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,Jp•a26a3 -(0.751 1 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD USE ONLY • REQUISITION FOR PARTIAL PAYMENT OF ANNUAL CONTRIBUTIONS HOUSING ASSISTANCE PAYMENTS PROGRAM V7oueherNumber SECTION 23 SECTION 8 Date of Requisition 4.05.18-5 Fiscal Year Ending Date g/3Q/R5For Quarter Ending NAME AND ADDRESS OF PUBLIC HOUSING AGENCY (Ineludinr Zip Code) Indian River County Board of County Commissioners 1840 25th St., Suite S-319, Vero Beach, Fla. 32960-33 DEPOSITARY BANK (Name, Address and Account Number) Southeast Bank, N.A. Vero Beach Banking Center Box 40, Vero Beach, Fla. 32960, A/C #107-453490 a. Number of Units Under Lease to Eligible Families as of Date of Requisition b. Estimated Number of Units to be under Lease at End of Requested Quarter e. Average Monthly Housing Assistance Payment Per Unit as of Date of Requisition DESCRIPTION ACC Contract Number H-3r+vy Project NumberFL29-E132-001 & M No. of Months In Fiscal Year 12 Typo of Project: 10 EXISTING [] NEW L REHAB. ESTIMATE OF REQUIRED TOTAL COST ANNUAL INCURRED Ynp"RIRUTtONS TO DATE PRELIMINARY ADMINISTRATIVE EXPENSE 0 1. Preliminary Administrative Expense—Prior to ACC (Account 40101 0 2. Preliminary Administrative Expense—After ACC (Account 4012) 0 3. Total Preliminary Administrative Expense (Lines I d 2) NONEXPENDABLE EQUIPMENT 4. Replacement of Nonexpendable Equipment (Account 75201 5. Property Betterments and Additions (Account 75401 S. Total Nonexpendable Equipment (Lines 4 d S) HOUSING ASSISTANCE PAYMENTS PO -7. Housing Assistance Payments (Account 4715) 478 ADMINISTRATIVE FEE B. Total Administrative Fee Approved for Fiscal Year 9. Monthly Rete of Administrative Fee (Line 8 dipided by number of months 1n fiscal ym) 10. Amount Previously Requisitioned for fiscal year 11. Estimated Additional Amount Required to end of Requested Quarter 12. Total Administrative Foe (Lincs 10 d 11) INDEPENDENT PUBLIC ACCOUNTANT AUDIT COSTS (Section 8 only) 2, 500 13. Total -independent Public Accountant Audit Costs SECURITY AND UTILITY DEPOSITS (Section 23 only) 14. Total Allowance Approved for Security and Utility Deposits 0 15. Amount Previously Requisitioned for Fiscal Year 16. Estimated Additional Amount Required to End of Requested Quarter. 17. Total Security and Utility Deposits (Lines 15 d 16) 175 90 189 STIMATEO I CUMULATIVE DDITIONAL TOTAL )ST TO END FUNDS REQUESTED QUARTER REQUIRED AMOUNT OF THIS REQUISITION 16. Total Funds Required to End of Requested Quarter (Lines 3. 6. 7. 12. 13 d 171 18. Total Partial Payments Received for Fiscal Year to Date A/ 20. Partial Payment Requested (Line 18 minus Line 19) IST 2ND 3RD 0 0 -- U 452,668� J33 117.590 TOTAL METHOD OF PAYMENT INSTALLMENT INSTALLMENT INSTALLMENT 21. Requested Installment Payments 39.1 39 1 T17 39,197, 1 CERTIFY that housing assistance payments have bean or will be made only with respect to units which; 111 are under lease by Families at the time such housing assistance payments are mode except as otherwise provided in the Housing Assistance Payments Contracts and 12) the Housing Agency has within one year prior to die making of such housing assistance payments, adequately inspected or caused to be inspected (Including Inspection of grounds. faculties. 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 pro- visions of the above numbered Contract have been complied with by the Housing Agency; and the his requisition for annual contributions has been exam- ined by me and to the best of my knowledge and belief it is true, correct and comploedrd yrl unty CoMmissioners May 8, 1985 (Date) HUD FIELD OFFICE APPROVAL .....� »d avtle nt Ulfinml Anthorizrd to ADDrot•e) and Tulle off Of'ficW Authorized to (Date) REGIONAL ACCOUNTING DIVISIONPAYMENT Prevelidated by: FOR MONTH OF AMOUNT PAID DATE CERTIFIED FOR PAYMENT CERTIFIED BY (Jnit(ab) (Signature) (Date) TOTAL HUD -526( A�ep�ces F�rm HUD -52663 dated June 1974. BOOK 6 0 80 4