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Beneficiaries Scores <br /> Form N -4 <br /> 1 . (a ) Enter the total funds requested (total CDBG $ 750,000 1 . ( b) Enter the total number of grant unduplicated <br /> request) 1 . (a ) VLI beneficiaries : 1 . (b) 60 <br /> 1 . (c) Enter the total number of grant unduplicated 1 . (d) Enter the total number of grant unduplicated <br /> LMI beneficiaries : 1 . (c) 83 beneficiaries : 1 . (d) 170 <br /> i <br /> 1 . (e) Enter the total number of unduplicated LMI <br /> households : 1 . (e) 140 <br /> a . VLI BENEFICIARY IMPACT SCORE : Calculate the unduplicated VLI UNDUPLICATED VLI BENEFICIARY PERCENTAGE SCORE <br /> beneficiary percentage : 30 . 00% or More 30 x <br /> 20 . 00% to 29 .99% 20 <br /> 1 . ( b) divided by 1 . (d) = 35 % 10 . 00% to 19 .99% 10 <br /> Less than 10 . 00% 0 <br /> Based on the result, designate with an X the score that is appropriate . <br /> I <br /> b. LMI BENEFICIARY IMPACT SCORE : Calculate the unduplicated LMI UNDUPLICATED LMI BENEFICIARY PERCENTAGE SCORE <br /> beneficiary percentage : 70 . 00% and above 135x <br /> 66. 00% to 69 . 99 120 <br /> 61 % to 65 . 99% 100 <br /> 1 . (c) divided by 1 . (d ) = 82 % 56 . 00% to 60 .99 75 <br /> Based on the result, designate with an X the score that is appropriate. <br /> 51 . 01 % to 55 . 99% 50 <br /> c. AVERAGE COST PER UNDUPLICATED LMI BENEFICIARY SCORE : Calculate COST PER UNDUPLICATED LMI BENEFICIARY I SCORE <br /> the AVERAGE COST PER UNDUPLICATED LMI BENEFICIARY : $ 11 ,000 or More 0 i <br /> $ 10,000 to $ 10,999 15 <br /> 1 . (a ) divided by 1 . (c. ) = $5357 $ 91000 to $9,999 30 <br /> Less than $9,000 40 x <br /> Based on the result, designate with an X the score that is appropriate. <br /> d . AVERAGE COST PER UNDUPLICATED LMI HOUSEHOLD SCORE : Calculate ' COST PER UNDUPLICATED LMI HOUSEHOLD SCORE <br /> the average cost per unduplicated LMI Household : $ 16,000 or More - 100 <br /> $ 13,000 to $ 15,999 40 <br /> 1 . (a ) divided by 1 . (e. ) = $8,928 $ 11 ,000 to $ 12,999 60 <br /> $ 91000 TO $ 10,999 75 <br /> Based on the result designate with an X the score that is appropriate. Less than $9, 000 100 x <br /> L_- <br /> 19 <br />