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• U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FOR HUD USE ONLY <br />REQUISITION FOR PARTIAL PAYMENT OF ANNUAL CONTRIBUTIONS <br />HOUSING ASSISTANCE PAYMENTS PROGRAM Voucher Number <br />SECTION 23 SECTION B <br />Data of Requisition 5/l/84 Fiscal Year Ending Date 9/30/84 For Quarter Ending 9/30/84 <br />NAME AND ADDRESS OF PUBLIC HOUSING AGENCY (Including Zip Code) <br />Indian River County Board of County Commissioners <br />ACC ConA-3409 <br />Numb — — <br />Project Number FL <br />1840 25th St. Suite S-319 Vero Beach Fla. 3296 <br />No.ofMonthsinFiscalYear 12 <br />Type of Project'. <br />DEPOSITARY BANK (Name, Address and Account Number) <br />First Bankers of Indian River County <br />Vero Beach, Fla. 32960 Acct. #98-04000-1 <br />UEXISTING 0NEW REHAB. <br />IL Number of Units Under Leese to Ellgible Families as of Date of Requisition 168 <br />b. Estimated Number of Units to be under Lease at End of Requested Quarter 190 <br />c. Average Monthly Housing Assistance Payment Per Unit as of Date of Requisition 169 <br />DESCRIPTION <br />ESTIMATE OF <br />REQUIRED <br />ANNUAL <br />CONTRIBUTIONS <br />TOTAL COST <br />INCURRED <br />TO DATE <br />ESTIMATED - <br />ADDITIONAL <br />COST TO END <br />OF REQUESTED <br />QUARTER <br />CUMULATIVE <br />TOTAL <br />FUNDS <br />REQUIRED <br />(1) <br />(2) <br />(3) <br />(4) <br />(5) <br />PRELIMINARY ADMINISTRATIVE EXPENSE <br />1. Preliminary Administrative Expense—Prior to ACC (Account 4010) <br />0 <br />n_ <br />0 <br />D <br />2. Preliminary Administrative Expense—After ACC (Account 4012) <br />0 <br />3. Total Preliminary Administrative Expense (Lures! & 2) <br />NONEXPENDABLE EQUIPMENT <br />4. Replacement of Nonexpendable Equipment (Account 7520) <br />0 <br />5. Property Betterments and Additions (Account 7540) <br />0 <br />0 <br />0 <br />0 <br />0 <br />S. Total Nonexpendable Equipment (Lines 4 & S) <br />HOUSING ASSISTANCE PAYMENTS <br />7. Housing Assistance Payments (Account 4715) <br />460,660 <br />224 13 <br />128.440 <br />352,570 <br />ADMINISTRATIVE FEE <br />B. Total Administrative Fee Apprwmd for Fiscal Year <br />66,754 <br />8. Monthly Rete of Administrative Fee (Line 8 divided by number of months <br />In Ascd year) <br />5,563, <br />10. Amount Previously Requisitioned for fiscal year <br />44,478 <br />22,276 <br />11. Estimated Additional Amount Required to end of Requested Quarter <br />66,754 <br />12. Total Administrative Fee (Lines 10 & 11) <br />INDEPENDENT PUBLIC ACCOUNTANT AUDIT COSTS (Section 8 only) <br />13. Total Independent Public Accountant Audit Costs <br />2,500 <br />900 <br />SECURITY AND UTILITY DEPOSITS (Section 23 only) <br />14. Total Allowance Approved for Security and Utility Deposits <br />0 <br />15. Amount Previously Requisitioned for Fiscal Year <br />0 <br />16. Estimated Additional Amount Required to End of Requested Quarter <br />0 <br />17. TotalSecurity and Utility Deposits (Lines 15 alt 16) <br />0 <br />AMOUNT OF THIS REQUISITION <br />X <br />18. Total Funds Required to End of Requested Quarter (Lines 3, 6, 7. 1Z <br />13d 17) <br />420,224 <br />310,535- <br />0r20. <br />19. Total Partial Payments Received for Fiscal Year to Date <br />109,b89 <br />20.Partial Payment Requested (Line 18 minus Line 19) <br />1ST <br />INSTALLMENT <br />2NO <br />INSTALLMENT <br />3RD <br />INSTALLMENT <br />TOTAL <br />METHOD OF PAYMENT <br />21. Requested Installment Payments <br />36,561, <br />a6,563 <br />36,563 <br />109 689 <br />1 CERTIFY that housing astlstance payments have toren or will be made only with tupect to units which: (1) are under lame by Families at the time such <br />housing arsdetaw-a payments are made except an otherwise provided in the Housing Assistance Pa{manto Contracts and (2) the Housing Agency has within <br />one yea prior to the making of such housing assistance payments, adequately inspected or caussd to be inspected (Including inspection of grounds, facilities. <br />and areas for the benefit and use of the Families) to samrre that decent, safe and sanitary housing accommodations are being provided; that all applicable pro- <br />visions of the above numbered Contract haw baso complied with by the Housing Agency; and that this requisition for annual contributions has been ere:n- <br />b»d by the and to the best of mar knowledge and belief it is true, correct and complete. <br />O erne o yb)Ic H sing Ag¢ <br />(D te) (Signature and 7ftle of Official A oriz to Certify) <br />HUD FIELD OFFICE APPROVAL <br />(3igrrature and Title of Official Authorlaed to Approue) <br />11 <br />(Date) <br />M 1984 <br />BOOK 5.7 PAGE . <br />