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r AUG 1984 <br />IhvO.5263 <br />Bog 57 Fr{r" <br />880 <br />U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FOR HUD USE ONLY <br />I <br />REQUISITION FOR PARTIAL PAYMENT OF ANNUAL CONTRIBUTIONS <br />HOUSING ASSISTANCE PAYMENTS PROGRAM voucher Number <br />SECTION 230 SECTION 0 <br />Oate of Requisition 8/1/84 Fiscal Year Ending Date 9.130_/8r; ---For Quarter Ending 1_2,110,/Rd <br />NAME AND ADDRESS OF PUBLIC HOUSING AGENCY (including Zip Code) <br />Indian River Count yy Board of County Commissioners <br />1840 25th St., Suife S-319, Vero Beach., Fla. 3296 <br />ACC Contract Number A--1Ona <br />ProjactNumberET 29—F.112—ani & nn� <br />No. of Months in Fiscel Year 1 <br />Type of Project: <br />DEPOSITARY BANK (Name, Address and Account Number) <br />Southeast Bank, N.A. , Vero Beach Banking Center, <br />P.O. BOX 40, V. B. Fl. 32960, A/C# 107-453490 <br />EXISTING NEW REHAB. <br />e. Number of Units Under Lease to Eligible Families as of Date of Requisition <br />b. Estimated Number of Units to be under Lease at End of Requested Quarter 1 9 n <br />c. Average Monthly Housing Assistance Payment Per Unit as of Date of Requisition 168 <br />ll) <br />ESTIMATE OF <br />REQUIRED <br />ANNUAL <br />CONTRIBUTIONS <br />(2) <br />TOTAL COST <br />INCURRED <br />TO DATE <br />(3) <br />ESTIMATED <br />ADDTITO END TOTAL <br />COSDESCRIPTION <br />OF REQUESTED <br />QUARTER <br />(4 <br />CUMULATIVE <br />FUNDS <br />REQUIRED <br />(5) <br />PRELIMINARY ADMINISTRATIVE EXPENSE <br />I. Preliminary Administrative Expense—Prior to ACC (Account 4010) <br />0 <br />0 <br />2. Preliminary Administrative Expense—After ACC (Account 4012) <br />3. Total Preliminary Adminittrathre Expense (Lines 1 & 2) <br />NONEXPENDABLE EQUIPMENT <br />4. Replacement of Nonexpendable Equipment (Account 7520) <br />0 <br />5. Property Betterments and Additions (Account 7540)0 <br />0 <br />0 <br />0 <br />6. Total Nonexpendable Equipment (Lines 4 d 5) <br />HOUSING ASSISTANCE PAYMENTS <br />7. Housing Assistance Payments (Account 4715) <br />478,402 <br />ADMINISTRATIiiE FEE <br />8. Total Administrative Fee Approved for Fiscal Year <br />67,298 <br />8. Monthly Rate of Administrative Fee (Line 8 dipided by number of months <br />In fiscal year) <br />5,608- <br />10. Amount Previously Requisitioned for fiscal year <br />11. Esdmeted Additional Amount Required to end of Requested Quarter <br />12. Total Administrative Fee (Lines 10 d 11) <br />INDEPENDENT PUBLIC ACCOUNTANT AUDIT COSTS (section 8 only) <br />13. Total Independent Public Accountant Audit Costs <br />29500 <br />, <br />0 --I <br />SECURITY AND UTILITY DEPOSITS (Section 23 only) <br />14. Total Allowance Approved for Security and Utility Deposits <br />15. Amount Previously Requisitioned for Fiscal Year <br />16. Estimated Additional Amount Required to End of Requested Quarter <br />17. Total Security and Utility Deposits (Lines 15 & 16) <br />0 <br />j <br />0 <br />0 <br />0 <br />AMOUNT OF THIS REQUISITION <br />18. Total Funds Required to End of Requested Quarter (Lines 3, 6, 7, 12, <br />13& 17) <br />19.. Total Partial Payments Received for Fiscal Year to Date <br />112, 584 <br />0 <br />20. Partial Payment Requested (Line 18 minus Line 19) <br />IST <br />ALMENT <br />2NO <br />INSTALMENT <br />3RD <br />INSTALLMENT <br />TOTAL <br />METHOD OF PAYMENT <br />21. Requested Installment Payments <br />F7L <br />7 5 2 8 <br />37,528 <br />1 CERTIFY that housing asalstance payments have been or will be made only with respect to units which: (1) are under leas by Familia at the time such <br />houskv assistance payments are made except as otherwise provided in the Housing Atobtance Payments Contracts and (2) the Housing Agency has within <br />one year prior to the making Of such housing assistance payments, adequately Imported or caused to be irapaoli" (including inspection of "rounds, facilities. <br />and areas for the benefit and use of the Families) to assure that decent. sato and sanitary housing ccsbmrtlodatiOro are being provided; that all applicable Pro- <br />visions of the above numbered Contrast have been complied with by the Housing Agency; and that this requisition for annual contributions ha been exam- <br />Inad by mo and to the bat of my knowledge and belief it is true, correct and complete. <br />August 8, 1984 (No of Pum Hous A"en <br />(Date) (Sigma -and Title of official Authorized t rtify) <br />HUD FIELD OFFICE APPROVAL <br />(Signature and Title of Official Authorised to Appraoe) (Date) <br />REGIONAL ACCOUNTING DIVISION <br />Prevalidaiedby: <br />PAYMENTA <br />FOR <br />MONTH OF <br />APIONT <br />DATE <br />CERTIFIED FOR <br />PAYMENT <br />CERTIFIED <br />BY <br />(initials) <br />(Signature) <br />(Date) <br />TOJW <br />Replaces Form HUD -52663 dated June 1974. <br />S V U-7,900 <br />