Section 3. Households Household Area Median Income Report the area median income(s) for all households served with HOPWA housing subsidy assistance. Data Check: The total number of households served with HOPWA housing subsidy assistance should equal Part 3C, Row 7, Column [1] and Part 3A, Section 1, Chart a (Total HOPWA Eligible Individuals Served with HOPWA Housing Subsidy Assistance). Note: Refer to for information on area median income in your community. Households Served with HOPWA Housing Subsidy Percentage of Area Median Income Assistance 1. 0-30% of area median income (extremely low) 2. 31-50% of area median income (very low) 3. 51-80% of area median income (low) 4. Total (Sum of Rows 1-3) Part 3: Summary Overview of Grant Activities B. Sources of Leveraging and Program Income Sources of Leveraging Report the source(s) of cash or in-kind leveraged federal, state, local or private resources identified in the grant proposal/renewal application and used in the delivery of the HOPWA program and the amount of leveraged dollars. In Column [1], identify the type of leveraging. Some common sources of leveraged funds have been provided as a reference point. You may add Rows as necessary to report all sources of leveraged funds. Include Resident Rent payments paid by clients directly to private landlords. Do NOT include rents paid directly to a HOPWA program as this will be reported in the next section. In Column [2] report the amount of leveraged funds expended during the operating year. Use Column [3] to provide some detail about the type of leveraged contribution (e.g., case management services or clothing donations). In Column [4], check the appropriate box to indicate whether the leveraged contribution was a housing subsidy assistance or another form of support. a. Source of Leveraging Chart [2] Amount of [3] Type of [4] Housing Subsidy [1] Source of Leveraging Leveraged Funds Contribution Assistance or Other Support Public Funding Housing Subsidy Assistance Other Support Ryan White-Housing Assistance Housing Subsidy Assistance Ryan White-Other Other Support Housing Subsidy Assistance Housing Choice Voucher Program Other Support Housing Subsidy Assistance Low Income Housing Tax Credit Other Support Housing Subsidy Assistance HOME Other Support Housing Subsidy Assistance Continuum of Care Other Support Housing Subsidy Assistance Emergency Solutions Grant Other Support Housing Subsidy Assistance Other Support Other Public:
Section 3. Households Household Area Median Income Report the area median income(s) for all households served with HOPWA housing subsidy assistance. Data Check: The total number of households served with HOPWA housing subsidy assistance should equal Part 3C, Row 7, Column [1] and Part 3A, Section 1, Chart a (Total HOPWA Eligible Individuals Served with HOPWA Housing Subsidy Assistance). Note: Refer to for information on area median income in your community. Percentage of Area Median Income Households Served with HOPWA Housing Subsidy Assistance 1. 0-30% of area median income (extremely low) 2. 31-50% of area median income (very low) 3. 51-80% of area median income (low) 4. Total (Sum of Rows 1-3) Part 3: Summary Overview of Grant Activities B. Sources of Leveraging and Program Income Sources of Leveraging Report the source(s) of cash or in-kind leveraged federal, state, local or private resources identified in the grant proposal/renewal application and used in the delivery of the HOPWA program and the amount of leveraged dollars. In Column [1], identify the type of leveraging. Some common sources of leveraged funds have been provided as a reference point. You may add Rows as necessary to report all sources of leveraged funds. Include Resident Rent payments paid by clients directly to private landlords. Do NOT include rents paid directly to a HOPWA program as this will be reported in the next section. In Column [2] report the amount of leveraged funds expended during the operating year. Use Column [3] to provide some detail about the type of leveraged contribution (e.g., case management services or clothing donations). In Column [4], check the appropriate box to indicate whether the leveraged contribution was a housing subsidy assistance or another form of support. a. Source of Leveraging Chart [1] Source of Leveraging [2] Amount of Leveraged Funds [3] Type of Contribution [4] Housing Subsidy Assistance or Other Support Public Funding Ryan White-Housing Assistance Housing Subsidy Assistance Other Support Ryan White-Other Housing Subsidy Assistance Other Support Housing Choice Voucher Program Housing Subsidy Assistance Other Support Low Income Housing Tax Credit Housing Subsidy Assistance Other Support HOME Housing Subsidy Assistance Other Support Continuum of Care Housing Subsidy Assistance Other Support Emergency Solutions Grant Housing Subsidy Assistance Other Support Other Public: Housing Subsidy Assistance Other Support
hopwa-apr-form-hud-40110-c.docx