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_ U.S. DEPARTMENT OF HOUSING ANn URBAN DEVELOPMENT'' —_ FOR HUD USE ONLY <br />• REGUISITION FOR PARTIAL PAYM=ANNUAL CONTRIBUTIONS <br />HOUSING ASSISTANCE PAYMENTS PROGRAM Voucher Number <br />SECTION 23 [3 SECTION B 0 <br />Date of Requisition 10 / 18 / 8 4 Fiscal Year Ending Date 9 / 3 0 f 8 5 For Quarter Ending f 1 / R 5 <br />NAME AND ADDRESS OF PUBLIC HOUSING AGENCY (including ZIP Code) <br />Indian River County Board of County Commissioners <br />ACC Contract Number A-3409 <br />Project Number FL29—E132-001,002,0 <br />1840 25th St., S-319, Vero Beach, Fla. 32960 <br />No. of Months in Fiscal Year 12 <br />Type of Project: <br />DEPOSITARY BANK (Name, Address and Account Number) <br />Southeast Bank, N.A. , Vero Beach Banking Center <br />Box 40, Vero Beach, Fla. 32960,A/C #107-453490 <br />EREXISTING 0NEW REHAB. <br />a. Number of Units Under Lease to Eligible Families as of Date of Requisition 173 <br />b. Estimated Number of Units to be under Lease at End of Requested Quarter 200 <br />c. Average Monthly Housing Assistance Payment Per Unit as of Date of Requisition 175 <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 END <br />OF REQUUESTED <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 />NEEL <br />1. Preliminary Administrative Expense—Prior to ACC (Account 4010) 1 <br />0 <br />n <br />a <br />2.351 <br />2. Preliminary Administrative Expense—After ACC (Account 4012) <br />3 <br />3. Total Preliminary Administrative Expense (Lines 1 & 4 <br />NONEXPENDABLE EQUIPMENT <br />4. Replacement of Nonexpendable Equipment (Account 7520) <br />0 <br />5. Property Betterments and Additions (Account 7540) <br />4,249 <br />0 <br />6.. Total Nonexpendable Equipment (Lines 4 d S) <br />HOUSING ASSISTANCE PAYMENTS <br />7. Housing Assistance Payments (Account 4715) <br />595,870 <br />ADMINISTRATIVE FEE <br />B. Total Administrative Fee Approved for Fiscal Year <br />78,106 <br />6,509 <br />9. Monthly Rete of Administrative Fee (Line 8 dipided by number• of months <br />in fiscal year) <br />10. Amount Previously Requisitioned for fiscal year <br />16,824 <br />19,527 <br />11. Estimated Additional Amount Required to and of Requested Quarter <br />36,351 <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 />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 />= <br />0 <br />0 <br />0 <br />17. Total Security and Utility Deposits (Lines 15 & 16) <br />AMOUNT OF THIS REQUISITION <br />X <br />18. Total Funds Required to End of Requested Quarter (Lines 3, 6, 7, 12, <br />13d 17) <br />236,898 <br />112,584 <br />19. Total Partial Payments Received for Fiscal Year to Date <br />124,314 <br />20. Partial Payment Requested (Line 18 minus Line 19) <br />IST <br />INSTALLMENT <br />2ND <br />INSTALLMENT <br />3RD <br />INSTALLMENT <br />TOTAL <br />METHOD OF PAYMENT <br />21. Requested installment Payments <br />41 .438 <br />41,438 <br />1 41,438 <br />124,-414 <br />1 CERTIFY that housing assistance payments have been or will be made only with respect to units which: (1) are under lease by Families at the time such <br />housing assistance payments are made except as otherwise provided in the Housing Assistance Payments Contracts and 12) the Housing Agency has within <br />one year prior to the making of such housing assistance payments. adequately inspected or caused to be inspected (including Inspection of grounds, facilities; <br />and areas for the benefit and use of the Families) to assure that decent, safe and sanitary housing accommodations are being provided; that all applicable pre- <br />visions of the above numbered Contract have been complied with by the Housing Agency; and that this requisition for annual contributions has been exam <br />Ined by me and to the beat of my knowledge and belief it is true, correct and '"'91-d of County Commissioners <br />November 7, 1984 ame of public x sing A ncy <br />(Date) (Signature and Title of Official AuthoKzed to Certify) <br />HUD FIELD OFFICE APPROVAL <br />(Signature and Title of Official Authorized to Approue) (Date) <br />REGIONAL ACCOUNTING DIVISION <br />Prevalidatedby: <br />PAYMENT <br />FOR <br />MONTH OF <br />APAIDNT <br />DATE <br />CERTIFIED FOR <br />PAYMENT <br />CERTIFIED <br />BY_I <br />(Initias) <br />(Signature) <br />(Date) <br />TOTAL <br />Replaces Form HND -52663 dated June 1974. 13'` <br />L- Nov 7 1984 BooK 58 pnF 759 <br />