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Instructions for Preparation of Form HUD -50075 -HCV Annual PHA Plan for HCV Only PHAs A. PHA Information. All PHAs must complete this section. (24 CFR 4903.23(4)(e)) A.1 Include the full PHA Name, PHA Code, PHA Type, PHA Fiscal Year Beginning (MM/YYYY), Number of Housing Choice Vouchers (HCVs), PHA Plan Submission Type, and the Availability of Information, specific location(s) of all information relevant to the public hearing and proposed PHA Plan. PHA Consortia: Check box if submitting a Joint PHA Plan and complete the table. (24 CFR 4943 128(a)) B. Annual Plan. All PHAs must complete this section. (24 CFR 4903.11(c)(3)) B.1 Revision of PHA Plan Elements. PHAs must: no revisions of the plan have been implemented; Identify specifically which plan elements listed below that have been revised by the PHA. To specify which elements have been revised, mark the "yes" box. If an element has not been revised, mark "no." ❑ Housing Needs and Strategy for Addressing Housing Needs. Provide a statement addressing the housing needs of low-income, very low-income families who reside in the PHA's jurisdiction and other families who are on the Section 8 tenant -based waiting list. The statement must identify the housing needs of (i) families with incomes below 30 percent of area median income (extremely low-income), (ii) elderly families and families with disabilities, and (iii) households of various races and ethnic groups residing in the jurisdiction or on the waiting list based on information provided by the applicable Consolidated Plan, information provided by HUD, and other generally available data. The identification of housing needs must address issues of affordability, supply, quality, accessibility, size of units, and location. (24 CFR 4903.7(a)(1) and 24 CFR §903.7(a)(2)(i)). Provide a description of the PHA's strategy for addressing the housing needs of families in the jurisdiction and on the waiting list in the upcoming year. 24 CFR 4903.7(a)(2)(ii) No CHANGES TO THE HOUSING NEEDS AND STRATEGY -ATTACHED ❑ Deconcentration and Other Policies that Govern Eligibility, Selection, and Admissions. A statement of the PHA's policies that govern resident or tenant eligibility, selection and admission including admission preferences for HCV. (24 CFR 4903.7(b)) N/A ❑ Financial Resources. A statement of financial resources, including a listing by general categories, of the PHA's anticipated resources, such as PHA HCV funding and other anticipated Federal resources available to the PHA, as well as tenant rents and other income available to support tenant -based assistance. The statement also should include the non -Federal sources of funds supporting each Federal program, and state the planned use for the resources. (24 CFR 4903.7(c)) ONLY RECEIVE HUD FUNDING FOR HCV — ATTACHED ❑ Rent Determination. A statement of the policies of the PHA governing rental contributions of families receiving tenant -based assistance, discretionary minimum tenant rents , and payment standard policies. (24 CFR 4903.7(d)) ADDRESSED IN THE ADMINISTRATIVE POLICY ❑ Operation and Management. A statement that includes a description of PHA management organization, and a listing of the programs administered by the PHA. (24 CFR 4903.7(0(3)(4)). OPERATED BY THE COUNTY ❑ Informal Review and Hearing Procedures. A description of the informal hearing and review procedures that the PHA makes available to its applicants. (24 CFR 4903.7(8) ADDRESSED IN THE ADMINISTRATIVE POLICY ❑ Homeownership Programs. A statement describing any homeownership programs (including project number and unit count) administered by the agency under section 8y of the 1937 Act, or for which the PHA has applied or will apply for approval. (24 CFR 4903.7(k)) N/A ❑ Self Sufficiency Programs and Treatment of Income Changes Resulting from Welfare Program Requirements. A description of any PHA programs relating to services and amenities coordinated, promoted, or provided by the PHA for assisted families, including those resulting from the PHA's partnership with other entities, for the enhancement of the economic and social self-sufficiency of assisted families, including programs provided or offered as a result of the PHA's partnerships with other entities, and activities under section 3 of the Housing and Community Development Act of 1968 and under requirements for the Family Self -Sufficiency Program and others. Include the program's size (including required and actual size of the FSS program) and means of allocating assistance to households. (24 CFR 4903.7(1)(i)) Describe how the PHA will comply with the requirements of section 12(c) and (d) of the 1937 Act that relate to treatment of income changes resulting from welfare program requirements. (24 CFR 4903.7(l)(iii)). N/A ❑ Substantial Deviation. PHA must provide its criteria for determining a "substantial deviation" to its 5 -Year Plan. (24 CFR 4903.7(r)(2)(i)) ATTACHED NO REVISIONS ❑ Significant Amendment/Modification. PHA must provide its criteria for determining a "Significant Amendment or Modification" to its 5 -Year and Annual Plan. Should the PHA fail to define `significant amendment/modification', HUD will consider the following to be `significant amendments or modifications': a) changes to rent or admissions policies or organization of the waiting list; or b) any change with regard to homeownership programs. See guidance on HUD's website at: Notice PIH 1999-51. (24 CFR 4903.7(r)(2)(ii)) NO REVISIONS If any boxes are marked "yes", describe the revision(s) to those element(s) in the space provided. B.2 New Activity. If the PHA intends to undertake new activity using Housing Choice Vouchers (HCVs) for new Project -Based Vouchers (PBVs) in the current Fiscal Year, mark "yes" for this element, and describe the activities to be undertaken in the space provided. If the PHA does not plan to undertake this activity, mark "no." (24 CFR 4983.57(b)(1) and Section 8(13)(C) of the United States Housing Act of 1937. N/A ❑ Project -Based Vouchers (PBV). Describe any plans to use HCVs for new project -based vouchers. If using PBVs, provide the projected number of project -based units and general locations, and describe how project -basing would be consistent with the PHA Plan. Page 4 of 5 form HUD -50075 -HCV (12/2014)