance, Section 8 supportive services or other. Financial Resources: Planned Sources and Uses Sources Planned $ Planned Uses 1. Federal Grants (FY 2005 rants) a) Public Housin O eratin Fund b) Public Housin Ca ital Fund c) HOPE VI Revitalization d) HOPE VI Demolition e) Annual Contributions for Section 8 Tenant- Based Assistance $4,103,367 f) Resident Opportunity and Self-Sufficiency Grants Communi Develo ment Block Grant 11 HOME $236,431 Other Federal Grants (list below) 2. Prior Year Federal Grants (unobligated Iunds onl list below 3. Public Housin Dwellin Rental Income 4. Other income (list below) 4. Non-federal sources (list below) Total resources $4,576,229 3. PHA Policies GoverninE Eligibility, Selection, and Admissions [24 CFR Part 903.12 (b), 903.7 (b)] A. Public Housing Exemptions: PHAs that do not administer public housing are not required to complete subcomponent 3A. Page 11 of 38 form HUD-50075SF (04/30/2003) PNA Name: Orange County 5-Year Ptan for fiscal Years: 2005 - 2010 Annual Plan (or FY 2005 ( " HA Code: NC104 _(1) LligibilitY a. When does the PHA verify eligibility for admission to public housing? (select all that apply) ^ When fannies are within a certain number of being offered a unit: (state number) ^ When families are within a certain time of being offered a unit: (state time) ^ Other: (describe) b. Which non-income (screening) factors does the PHA use to establish eligibility for admission to public housing (select all that apply)? ^ Criminal or Drug-related activity ^ Rental history ^ Housekeeping ^ Other (describe) c. ^ Yes ^ No: Does the PHA request criminal records from local law enforcement agencies for screening purposes? d. ^ Yes ^ No: Does the PHA request criminal records from State law enforcement agencies for screening purposes? e. ^ Yes ^ No: Does the PHA access FBI criminal records from the FBI for screening purposes? (either directly or through an NCIC-authorized source) (2)Waitiag List Organization a. Which methods does the PHA plan to use to organize its public housing waiting list (select all that apply) ^ Community-wide list ^ Sub-jurisdictional lists ^ Site-based waiting lists ^ Other (describe) b. Where may interested persons apply for admission to public housing? ^ PHA main administrative office ^ PHA development site management office ^ Other (list below) a Site-Based Waiting Lists-Previous Year 1. Has the PHA operated one or' more site-based waiting lists in the previous yeaz? If yes, complete the following table; if not skip to d. Page 12 of 38 form HUD-50075-SF (04/3012003) PHA Name: Orange County 5-Year Plan for Fiscal Ycars: 2005 - 2010 Annuai Pian for lY 2005 HA Code: NC104 Site-Based Waiting Lists Development Information: (Name, number, location) Date Initiated Initial mix of Racial, Ethnic or Disability Demographics Current mix of Racial, Ethnic or Disability Demographics since Initiation of SBWL Percent change behveen initial and current mix of Racial, Ethnic, or Disability demo ra hits 2. What is the number of'site based waiting list developments to which families may apply at one time? .3. How many unit offers may an applicant turn down before being removed from the site- based waiting list? 4, ^ Yes ^ No: Is the PHA the subject of any pending fair housing complaint by I-ICIL> or any court order or settlement agreement? If yes, describe the order, agreement or complaint and describe how use of asite-based waiting list will not violate or be inconsistent with the order, agreement or complaint below: d, Site-Based Waiting Lists -Coming Year If the PHA plans to operate one or more site-based waiting lists in the coming year, answer each of the following questions; if not, skip to subsection (3) Assignment 1.. How many site-based waiting lists will the PHA operate in the coming year? 2. ^ Yes ^ No: Are any or all of the FHA's site-based waiting lists new for the upcoming year (that is, they aze not part of a previously-HUD-approved site based waiting list plan)? If yes, how many lists? 3. ^ Yes ^ No: May fanilies be on more than one list simultaneously If yes, how many lists? 4, Where can interested persons obtain more information about and sign up to be on the site- based waiting lists (select al] that apply)? ^ PHA main administrative office ^ All PHA development management offices ^ Management offices at developments with site-based waiting lists ^ At the development to which they would like to apply ^ Other (list below) Page 13 of 38 form HUD-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan for Fiscal Ycars: 2005 - 2010 Annual Plan for FY 2005 r1A Code: NCI04 (3) Assienment a. How many vacant unit choices are applicants ordinarily given before they fall to the bottom of or are removed from the waiting list? (select one) ^ One ^ Two ^ Three or More b. ^ Yes ^ No: Is this policy consistent across all waiting list types? a If answer to b is no, list variations for any other than the primary public housing waiting lists for the PHA: (4) Admissions Preferences a. Income tazgeting: ^ Yes ^ No: Does the PHA plan to exceed the federal targeting requirements by targeting more than 40% of all new admissions to public housing to families at or below 30% of median area income? b. Transfer policies: In what circumstances will transfers take precedence over new admissions? (list below) ^ Emergencies ^ Oven-housed ^ Under-housed ^ Medical justification ^ Administrative reasons determined by the PHA (e.g,, to permit modernization work) ^ Resident choice: (state circumstances below) ^ Other: (list below) c. Preferences 1, ^ Yes ^ No: Has the PHA established preferences for admission to public housing (other than date and time of application)? (If "no" is selected, skip to subsection (5) Occupancy) 2. Which of the following admission preferences does the PHA plan to employ in the coming year? (select all that apply from either former Federal preferences or other preferences) Former Federal preferences: ^ Involuntary Displacement (Disaster, Govermnent Action, Action of Housing Owner, Inaccessibility, Property Disposition) ^ Victims of domestic violence ^ Substandard housing ^ Homelessness ^ High rent burden (rent is > 50 percent of income) ~S Page 14 of 38 form HUD-50075-SF (04!30!2003) PHA Name: Omngc County 5-Year Plan (or Piscal Ycars: 2005 - 20t0 Annual Plan 1'or PY 2005 HA Code: NCI04 Other preferences: (select below) ^ Working families and those unable to work because of age or disability ^ Veterans and veterans' fanilies ^ Residents who live and/or work in the,jurisdiction ^ Those enrolled currently in educational, training, or upward mobility programs ^ Households that contribute to meeting income goals (broad range of incomes) ^ Households that contribute to meeting income requirements (targeting) ^ Those previously enrolled in educational, training, or upward mobility programs ^ Victims of reprisals or hate crimes ^ Other preference(s) (list below) 3, If the PHA will employ admissions preferences, please prioritize by placing a "1" in the space that represents your first priority, a " 2" in the box representing your second priority, and so on.. If you give equal weight to one or more of these choices (either through an absolute hierarchy or through a point system), place the same number next to each. That means you can use "1"more than once, " 2" more than once, etc. ^ Date and Time Former Federal preferences: ^ Involuntazy Displacement (Disaster, Government Action, Action of Housing Owner, Inaccessibility, Property Disposition) ^ Victims of domestic violence ^ Substandard housing ^ Homelessness ^ High rent burden Other preferences (select all that apply) ^ Working families and those unable to work because of age or disability ^ Veterans and veterans' families ^ Residents who live and/or work in the jurisdiction ^ Those enrolled currently in educational, training, or upward mobility programs ^ Households that contribute to meeting income goals (broad range of incomes) ^ Households that contribute to meeting income requirements (taggeting) ^ Those previously enrolled in educational, training, or upward mobility programs ^ Victims of reprisals or hate crimes ^ Other preference(s) (list below) 4. Relationship of preferences to income targeting requirements: ^ The PHA applies preferences within income tiers ^ Not applicable: the pool of applicant families ensures that the PHA will meet income targeting requirements Page 15 of 38 form HUD-50075-SF (04/30/2003) PISA Name: Orange County 5-Year Ptan (or Piscal Years: 2005 - 2010 Annual Plan I'or FY 2005 r-~+ `-' HA Code: NC104 (5) Occupancy a. What reference materials can applicants and residents use to obtain information about the rules of occupancy of public housing (select all that apply) ^ The PHA-resident lease ^ The PHA's Admissions and (Continued) Occupancy policy ^ PHA briefing seminars or written materials ^ Other source (list) b, How often must residents notify the PHA of changes in family composition? (select all that apply) ^ At an annual reexamination and lease renewal ^ Any time family composition changes ^ At family request for revision ^ Other (list) (6) Deconcentration and Income Mixint= a. ^ Yes ^ No: Does the PHA have any general occupancy (family) public housing developments covered by the deconcentration rule? If no, this section is complete, If yes, continue to the next question.. b. ^ Yes ^ No: Do any of these covered developments have average incomes above or below 85% to 115% of the average incomes of all such developments? If no, this section is complete. If yes, list these developments on the following table: Deconcentration Policy for Covered Develo menu Development Name Number of Units Explanation (if any) (see step 4 at §90.3.2(c)(1)(iv)1 Deconcentration policy (if no explanation) (see step 5 at 9032 c 1 v B. Section 8 Exemptions: PHAs that do not administer section 8 are not required to complete sub-component 3B Unless otherwise specified, all questions in this section apply only to the tenant-based section 8 assistance program (vouchers, and until completely merged into the voucher program, certificates). ~) Eligibility a. What is the extent of screening conducted by the PHA? (select all that apply) ® Criminal or drug-related activity only to the extent required bylaw or regulation Page t6 of 30 form HIID-50075-SF (04/30/2003) PHA Name; Orange County 5-Year Plan for Fiscal Years: 2005 - 2010 IiA Code: NCI04 Annual Ptan for FY 2005 ^ Criminal and drug-related activity, more extensively than required by law or regulation ^ More general screening than criminal and drug-related activity (list factors): ^ Other (list below) b. ®Yes ^ No: Does the PHA request criminal records from local law enforcement agencies for screening purposes? c. ® Yes ^ No: Does the PHA request criminal records from State law enforcement agencies for screening purposes? d. ^ Yes ® No: Does the PHA access FBI criminal records from the FBI for screening purposes? (either directly or through an NCIC-authorized source) e. Indicate what kinds of information you shaze with prospective landlords? (select all that apply) ^ Criminal ordrug-related activity ® Other (describe below) None -verify program eligibility only (2) Waiting List Organization a. With which of the following program waiting lists is the section 8 tenant-based assistance waiting list merged? (select all that apply) ® None ^ Federal public housing ^ Federal moderate rehabilitation ^ Federal project-based certificate program ^ Other federal or local program (list below) b. Where may interested persons apply for admission to section 8 tenant-based assistance? (select all that apply) ® PHA main administrative office ® Other (list below) Satellite office irr Chapel Hill (3) Search Time a. ®Yes ^ No: Does the PHA give extensions on standard GO-day period to search for a unit? If yes, state circumstances below: Two tlzirty-day extezrsiorrs are available upon request. (4) Admissions Preferences a. Income targeting ^ Yes ® No: Does the PHA plan to exceed the federal targeting requirements by targeting Page 17 of 30 form HUD-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan for fiscal Years: 2005 - 2010 Annual Plan for FY 2005 ~, FIA Codc: NCI04 b. Preferences 1. ® Yes ^ No: more than 75% of all new admissions to the section 8 program to families at or below 30% of median area income? Has the PHA established preferences for admission to section 8 tenant- based assistance? (other than date and time of application) (if no, skip to subcomponent (5) Special purpose section 8 assistance programs) 2. Which of the following admission preferences does the PHA plan to employ in the coming year? (select all that apply from either former Federal preferences or other preferences) Former Federal preferences ® Involuntary Displacement (Disaster, Goverrunent Action, Action of Housing Owner, Inaccessibility, Property Disposition) ® Victims of domestic violence ® Substandard housing ® Homelessness ® High rent burden (rent is > 50 percent of income) Other preferences (select all that apply) ^ Working families and those unable to work because of age or disability ® Veterans and veterans' families ® Residents who live and/or work in your jurisdiction ® Those enrolled currently in educational, training, or upward mobility programs ^ Households that contribute to meeting income goals (br'oad range of incomes) ^ Households that contribute to meeting income requirements (targeting) ^ Those previously enrolled in educational, training, or upward mobility programs ^ Victims of reprisals or' hate crimes ^ Other preference(s) (list below) 3. If the PHA will employ admissions preferences, please prioritize by placing a "1" in the space that represents your frst priority, a" 2" in the box representing your second priority, and so on. If you give equal weight to one or more of these choices (either through an absolute hierarchy or tluough a point system), place the same number next to each. That means you can use "1"more than once, " 2" more than once, etc. 1 ^ Date and Time Former Federal preferences: 1 ^ Involuntary Displacement (Disaster, Government Action, Action of Housing Owner, Inaccessibility, Property Disposition) 1^ Victims of domestic violence 1^ Substandard housing 1^ Homelessness 1 ^ High rent burden Page 18 of 38 form Hl1D-50075-SF (04/30/2003) PHA Name: Omnge County 5-Year Plan (or Fiscal Years: 2005 - 2010 Annual Ptan for FY 2005 O~ ~J HA Code: NC104 Other preferences (select all that apply) ^ Working families and those unable to work because of age or disability ® Veterans and veterans' fanrilies ® Residents who live and/or work in your,jurisdiction ® Those emolled currently in educational, training, or upward mobility programs ^ Households that contribute to meeting income goals (broad range of incomes) ^ Households that contribute to meeting income requirements (targeting) ^ Those previously emolled in educational, training, or upward mobility programs ^ Victims of reprisals or hate crimes ^ Other preference(s) (list below) 4, Among applicants on the waiting list with equal preference status, how are applicants selected? (select one) ® Date and time of application ^ Drawing (lottery) or other random choice technique 5. If the PHA plans to employ preferences for "residents who live and/or work in the jurisdiction" (select one) ® This preference has previously been reviewed and approved by HUD ^ The PHA requests approval for this preference through this PHA Plan 6. Relationship of preferences to income targeting requirements: (select one) ^ The PHA applies preferences within income tiers ^ Not applicable: the pool of applicant families ensures that the PHA will meet income targeting requirements (5) Special Purpose Section 8 Assistance Programs a, In which documents or other reference materials are the policies governing eligibility, selection, and admissions to any special-purpose section 8 program administered by the PHA contained? (select all that apply) ® The Section 8 Administrative Plan ^ Briefing sessions and written materials ® Other (list below) Program specific promotional material b, How does the PHA announce the availability of any special-purpose section 8 programs to the public? ® Tluough published notices ^ Other (list below) 4. PHA Rent Determination Policies [24 CPR Part 903,12(b), 903,7(d)] Page 79 of 38 form HUD-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan for Fiscal Ycars: 2005 - 2010 Annual Plan for FY 2005 I1A Codc: NC104 A. Public Housing Exemptions: PHAs that do not administer public housing are not required to complete sub-component 4A. (11 Income Based Rent Policies Describe the PHA's income based rent setting policy/ies for public housing using, including discretionary (that is, not required by statute or regulation) income disregards and exclusions, in the appropriate spaces below. a. Use of discretionary policies: (select one of the following two) ^ The PHA will not employ any discretionary rent-setting policies for income-based rent in public housing. Income-based rents are set at the higher of .30% of adjusted monthly income, 10% of unadjusted monthly income, the welfare rent, or minimum rent (less HUD mandatory deductions and exclusions). (If selected, skip to sub-component (2)) ^ The PHA employs discretionary policies for determining income-based rent (If selected, continue to question b.) b. Minimum Rent 1. What amount best reflects the PHA's minimum rent? (select one) ^ $0 ^ $1-$25 ^ $26-$50 2.. ^ Yes ^ No: Has the PHA adopted any discretionary minimum rent hazdship exemption policies? 3. If yes to question 2, list these policies below: c. Rents set at less than .30% of adjusted income L ^ Yes ^ No: Does the PHA plan to charge rents at a fixed amount or percentage less than 30% of adjusted income? If yes to above, list the amounts or percentages charged and the circumstances under which these will be used below: d. Which of the discretionary (optional) deductions and/or exclusions policies does the PHA plan to etnploy (select all that apply) ^ For the earned income of a previously unemployed household member ^ For increases in earned income ^ Fixed amount (other than general rent-setting policy) If yes, state amounts and circumstances below: ^ Fixed percentage (other than general rent-setting policy) If yes, state percentage/s and circumstances below: a~- Page 20 of 38 form HUD-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan ('or Fiscal Years: 2005 - 2010 Annual Plan for PY 2005 rIA Code: NC104 ^ For household heads ^ For other family members ^ For transportation expenses ^ For the non-reimbursed medical expenses of non-disabled or non-elderly families ^ Other (describe below) e. Ceiling rents 1, Do you have ceiling rents? (rents set at a level lower than :30% of adjusted income) (select one) ^ Yes for all developments ^ Yes but only for some developments ^ No 2. For which kinds of developments are ceiling rents in place? (select all that apply) ^ For all developments ^ For al] general occupancy developments (not elderly or disabled or elderly only) ^ For specified general occupancy developments ^ For certain parts of developments; e.g,, the high-rise portion ^ For certain size units; e.g., larger bedroom sizes ^ Other (list below) Select the space or spaces that best describe how you arrive at ceiling rents (select all that aPP1Y) ^ Market comparability study ^ Fair market rents (FMR) ^ 95'h percentile rents ^ 75 percent of operating costs ^ 100 percent of operating costs for general occupancy (family) developments ^ Operating costs plus debt service ^ The "rental value" of the unit ^ Other (list below) f: Rent re-determinations 1. Between income reexaminations, how often must tenants report changes in income or family composition to the PHA such that the changes result in an adjustment to rent? (select all that apply) ^ Never ^ At family option a5 Page 21 of 38 form HUD•50075SF (04/30/2003) PItA Name: Orange County 5-Year Plan for Fiscal Years: 2005 - 2010 Annual Plan for FY 2005 ~ "' FIA Code: NC10-0 ^ Any time the family experiences an income increase ^ Any time a family experiences an income increase above a threshold amount or percentage: (if selected, specify threshold) ^ Other (list below) g. ^ Yes ^ No: Does the PHA plan to implement individual savings accounts for residents (ISAs) as an alternative to the required 12 month disallowance of earned income and phasing in of rent increases in the next year? (2) Flat Rents a. In setting the market-based flat rents, what sources of information did the PHA use to establish comparability? (select all that apply.) ^ The section 8 rent reasonableness study of comparable housing ^ Survey of rents listed in local newspaper ^ Survey of similar unassisted units in the neighborhood ^ Other' (list/describe below) B. Section 8 Tenant-Based Assistance Exemptions: PHAs that do not administer Section 8 tenant-based assistance are not required to complete sub- component 4B, Unless otherwise specified, all questions in this section apply only to the tenant-based section S assistance program (vouchers, and until completely merged into the voucher program, certificates). (1) Payment Standards Describe the voucher payment standards and policies. a. What is the FHA's payment standard? (select the category that best describes your standard) ^ At or above 90°/o but below100% of FMR ® 100% of FMR ^ Above 100% but at or below 110% of FMR ^ Above 110% of FMR (if HUD approved; describe circumstances below) b. If the payment standard is lower than FMR, why has the PHA selected this standard? (select all that apply) ^ FMRs ar'e adequate to ensure success among assisted families in the FHA's segment of the FMR area ^ The PHA has chosen to serve additional families by lowering the payment standard ^ Reflects market or submarket ^ Other (list below) c, If the payment standard is higher than FMR, why has the PHA chosen Chis level? (select all that apply) ^ FMRs are not adequate to ensure success among assisted families in the FHA's segment of the FMR area ^ Reflects market or submarket Page 22 of 38 form Hl1D-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan I'or fiscal Years: 2005 - 2010 Annual Plan (or PY 2005 ~~ HA Codc: NC104 ^ To increase housing options for' families ^ Other (list below) d. How often are payment standards reevaluated for adequacy? (select one) ® Annually ^ Other (list below) e. What factors will the PHA consider in its assessment of the adequacy of its payment standard? (select all that apply) ® Success rates of assisted families ® Rent burdens of assisted families ^ Other (list below) (2) Minimum Rent a. What amount best reflects the PHA's minimum rent? (select one) ^ $0 ® $1-$25 ^ $26-$50 b.. ^ Yes ® No: Has the PHA adopted any discretionary minimum rent hardship exemption policies? (if yes, 1rst below) 5. Capital Improvement Needs [24 CFR Part 903.12(6), 903.7 (g)] Exemptions from Component 5: Section 8 only PHAs are not required to complete this component and may skip to Component 6. A. Capital Fund Activities Exemptions from sub-component SA: PHAs that will not participate in the Capital Fund Program may skip to component SB. All other PHAs must complete SA as instructed. (1) Capital Fund Program a. ^ Yes ^ No Does the PHA plan to participate in the Capital Fund Program in the upcoming year? If yes, complete items 12 and 1:3 of this template (Capital Fund Program tables). If no, skip to 13. b. ^ Yes ^ No: Does the PHA propose to use any portion of its CFP funds to repay debt incurred to finance capital improvements? If so, the PHA must identify in its annual and 5-year capital plans the development(s) where such improvements will be made and show both how the proceeds of the financing will be used and the amount of the annual payments required to service the debt. (Note that separate HUD approval is required for such financing activities.). Page 23 of 36 form Hl1D-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Plan for Fiscal Years: 2005 - 2010 Annual flan for FY 2005 [,J HA Code: NC104 B. HOPE VI and Public Housing Development and Replacement Activities (Non-Capital Fund) Applicability ofsub-component SB: All PHAs administering public housing. Identify any approved HOPE VI and/or public housing development or replacement activities not described in the Capital Fund Program Annual Statement. (1) Hope VI Revitalization a. ^ Yes ^ No: Has the PHA received a HOPE VI revitalization grant? (if no, skip to next component; if yes, provide responses to questions on chart below for each grant, copying and completing as many times as necessary) b. Status of HOPE VI revitalization grant (complete one set of questions for each grant) Development name: Development (project) number: Status of grant: (select the statement that best describes the current status) ^ Revitalization Plan under development ^ Revitalization Plan submitted, pending approval ^ Revitalization Plan approved ^ Activities pursuant to an approved Revitalization Plan underway c. ^ Yes ^ No: Does the PHA plan to apply for a HOPE VI Revitalization grant in the Plan year? If yes, list development nanre/s below: d. ^ Yes ^ No: Will the PHA be engaging in any mixed-finance development activities for public housing in the Plan year? If yes, list developments or activities below: e. ^ Yes ^ No: Will the PHA be conducting any other public housing development or replacement activities not discussed in the Capital Fund Program Annual Statement? If yes, list developments or activities below: 6. Demolition and Disposition [24 CFR Part 903 12(b), 903.7 (h)] Applicability of component 6: Section 8 only PHAs are not required to complete this section. a. ^ Yes ^ No: Does the PHA plan to conduct any demolition or disposition activities (pursuant to section 18 or 24 (Hope VI)of the U.S. Housing Act of 19.37 (42 U,S,C, 14.37p) or Section 202/Section 33 (Mandatory Conversion) in the plan Fiscal Year? (If "No", skip to component 7; if "yes", complete one activity description for each development on the following chart.) Page 24 of 38 form HUD-50075-SF (04/30/2003) PHA Name: Omnge County 5-Year Plan (or Fiscal Ycars: 2005 - 2010 HA Cadc: NC104 a~ Annual Plan t'or FY 2005 Demolition/Dis osition Activi Descri tion la. Development name: lb. Develo ment ( roject) number: 2, Activity type: Demolition ^ Dis osition ^ 3. Application status (select one) Approved ^ Submitted, pending approval ^ Planned a lieation ^ 4. Date a lication a roved, submitted, or larmed for submission: (DD/MM/YY) 5. Number of units affected: 6. Coverage of action (select one) ^ Part of the development ^ Iotal develo ment 7 Timeline for activity: a. Actual or projected start date of activity: b. Pr'o ected end date of'activity: 7. Section 8 Tenant Based Assistance--Section 8(v) Homeownership Program [24 CFR Pazt 903.12(b), 903.7(k)(1)(i)] (1) ® Yes ^ No: Does the PHA plan to administer a Section 8 Homeownership program pursuant to Section 8(y) of the U.S.H.A, of 1937, as implemented by 24 CFR part 982 ? (If "No", skip to the next component; if "yes", complete each program description below (copy and complete questions for each program identified.) (2) Program Description A conanattnity based working group will be established to develop clear program guidelines for the Section 8 Homeowaterslaip Program. It is eaavisioned that any program created would blend with existing first-time bmebuyer programs. More specifically, participants in this program will be strongly encouraged to participate in existing Homebuyer Education classes and Homebuyer Clubs (support groups). a. Size of Program ® Yes ^ No: Will the PHA limit the number of families participating in the Section 8 homeownership option? if the answer to the question above was yes, what is the maximum number of participants this fiscal year? 0 b. PHA-established eligibility criteria Page 25 of 38 form HUD-50075-SF (04/30/20D3) PHA Name: Orangc County 5-Year Plan for Piscal Yenrs: 2005 - 2010 HA Code: NCI04 Annual Plan for PY 2005 30 ^ Yes ® No: Will the PHA's program have eligibility criteria for participation in its Section 8 Homeownership Option program in addition to HUD criteria? If yes, list criteria below: c. What actions will the PHA undertake to implement the program this year (list)? 1. Convene planning committee to develop guidelines. 2. Seek public comment and governing board approval of proposed guidelines. 3. Prepare marketing material. 4. (3) Capacity of the PHA to Administer a Section 8 Homeownership Program The PHA has demonstrated its capacity to administer the program by (select all that apply): a. ^ Establishing a minimum homeowner downpayment requirement of at least 3 percent of purchase price and requiring that at least 1 percent of the purchase price comes from the family's resources. b, ^ Requiring that financing for purchase of a home under its Section 8 homeownership will be provided, insured or guaranteed by the state or Federal government; comply with secondary mortgage market underwriting requirements; or comply with generally accepted private sector underwriting standards. c. ^ Partnering with a qualified agency or agencies to administer the program (list name(s) and years of experience below). d. ^ Demonstrating that it has other relevant experience (list experience below). 8. Civil Rights Certifications [24 CFR Part 903.12 (b), 903.7 (o)] Civil rights certifications are included in the PHA Platt Certifications of Compliance with the PHA Plates m:d Related Regulations: Board Resolution to Accompany the Standatzl Annual, Standm•d Five-Yem•, and Str'eantlined Five-Yem/Annual Plates, which is submitted to the Field Office in hard copy-see Table of Contents. 9. Additional Information [24 CFR Part 903.12 (b), 903.7 (r)] A. PHA Progress in Meeting the Mission and Goals Described in the 5- Year Plan (Pranirle n statenewet oJtbe PHA's progress against the goals and objectives ertnb/isberl be the previous 5-Yem Plan for the periarl FY 20_ - 20~ B. Criteria for Substantial Deviations and Significant Amendments (i) Amendment and Deviation Definitions 24 CFR Part 903.7(r) Page 26 of 38 form HUD-50075-SF (04/30/2003) PHA Name: Orange County 5-Year Ptan (or Piscal Ycars: 2005 - 2010 Annual Ptan for FY 2005 HA Code: NCI04 PHAs are required to define and adopt their own standards of'substantial deviation from the 5-year Plan and Significant Amendment to the Annual Plan. The definition oF'significant amendment is important because it defines when the PHA will subject a change to the policies or activities described in the Annual Plan to full public hearing and HUD review before implementation. a. Substantial Deviation from the 5-Year Plan Substantial deviation is defined as a charge in one of the, followings 1. CJ:ange in the PHA's Overall Mission; or 2, Change in the PHA's goals and objectives that affect services provided to local residents, Disclaimer: This does not include changes necessary as a result of changes in HUD regzzlatory requirements, b. Significant Amendment or Modification to the Annual Plan Significant Amendment is defined as a change in one of the following: 1. Change in admission policies 2. Change in rent policies; or 3, Change in the organization of the waiting list, Disclaimer; Tlris does not include changes necessary as a reszdt of changes irr HUD regYZlatory requirements, C. Other Information [24 CFR Part 903.13, 903..15] (1) Resident Advisory Board Recommendations a. ^ Yes ^ No: Did the PHA receive any comments on the PHA Plan from the Resident Advisory Boards? If yes, provide the comments below: b. In what mamrer did the PHA address those comments? (select all that apply) ^ Considered comments, but detennined that no changes to the PHA Plan were necessary.. ^ The PHA changed portions of the PHA Plan in response to comments List changes below: ^ Other: (list below) Page 27 of 38 form HUD-50075•SF (04/30/2003) PI1A Name: Orange County 5-Year Plan for Fiscal Years: 2005 - 2010 11A Codc: NC104 Annual Plan for PY 2005 3 (2) Resident Membership on PHA Governing Board The governing board of each PHA is required to have at least one member who is directly assisted by the PHA, unless the PIiA meets certain exemption criteria. Regulations governing the resident board member are found at 24 CFR Part 964, Subpart E. a. Does the PHA governing board include at least one member who is directly assisted by the PHA this year? ^ Yes ® No: Exempt If yes, complete the following: Name of Resident Member of the PHA Governing Board: Method of Selection: ^ Appointment The term of appointment is (include the date term expires): ^ Election by Residents (if checked, complete next section--Description of Resident Election Process) Description of Resident Election Process Nomination of candidates for place on the ballot: (select al] that apply) ^ Candidates were nominated by resident and assisted family organizations ^ Candidates could be nominated by any adult recipient of PHA assistance ^ Self-nomination: Candidates registered with the PHA and requested a place on ballot ^ Other: (describe) Eligible candidates: (select one) ^ Any recipient of PHA assistance ^ Any head of household receiving PHA assistance ^ Any adult recipient of PHA assistance ^ Any adult member of a resident or assisted family organization ^ Other (list) Eligible voters: (select all that apply) ^ All adult recipients of'PHA assistance (public housing and section 8 tenant-based assistance) ^ Representatives of all PHA resident and assisted family organizations ^ Other (list) b. If the PHA governing board does not have at least one member who is directly assisted by the PHA, why not? ^ The PHA is located in a State that requires the members of a governing board to Page 28 of 38 form HUD-50075-SF (04/30/2003) PNA Name: Orange County 5-Year Plan f'or Fiscal Years: 2005 - 2010 HA Codc: NC104 be salaried and serve on a full time basis Annual Plan (or f•Y 2005 3 ^ The PHA has less than 300 public housing units, has provided reasonable notice to the resident advisory board of the opportunity to serve on the governing board, and has not been notified by any resident of their interest to participate in the Board, ^ Other (explain): Date of next term expiration of a governing board member: Name and title of appointing official(s) for governing board (indicate appointing official for' the next available position): (3) PHA Statement of Consistency with the Consolidated Plan [24 CFR Part 903.15] For each applicable Consolidated Plan, make the following statement (copy questions as many times as necessary). Consolidated Plan jurisdiction: (provide name here) a, The PHA has taken the following steps to ensure consistency of this PHA Plan with the Consolidated Plan for the,jurisdiction: (select all that apply): ® The PHA has based its statement of needs of families on its waiting list on the needs expressed in the Consolidated Plans. ® The PHA has participated in any consultation process organized and offered by the Consolidated Plan agency in the development of the Consolidated Plan.. ® The PHA has consulted with the Consolidated Plan agency during the development of this PHA Plan. ® Activities to be undertaken by the PHA in the coming year are consistent with the initiatives contained in the Consolidated Plan. (list below) L:cl°easing t7re oppw•turrities fwd first-time homeownership (Section 8 Homeownership Program) ^ Other: (list below) b. The Consolidated Plan of the,jurisdretion supports the PHA Plan with the following actions and commitments: (describe below) Goal 1 Priority LZ Low-income renters (<60%AMI) tl¢at live i/r substandard housing Priority 1.4 Low-income renters (<.50%AMI) that are potential hornebuyers. Page 29 of 38 form HUD-50075-SF (04/30/2003) PI1A Name: Orange County 5-Year Ptan for Piscal Years: 2005 - 2010 Annual Ptan 1'or FY 2005 ~~ FIA Code: NC104 (4) (Reserved) Use this section to provide any additional information requested by HUD. 10. Proiect-Based Voucher Program a, ^ Yes ® No: Does the PHA plan to "project-base" any tenant-based Section 8 vouchers in the coming year? Ifyes, answer the following questions, b. ^ Yes ^ No: Are there circumstances indicating that the project basing of the units, rather than tenant-basing of the same amount of assistance is an appropriate option? If yes, check which circumstances apply: ^ Low utilization rate for vouchers due to lack of suitable rental units ^ Access to neighborhoods outside of high poverty azeas ^ Other (describe below:) c. Indicate the number of units and general location of units (e.g. eligible census tracts or smaller areas within eligible census tracts): Page 30 of 38 form HUD-50075SF (04/30/2003) PHA Name: Omnge County 5-Year Plan for Piscal Years: 2005 - 2010 Annual Ptan for FY 2005 ~~ HA Code: NCI04 11. List of Supporting Documents Available for Review for Streamlined Five-Year/ Annual PHA Plans PHAS ate to indicate which documents are available for public review by placing a mark in the "Applicable & On Display" column in the appropriate rows All listed documents must be on display if applicable to the program activities conducted by the PHA. Lis[ of Su ortin Documents Available for Review Applicable Supporting Document Related Plan Component On Dis lay X PHA Certifrcaiions ojConrpliance with the PHA P/ans mrd Re(a/ed Regrda/ions Standard 5 Year and and Board Resolmion m Accorupany the Standard ~Luroa/, SYmtdarei Five-Year, Annual Plans; streamlined and S(ream/fined Five-Year/Annual P/ans. 5 Year Plans X State/Local Government Certification of Consistent with the Consolidated Plan. 5 Year Plans X Fair Housing Documentation Supporting Fair Housing Certifications: Records 5 Year and Annual Plans reflecting that the PHA has examined its programs or proposed programs, identified any impediments to fair housing choice in [hose programs, addressed or is addressing those impediments in a reasonable fashion in view of the resources available, and worked or is working with local jurisdictions to implement any of the jurisdictions' initiatives to affirmatively further fair housing that require the PFIA's involvement. X Housing Needs Statement of the Consolidated Plan for the jurisdiction(s) in which Annual Plan: the PHA is located and any additional backup data to support statement of housing Housing Needs needs for families on the PHA's public housing and Section 8 tenant-based waiting lists. Most recent board-approved operating budget for the public housing program Annual Plan: Financial Resources Public Housing Admissions and (Continued) Occupancy Policy (A&O/ACOP), Annual Plan: Eligibility, which includes the Tenant Selection and Assignment Plan [TSAP] and the Site- Selection, and Admissions Based Waitin List Procedure. Policies Any policy goveming occupancy of Police Officers and Over-Income Tenants in Annual Plan: Eligibility, Public Housing. ^ Check here if included in the public housing A&O Policy Selection, and Admissions Policies X Section 8 Adminishativc Plan Annual Plan: Eligibility, Selection, and Admissions Policies Public housing rent determination policies, including [he method for setting public Annual Plan: Rent housin flat rents. ~ Check here if included in the ublic housin A & 0 Polic . Determination Schedule of Flat rents offered at each public housing development Annual Plan: Rent ^ Check here if~included in the ublic housin A & O Polic . Determination Section 8 rent determination (payment standard) policies (if included in plan, not Annual Plan: Rent necessary as a supporting document) and written analysis of Section 8 payment Determination standard policies ® Check here if included in Section 8 Administrative Plan. Public housing management and maintenance policy documents, including politics Annual Plan: Operations for [he prevention or eradication of pest infestation (including cockroach and Maintenance infestation). Results of latest Public Housing Assessment System (PHAS) Assessment (or other Annual Plan: Management a licable assessment). and O erations Follow-up Plan to Results of dte PHAS Resident Satisfaction Survey (if necessary) Annual Plan: Operations and Maintenance and Community Service & Self-Sufficient X Results of latest Section 8 Management Assessment System (SEMAP) Annual Plan: Management and O erations X Any policies goveming any Section 8 special housing types Annual Plan: Operations ® check here if included in Section 8 Administrative Plan and Maintenance Page 31 of 38 form HUD-50075-SF (04/30/2003) PFIA Name: Orange County 5-Year Plan for Fiscal Years: 2005 - 2010 Mnuat Plan ('or FY 2005 HA Code: NCI04 List of Su ortin Documents Available for Review Applicable Supporting Document Related Plan Component On Dis Iav Consortium agreement(s). Annual Plan: Agency Identification and Operations/ Management Public housing grievance procedures Annual Plan: Grievance ^ Check here if included in the vblic housin A & O Palic . Procedures x Section 8 informal review and hearing procedures. Annual Plan: Grievance ® Check here if included in Section 8 Administrative Plan. Procedures The Capital Fund/Comprehensive Grant Program Annual Statement /Performance Annual Plan: Capital and Evaluation Re ort for an active rant ear. Needs Most recent CIAP Budget/Progress Report (HUD 52825) for any active CIAP Annual Ptan: Capital rants. Needs Approved HOPE VI applications or, if more recent, approved or submitted HOPE Annual Plan: Capital VI Revitalization Plans, or any other approved proposal for development of public Needs housin . Self-evaluation, Needs Assessment and Transition Plan required by regulations Annual Plan: Capital implementing Section 504 of the Rehabilitation Act and the Americans with Needs Disabilities Act. See PIH Notice 99-52 (HA). Approved or submitted applications for demolition and/or disposition of public Annual Plan: Demolition housin and Dis osition Approved or submitted applications for designation of public housing (Designated Annual Plan: Designation Housin Plans). of Public Housin Approved or submitted assessments of reasonable revitalization of public housing Annual Plan: Conversion and approved or submitted conversion plans prepared pursuant to section 202 of the of Public Housing 1996 HUD Appropriations Act, Section 22 of the US Housing Act of 19.37, or Section 33 of the US Housin Act of 1937. Documentation for required Initial Assessment and any additional information Annual Plan: Voluntary required by HUD for Voluntary Conversion. Conversion of Public Housin Approved or submitted public housing homeownership programs/plans Annual Plan: Homeownershi Policies governing any Section 8 Homeownership program Annual Plan: (Section of the Section 8 Administrative Plan) Homeownershi Public Flousing Community Service Policy/Programs Annual Plan: Community ^ Check here if included in Public Housin A & O Folic Service &Self--Sufficient Cooperative agreement between the PFIA and the TANF agency and between the Annual Plan: Community PHA and local em to ent and trainin service a ~encies. Service & Self-Sufficient FSS Action Plan(s) for public housing and/or Section 8. Annual Plan: Community Service & Sclf-Suftcienc Section .3 documentation required by 24 CPR Part 135, Subpart E for public Annual Plan: Community housin Service & Self-Sufficient Most recent self-sufficiency (ED/SS, TOP or ROSS or other resident services grant) Annual Plan: Community rant ro ram re orts for ublic housin . Service &Self--Sufficient Policy on Ownership of Pets in Public Housing Family Developments (as required Pet Policy by regulation at 24 CF R Part 960, Subpart G) ^ Check here if included in the ublic housin A & O Folic . The results of the most recent fiscal year audit of the PHA conducted under the Annual Plan: Annual X Single Audit Act as implemented by OMB Circular A-133, the results of that audit Audit and the FHA's res onse to an findin s. Consortium agreement(s), if a consortium administers PHA programs. ]oint PFIA Plan for Consortia Consortia loin[ PHA Plans ONLY: Certification that consortium agreement is in Joint PHA Plan for compliance with 24 CFR Part 943 pursuant to an opinion of counsel on file and Consortia available for ins ection Other su ortin documents (o tional). List individual) . (S ecif as needed) Page 32 of 38 form HUD-50075-SF (04/30/2003) 3~ vo= b °' n ~ G wwC7 a o x w U ro ~ ~ ~ ~ Q o ~ ~ ' o fl H a i-i ro Y "" a p; O o W c w U ° o l _ Vl w •a ai b V ~" C y ` ++ p C ~^ ? a a v z ~ n U es w ~ Ta > ~ w b a z~ , t7 c `o a c 6 N ~ ttl •.. U ~ [ La C O o . E E~ c u d C W ~r a ~ E .o a n m a x m ~ E" c ~ a a c c ~ ~i u °^ y a o °' a, u. ~ fY ^ w O ~ ee E+M~ h ~ ~' '~' O ~ a n. L a 'u W O U a ' C7 C ~ d ~+ co a~ e• a >~ wF ~ _ ,~ O f. yy, 'O ~ yw o `° ~ y ~ y ~ ~A" b y o a m O 4... o U o W "~' A~ ~ ~ V V] E ~ ~ w b O P. ~ y u ~ " ° I x h w L G k a •~ q t o V RI y c ,¢ m i q Vl ~ ~ ~% c% y a` b a Da v ~ ~ o ~ y v o 0 o vi c o 8'b d o ~ N ,~ E ~ n Q •• ~ ~ v ° p t0 c•°- ~ ,., a ro q a •~ O ~ ~ ,pl Q y p L m _y ~y $ a m i ~" ~ ~ N ~ ~ 4 Q y ~ ~ ? ~ W ai O U ¢ ~ ~ ~, f3; ~i ~ a ~ 7. A i a 44 ti N m .O (~ N ~ tJ ~ W .~ .~ G aci ~ O N ~ v ~ N N N ~ ~ W A ~' c ° N b a, b ~ O ~. '~ N N o N up O ~ ~N+ c p a ~ N Q O ~ i N N .. 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A ~ w U F O h z Y ~ , U ~ E ~ ~ a o i s, u v C1 pa A Applicant Name ProgramlAClivity Recelving Federal Grant Funding Acting on behalf of the above named Applicant as its Authorized Official, I make the following certifications and agreements to the Department of I-]ousing and Urban Development (1-IUD) regarding the sites listed below: I certify that the above named Applicant will or will continue to provide adrug-flee workplace by: a. Publishing a statement notifying employees that the un- lawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the Applicant's work- place and specifying the actions that will be taken against employees for violation of such prohibition. b. Establishing an on-going drug-flee awareness program to inform employees --- (1) The dangers of drug abuse in the workplace; (2) The Applicant's policy of maintaining adrug-flee workplace; (3) Any available drug counseling, rehabilimtion, 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 to be engaged in the performance of the grant be given a copy of the statement required by paragraph a.; d, Notifying the employee in the statement required by para- graph a. that, as a condition of employment under the grant, the employee will --- (1) Abide by the terms of the statement; and (2) Notify the employer in writing of his or her convic- tion for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; e. Notifying the agency in writing, within ten calendar days after receiving notice under subparagraph d.(2) flora an em- ployee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, includ- ing position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federalageney has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; f: Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph d. (2), with respect to any employee who is so convicted --- (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfacto- rily in a drug abuse assistance or rehabilitation program ap- proved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; g. Making a good faith effort to continue to maintain adrug- free workplace through implementation of paragraphs a. thru f. 2. Sites fur Wark Performance., The Applicant shall list (on sepnrate pages) the site(s) for the performance of work done in connection with the FIUD funding of the program/activity shown above: Place of Performance shall include the street address, city, county, State, and zip code. Identify each sheet with the Applicant name and address and the program/activity receiving grant funding.) Check here^ if there are workplaces on file that are not identifed on the attached shee(s. t hereby certify that all the information stated herein, as welt as any information provided in the accompaniment herewith, is true and accurate Warning: HUDwill prosecute false claims and statements. Convic(ion may result in criminal and/or civil penalties (18 U.S C 1001.1010.1012; 31 U.S.C 3729.3802) Signature ua~e form HUD-50070 (3/g8) ref Handbooks 74171.747513.7485.1& 3 Standard PHA Plan PISA Certifications of Compliance U.S, Department of Housing and Urban Development Office of Public and Indian Housing PHA Certifications of Compliance with the PHA Plans and Related Regulations: Board Resolution to Accompany theStmrdardAnrtua[, Standard S-Year/Annnal, and Streamlined .S-Year/Annnal PHA Plans Actingon behalf ofdre Boa~d aJConunissioners oJdre Public HmrsingAgency (PHA) listed below, as its Chairman or other audrorized PfIA official ijthere is no Doard of Commissioners, /approve the submission of d~e_stmrdard Annual, _ standard .5- Year/Annual or _slrearufined 5-Year/~Imrual PHI Plmr for the PHA fiscal year beginning , hereinajier referred to as"the Plan ". of which this document is a part and make the Jalfow6rg certifications and agreenrents with the Department oJHousing and Urban Development (HUD) in cwurectiar with the submission ojthe Plan and inrplenrentatiar theneoJ' 1. The Plan is consistent with the applicable comprehensive housing affordability strategy (or any plan incorporating such strategy) for the jurisdiction in which the PHA is located. 2. The Plan contains a certification by the appropriate State or local officials tlmt the Plan is consistent with the applicable Consolidated Plan, which includes a certification that requires the preparation ofan Analysis of Impediments to Fair Housing Choice, for the PHA'sjurisdiction and a description of the manner in which the PHA Plan is consistent with the applicable Consolidated Plan. :3 The PHA has established a Resident Advisory Board or Boards, the membership ofwhich represents the residents assisted by the PI1A, consulted with this Board or Boards in developing the Plan, and considered the recommendations of the Board or Boards (24 CFR 903.13). The PHA has included in the Plan submission a copy of the recommendations made by the Resident Advisory Board or Boards and a description of the manner in which the Plan addresses these recommendations. 4. The PHA made the proposed Plan and all information relevant to the public hearing available for public inspection at least 45 days before the hearing, published a notice that a hearing would beheld and conducted a hearing to discuss the Plan and invited public comment. 5. The PHA will carry out the Plan in conformity with Title VI of [he Civil Rights Act of 1964, the Fair Housing Act, section 504 of the Rehabilitation Ac[ of 1973, and title 11 of the Americans with Disabilities Act of 1990 6. The PHA will affirmatively further fair housing by examining their programs or proposed programs, identify any impediments to fair housing choice within those programs, address those impediments in a reasonable fashion in view of the resources available and work with local jurisdictions to implement any ofthejurisdiction's initiatives to affirmatively further fair housing that require the PHA's involvement and maintain records reflecting these analyses and actions. 7. For PHA Plan that includes a policy for site based waiting lists: The PHA regularly submits required data to HUD's MTCS in an accurate, complete and timely manner (as specified in PIH Notice 99-2); The system of site-based waiting lists provides for full disclosure [o each applicant in the selection of the development in which to reside, including basic information about available sites; and an estimate of the period of time the applicant would likely have to wait to be admitted to units of different sizes and types a[ each site; Adoption of site-based waiting list would not violate any court order or settlement agreement or be inconsistent with a pending complaint brought by HUD; The PHA shall take reasonable measures to assure that such waiting list is consistent with affirmatively furthering fair housing; The PHA provides for review of its site-based waiting list policy to determine if it is consistent with civil rights laws and certifications, as specified in 24 CFR part 903.7( c)( I ) 8. The PI1A will comply with the prohibitions against discrimination on [he basis of age pursuant to the Agc Discrimination Act of 1975. 9. The PHA will comply with the Architectural Barriers Act of 1968 and 24 CFR Part 41, Policies and Procedures fbr the Enforcement of Standards and Requirements for Accessibility by the Physically Flandicapped. 10 The PHA will comply with the requirements of section 3 of the Housing and Urban Development Act of 1968, Employment Opportunities for Low-or Very-Low Inemne Persons, and widt its implementing regulation a[ 24 CFR Part L35. 1 I. The PHA has submitted with the Plan a certification with regard to a drug free workplace required by 24 CFR Part 24, Subpart F 12 The PHA has submitted with the Plan a certification with regard to compliance with restrictions on lobbying required by 24 CFR Part 87, together with disclosure forms if required by this Part, and with restrictions on payments to inFluence Federal Transactions, in accordance with the Byrd Amendment and implementing regulations at 49 CFR Part 24. Page 1 of 2 form HUD-50077 (04/30/2003) ~I`J` 1.3 The PHA will comply with acquisition and relocation requirements of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 and irrplementing regulations at 49 CFR Part 24 as applicable. 14.7he PHA will take appropriate affirmative action to award contracts to minority and women's business enterprises under 24 CPR 5.105( a). I S The PHA will provide HUD or the responsible entity any documentation that the Department needs to carry out its review under the National Environmental Policy Act and other related authorities in accordance with 24 CFR Part 58 16. With respect to public housing the PNA will comply with Davis-Bacon or HUD determined wage rate requirements under section I2 of the United States Housing Act of 1937 and the Contract Work Nours and Safety Standards Act. I7. The PHA will keep records in accordance with 24 CFR 8520 and facilitate an effective audit to determine compliance with program requirements. I8. The PHA will comply with the Lead-Based Paint Poisoning Prevention Act and 24 CFR Part 35. 19. The PHA will comply with the policies, guidelines, and requirements of OMB Circular No. A-87 (Cos[ Principles for State, L-ocal and Indian Tribal Governments) and 24 CFR Part 85 (Administrative Requirements for Grants and Cooperative Agreements to State, Local and Federally Recognized Indian Tribal Governments ) 20 The PHA will undertake only activities and programs covered by the Plan in a manner consistent with its Plan and will utilize covered grant funds only for activities that are approvable under the regulations and included in its Plan. 21. All attachments to the Plan have been and will continue to be available at all times and all locations that the PHA Plan is available for public inspection, All required supporting documents have been made available for public inspection along with the Plan and additional requirements at the primary business office of the PHA and at all other times and locations identified by the PHA in its PHA Plan and will continue to be made available at least at the primary business office of the PHA. PHA Name PHA Number/HA Code _ Standard PHA Plan for Fiscal Year: 20 Standard Five-Year PHA Plan for Fiscal Years 20_ - 20_, including Annual Plan for FY 20_ Srieamlined Five-Year PHA Plan for Fiscal Years 20_ - 20_, including Annual Plan for FY 20_ 1 ere y mnily t at a t e mlonnauon slate reran, as well as nny mfonnanon provr cd m w accompaniment rcrewuh, is true and accurate Warning: HUU wi I prosecute raise claims and statements. Conviction may nsult in criminal and/or civil penalties. (18 U.S.C. 1001, IOIO, IOI2; 31 U.S.C. 3729, 3802) Name of Authorized Olfidal I Title Signature ~ Dafe Page 2 of 2 form HU0.50077 (04/30/2003)