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Form SHIP AR/2009 <br />67-37.008(3)(f), F.A.C. <br />Effective Date: 11/2009 <br />Form 3 <br />Number of Households/Units Produced <br />Strategy <br />List Unincorporated <br />and Each <br />Municipality <br />ELI <br />VLI <br />Low <br />Mod <br />Total <br />Purchase Assistance <br />with Rehab <br />Indian River County <br />Total <br />Purchase Assistance <br />with Rehab <br />1 <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />1 <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />Indian River County <br />1 <br />1 <br />1 <br />1 <br />1 <br />Totals: <br />Characteristics/Age (Head of Household) <br />2 <br />Description <br />List Unincorporated <br />and Each <br />Municipality <br />0 <br />- 25 <br />26 <br />- 40 <br />41 <br />- 61 <br />62+ <br />Total <br />Purchase Assistance <br />with Rehab <br />Indian River County <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />1 <br />1 <br />1 <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />1 <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />Indian River County <br />1 <br />1 <br />1 <br />1 <br />Totals: <br />Family Size <br />1 <br />1 <br />Description <br />List Unincorporated <br />and Each <br />Municipality <br />1 <br />Person <br />2- 4 <br />People <br />5 + <br />People <br />Total <br />Purchase Assistance <br />with Rehab <br />Indian River County <br />1 <br />Purchase Assistance <br />with Rehab <br />Indian River County <br />1 <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />Indian River County <br />1 <br />1 <br />Totals: <br />Race (Head of Household) <br />1 <br />1 <br />2 <br />2 <br />Description <br />List Unincorporated <br />and Each <br />Municipality <br />White <br />Black <br />Hisp- <br />anic <br />Asian <br />Amer - <br />Indian <br />Other <br />Total <br />Purchase Assistance <br />with Rehab <br />Indian River County <br />1 <br />1 <br />Purchase Assistance <br />with Impact Fee <br />Loan <br />Indian River County <br />1 <br />1 <br />Totals: <br />Demographics (Any Member of Household) <br />1 <br />Page 4 <br />1 <br />