3. HTF Rental Set-Aside (check all that apply) 4. DISTRICT INDICATOR-(Select only ONE) Congressional District 1 Permanent Housing (Continuum of Care) Congressional District 2 Balance of State CoC, Region Congressional District 3 Lincoln CoC 5. SERVICE AREA Omaha CoC Area to be served [city and county]. Please list: Targeted Needs Description of Targeted Needs: Nebraska Legislative District(s) Nebraska Congressional District(s) 7. HOUSEHOLD BENEFICIARIES # at or below 30% of the Area Median Family Income 6. TYPE OF APPLICANT # Total Non-Profit 501(c)(3) Non-Profit 501(c)(4) Single Family - # of units at or below 30% AMI Non-Profit 501(c)(3) CHDO Non-Profit 501(c)(4) CHDO Duplex - # of units at or below 30% AMI Public Housing Authority Multi-Family - # of units at or below 30% AMI 8. CERTIFYING OFFICIAL: To the best of my knowledge and belief, data and information in this application is true and correct, including any commitment of local or other resources. The governing body of the applicant has duly authorized this application. This applicant will comply with all Federal and state requirements governing the use of HTF funds. UPLOAD THE SCANNED COPY of the HTF TO: 9. SUBMIT THE ORIGINAL HTF TO: Nebraska Department of Economic Development Housing Coordinator Housing and Community Development 301 Centennial Mall South - PO Box 94666 Pamela Otto, Lincoln, NE 68509-4666 Individuals, who are hearing and/or speech impaired and have a TTY, may contact the Department through the Statewide Relay System by calling (800) 833-7352 (TTY) or (800) 833-0920 (voice). The relay operator should be asked to call DED at (800) 426-6505 or (402) 471-3111. HTF PROGRAM PART II. FUNDING SUMMARY Code Activity HTF Funds Non-Federal Total Source(s) of Funding Funds Project Sources Financing 0520 Acquisition of Property 0521 Acquisition of Vacant Land 0522 Demolition SF Housing Rental 0541 Rehabilitation SF Housing New 0544 Construction Rental 0561 MF Rehabilitation 0562 MF New Construction Subtotal 0581 Rent-up Reserves 0582 Operating Reserves
3. HTF Rental Set-Aside (check all that apply) Permanent Housing (Continuum of Care) Balance of State CoC, Region Lincoln CoC Omaha CoC Targeted Needs Description of Targeted Needs: 4. DISTRICT INDICATOR-(Select only ONE) Congressional District 1 Congressional District 2 Congressional District 3 5. SERVICE AREA Area to be served [city and county]. Please list: Nebraska Legislative District(s) Nebraska Congressional District(s) 7. HOUSEHOLD BENEFICIARIES # at or below 30% of the Area Median Family Income # Total Single Family - # of units at or below 30% AMI Duplex - # of units at or below 30% AMI Multi-Family - # of units at or below 30% AMI 6. TYPE OF APPLICANT Non-Profit 501(c)(3) Non-Profit 501(c)(3) CHDO Non-Profit 501(c)(4) Non-Profit 501(c)(4) CHDO Public Housing Authority 8. CERTIFYING OFFICIAL: To the best of my knowledge and belief, data and information in this application is true and correct, including any commitment of local or other resources. The governing body of the applicant has duly authorized this application. This applicant will comply with all Federal and state requirements governing the use of HTF funds. 9. SUBMIT THE ORIGINAL HTF TO: UPLOAD THE SCANNED COPY of the HTF TO: Nebraska Department of Economic Development Housing Coordinator Housing and Community Development 301 Centennial Mall South - PO Box 94666 Lincoln, NE 68509-4666 Pamela Otto, Individuals, who are hearing and/or speech impaired and have a TTY, may contact the Department through the Statewide Relay System by calling (800) 833-7352 (TTY) or (800) 833-0920 (voice). The relay operator should be asked to call DED at (800) 426-6505 or (402) 471-3111. HTF PROGRAM PART II. FUNDING SUMMARY Code Activity HTF Funds Non-Federal Funding Sources Total Funds Source(s) of Project Financing 0520 Acquisition of Property 0521 Acquisition of Vacant Land 0522 Demolition 0541 SF Housing Rental Rehabilitation 0544 SF Housing New Construction Rental 0561 MF Rehabilitation 0562 MF New Construction Subtotal 0581 Rent-up Reserves 0582 Operating Reserves