Form HUD-52737 (Excel) HUD-52737 (Excel) Indian Housing Plan/Annual Performance Report

Indian Housing Block Grants (IHBG) Program Reporting

Copy of Excel HUD-52737.xls

Indian Housing Block Grants (IHBG) Program Reporting

OMB: 2577-0218

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Section 1
Section 2
Section 3 (1)
Section 4
Section 5
Section 6
Section 7
Section 8
Section 9
Section 10
Section 11
Section 12
Section 13
Section 14
Section 15

Sheet 1: Instructions


































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 2: Section 1
SECTION 1: COVER PAGE




Enter number of the grant covered by the IHP and APR sections of the form. (1) Grant Number:




Use the drop down menu to select the start and end dates that correspond with the IHP and APR. If selected "Other" identify the start and end dates in the space below. (2) Recipient Program Year:



Enter the Federal Fiscal Year that corresponds with the IHP and APR. (3) Federal Fiscal Year:




Check this box if the submission is an Initial IHP. Complete all portions of the form highlighted in yellow. (4) Initial Plan (Complete this Section then proceed to Section 2)



Check this box if the submission is an Amended IHP. Then check the appropriate box below to identify whether the IHP or APR portion of the amendement is to be completed. Complete the yellow portions for the IHP amendments and the green portions for the APR. (5) Amended Plan (Complete this Section, Section 8 if applicable, and Section 16)

Check this box if the submission is an APR. Complete all portions of the form highlighted in green. (6) Annual Performance Report (Complete items 27-30 and proceed to Section 3)



Check this box if the recipient is a tribe. (7) Tribe




Check this box if the recipient is a TDHE. (8) TDHE




Enter the name of the tribe or TDHE. (9) Name of Recipient:


Enter the contact person’s name. (10) Contact Person:


Enter the contact person’s telephone number. (11) Telephone Number with Area Code:

Enter the contact person’s mailing address. (12) Mailing Address:




(13) City: (14) State: (15) Zip Code:



Enter the contact person’s fax number. (16) Fax Number with Area Code (if available):

Enter the contact person’s email address. (17) Email Address (if available):

If the recipient is a TDHE working on behalf of one or more tribes, list the tribes covered by the IHP or APR. If the TDHE is an umbrella organization submitting one IHP or APR on behalf of multiple tribes, each of the tribes must be listed on Line 18. (18) If TDHE, List Tribes Below:

Enter the DUNS number for the recipient. (20) DUNS Number:
Enter the date that the recipient’s Central Contractor Registration (CCR) number expires. (21) CCR/SAM Expiration Date:
Enter the recipient’s actual or estimated amount of IHBG formula funds. (22) IHBG Fiscal Year Formula Amount:
Enter the name and title of the person authorized to submit the IHP. (23) Name of Authorized IHP Submitter:
Enter the title of the person authorized to submit the IHP. (24) Title of Authorized IHP Submitter:
The person authorized to submit the IHP must sign the IHP submission. (25) Signature of Authorized IHP Submitter:
Enter the date of the IHP submission. (26) IHP Submission Date:
Enter the name of the person authorized to submit the APR. (27) Name of Authorized APR Submitter:
Enter the title of the person authorized to submit the APR. (28) Title of Authorized APR Submitter:
The person authorized to submit the APR must the APR submission. (29) Signature of Authorized APR Submitter:
Enter the date of the APR submission. (30) APR Submission Date:









Certification: The information contained in this document is accurate and reflects the activities actually planned or accomplished during the program year. Activities planned and accomplished are eligible under applicable statutes and regulations.



Warning: If you knowingly make a false statement on this form, you may be subject to civil or criminal penalties under Section 1001 of Title 18 of the United States Code. In addition, any person who knowingly and materially violates any required disclosure of information, including intentional disclosure, is subject to a civil money penalty not to exceed $10,000 for each violation.

Sheet 3: Section 2
ONE YEAR PLAN & ANNUAL PERFORMANCE REPORT




The purpose of this section is to identify the types of housing needs that the recipient has identified for low-income Indian families and all Indian families in the tribe’s jurisdiction. SECTION 2: HOUSING NEEDS


NAHASDA § 102(b)(2)(B)






(1)   Type of Need: Check the appropriate box(es) below to describe the estimated types of housing needs and the need for other assistance for low-income Indian families (column B) and all Indian families (column C) inside and outside the jurisdiction.




Check the appropriate boxes in Column B and C to identify the types of housing need.
Check as many or as few needs as are applicable to the recipient’s community. Check All That Apply
(A) Check the boxes that describe the estimated types of housing needed and the need for other housing-related assistance for low-income Indian families in the tribe’s jurisdiction (those earning less than 80 percent of median income). This list should reflect the needs of all low-income Native Americans in the jurisdiction, including tribal and non-tribal members. Check as many or as few needs as are applicable to the recipient’s community. (B) Check the boxes that describe the estimated types of housing needed and the need for other housing-related assistance for all Indian families in the tribe’s jurisdiction, including non-low-income families. (C)
Type of Need



Low-Income Indian Families All Indian Families
(1)     Overcrowded Households


(2)     Renters Who Wish to Become Owners
(3)     Substandard Units Needing Rehabilitation

(4)     Homeless Households

(5)     Households Needing Affordable Rental Units
(6)     College Student Housing
(7)     Disabled Households Needing Accessibility

(8)     Units Needing Energy Efficiency Upgrades
(9)     Infrastructure to Support Housing
(10)  Other (specify below)








If “Other” was checked for Line 1, describe the specific housing needs that are not included among the other types of need. This line should include a description of the housing needs of low-income and non-low-income Indian families in the tribe’s jurisdiction, as applicable. If desired, use the "Add Bullet" button for listing other needs. (2)   Other Needs. (Describe the “Other” needs below. Note: this text is optional for all needs except “Other.”):



Describe how the One-Year IHP’s planned IHBG programs will address the affordable housing needs identified in Lines 1 and 2. For example, if the recipient checked that there is a need for college housing, it would then describe how the recipient’s planned program(s) addresses this need. For many tribes, affordable housing need far exceeds funding, and so it is not expected that all identified needs will be able to be addressed through the One-Year Plan. If desired, use the "Add Bullet" button for listing planned program benefits. (3) Planned Program Benefits. (Describe below how your planned programs and activities will address the needs of low income families identified above. Also describe how your planned programs will address the various types of housing assistance needs. NAHASDA § 102(b)(2)(B)):



Describe how the program intends to distribute assistance throughout the geographic area, and how this ties to the housing needs of low-income families. For example, if the recipient intends to focus its rental housing program on buying units in a nearby county, the recipient should explain that this distribution of assistance meets the needs of low-income tribal members living in that area. If desired, use the "Add Bullet" button for listing and describing geographic distributions. (4)   Geographic Distribution. (Describe below how the assistance will be distributed throughout the geographic area and how this geographic distribution is consistent with the needs of low income families. NAHASDA § 102(b)(2)(B)(i)):

Sheet 4: Section 3 (1)
SECTION 3: PROGRAM DESCRIPTIONS In this section, the recipient must provide a description of its planned eligible activities, and intended outcomes and outputs for the One-Year IHP. The recipient can select any combination of activities eligible under NAHASDA and intended outcomes and outputs that are based on local needs and priorities. There is no maximum or minimum number of eligible activities or intended outcomes and outputs. Rather, the One-Year IHP should include a sufficient number of eligible activities and intended outcomes to fully describe any tasks that the recipient intends to fund in whole or in part with IHBG funds, IHBG program income, and Title VI funds during the coming program year. Subtitle B of NAHASDA authorizes recipients to establish a program for self-determined housing activities involving construction, acquisition, rehabilitation, or infrastructure relating to housing activities or housing that will benefit the low-income households served by the Indian tribe. A recipient may use up to 20 percent of its annual allocation, but not more than $2 Million, for this program. Section 233(a) of NAHASDA requires a recipient to include its planned self-determination program activities in the IHP, and Section 235(c) requires the recipient to report the expenditures, outputs, and outcomes for its self-determination program in the APR. For more information, see PIH Notice 2010-35 (Demonstration Program - Self-Determined Housing Activities for Tribal Governments) at http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_8814.pdf The One-Year IHP is not required to include eligible activities or intended outcomes and outputs that will not receive IHBG funding or will not be funded by IHBG program income or with Title VI funds. For example, the recipient may be planning to apply for Low Income Housing Tax Credits (LIHTC) from its state. If those tax credit projects will not receive IHBG assistance (whether grant funds, program income, or Title VI), they are not required to be described in the IHP. However, the recipient may wish to include non-IHBG activities in the IHP to provide tribal members with a more complete picture of housing activities. • If an activity will receive partial funding from IHBG, IHBG program income, or Title VI, it must be described in the IHP. • For example, if the recipient uses IHBG-funded staff persons to manage, inspect, or maintain an LIHTC-funded rental project, that project would be considered an IHBG-assisted project and the related activities must be described in the IHP. For the IHP, complete the unshaded sections to describe the planned activities, outcomes and outputs in the coming 12-month program year. The recipient must complete Lines 1.1 through 1.10 for each eligible activity or program planned for the One-Year IHP. For the APR, complete the shaded sections to describe actual activities, outcomes, and outputs for the previous 12-month program year. In particular, complete Lines 1.5, 1.8 and 1.10 for each program included in the IHP.
























NAHASDA §§ 102(b)(2)(A), 233(a), 235(c), 404(b); 24 CFR §1000.512


















































Planning and Reporting Program Year Activities
























For the IHP, the purpose of this section is to describe each program that will be operating during the 12-month program year. Each program must include the eligible activity, its planned outputs, intended outcome, who will be assisted, and types and levels of assistance. Each of the eligible activities has a specific, measurable output. The first column in table below lists all eligible activities, the second column identifies the output measure for each eligible activity, and the third column identifies when to consider an output as completed for each eligible activity. Copy and paste text boxes 1.1 through 1.10 as often as needed so that all of your planned programs are included.






















For the APR, the purpose of this section is to describe your accomplishments, actual outputs, actual outcomes, and any reasons for delays.
















































Eligible Activity May Include (citations below all reference sections in NAHASDA):
























Eligible Activity Output Measure Output Completion






















(1) Modernization of 1937 Act Housing [202(1)] Units All work completed and unit passed final inspection






















(2) Operation of 1937 Act Housing [202(1)] Units Number of units in inventory at Program Year End (PYE)






















(3) Acquisition of Rental Housing [202(2)] Units When recipient takes title to the unit






















(4) Construction of Rental Housing [202(2)] Units All work completed and unit passed final inspection






















(5) Rehabilitation of Rental Housing [202(2)] Units All work completed and unit passed final inspection






















(6) Acquisition of Land for Rental Housing Development [202(2)] Acres When recipient takes title to the land






















(7) Development of Emergency Shelters [202(2)] Households Number of households served at any one time, based on capacity of the shelter






















(8) Conversion of Other Structures to Affordable Housing [202(2)] Units All work completed and unit passed final inspection






















(9) Other Rental Housing Development [202(2)] Units All work completed and unit passed final inspection






















(10) Acquisition of Land for Homebuyer Unit Development [202(2)] Acres When recipient takes title to the land






















(11) New Construction of Homebuyer Units [202(2)] Units All work completed and unit passed final inspection






















(12) Acquisition of Homebuyer Units [202(2)] Units When recipient takes title to the unit






















(13) Down Payment/Closing Cost Assistance [202(2)] Units When binding commitment signed






















(14) Lending Subsidies for Homebuyers (Loan) [202(2)] Units When binding commitment signed






















(15) Other Homebuyer Assistance Activities [202(2)] Units When binding commitment signed






















(16) Rehabilitation Assistance to Existing Homeowners [202(2)] Units All work completed and unit passed final inspection






















(17) Tenant Based Rental Assistance [202(3)] Households Count each household once per year






















(18) Other Housing Service [202(3)] Households Count each household once per year






















(19) Housing Management Services [202(4)] Households Count each household once per year






















(20) Operation and Maintenance of NAHASDA-Assisted Units [202(4)] Units Number of units in inventory at PYE






















(21) Crime Prevention and Safety [202(5)] Dollars Dollars spent (report in Uses of Funding Table only)






















(22) Model Activities [202(6)] Dollars Dollars spent (report in Uses of Funding Table only)






















(23) Self-Determination Program [231-235]
























Acquisition Units When recipient takes title to the unit






















Construction Units All work completed and unit passed final inspection






















Rehabilitation Units All work completed and unit passed final inspection






















Infrastructure Dollars Dollars spent (report in Uses of Funding Table only)






















(24) Infrastructure to Support Housing [202(2)] Dollars Dollars spent (report in Uses of Funding Table only)






















(25) Reserve Accounts [202(9)] N/A N/A
















































Outcome May Include:























(1) Reduce over-crowding (7) Create new affordable rental units





















(2) Assist renters to become homeowners (8) Assist affordable housing for college students





















(3) Improve quality of substandard units (9) Provide accessibility for disabled/elderly persons





















(4) Improve quality of existing infrastructure (10) Improve energy efficiency





















(5) Address homelessness (11) Reduction in crime reports





















(6) Assist affordable housing for low income households (12) Other – must provide description in boxes 1.4 (IHP) and 1.5 (APR) below















































IHP: PLANNED PROGRAM YEAR ACTIVITIES (NAHASDA § 102(b)(2)(A))
























For each planned activity, complete all the non-shaded sections below. It is recommended that for each program name you assign a unique identifier to help distinguish individual programs. This unique number can be any number of your choosing, but it should be simple and clear so that you and HUD can track tasks and results under the program and collect appropriate file documentation tied to this program.





















§  One way to number your programs is chronologically. For example, you could number your programs 2011-1,





















2011-2, 2011-3 etc.
























§  Or, you may wish to number the programs based on type. For example rental 1, rental 2, homebuyer1,





















homebuyer 2 etc. This type of numbering system might be appropriate if you have many programs
























that last over several years.
























§  Finally, you may wish to use an outline style of numbering. For example, all programs under your first





















eligible activity would start with the number 1 and then be consecutively numbered as 1.1, 1.2, 1.3 etc.
























The programs under the second eligible activity would be numbered as 2.1, 2.2, 2.3 etc.


















































APR: REPORTING ON PROGRAM YEAR PROGRESS (NAHASDA § 404(b))


















































Complete the shaded section of text below to describe your completed program tasks and actual results. Only report on activities completed during the 12-month program year. Financial data should be presented using the same basis of accounting as the Schedule of Expenditures of Federal Awards (SEFA) in the annual OMB Circular A-133 audit. For unit accomplishments, only count units when the unit was completed and occupied during the year. For households, only count the household if it received the assistance during the previous 12-month program year.















































The program name should easily identify the program and should be unique. It is recommended that a unique identification number be used in front of each One-Year Plan program. This might be especially helpful for tracking similar program types from year to year or within a single 12-month period. This unique number can be any number of the recipient’s choosing, but it should be simple and clear so that staff can track tasks and results under the program and maintain appropriate file documentation tied to this program. • One way to number the programs is chronologically. For example, the recipient could number its programs 2011-1, 2011-2, 2011-3 etc. • Or, the recipient may wish to number the programs based on type. For example rental 1, rental 2, homebuyer 1, homebuyer 2 etc. This numbering system might be appropriate for a recipient with many programs that last over several years. • Finally, the recipient may wish to use an outline style of numbering. For example, all programs under the first eligible activity would start with the number 1 and then be consecutively numbered as 1.1, 1.2, 1.3 etc. The programs under the second eligible activity would be numbered as 2.1, 2.2., 2.3 etc. • Please note that because program administration and loan repayments are already identified on the Uses of Funding Table, a separate program for these two activities should not be included in this Section of the form. 1.1. Program Name and Unique Identifier:






















Summarize each program that will be funded with IHBG funds, IHBG program income, or Title VI funds during the 12-month program year. At a minimum, the recipient must describe what specific type of projects will be developed under the planned program. • Describe how the program will benefit eligible families. • For example, assume that the recipient has chosen the eligible activity of “Tenant Based Rental Assistance” and an intended outcome that will “Assist Affordable Housing for College Students.” The program description might then highlight that the recipient’s program is designed to assist college-bound, eligible Native Americans to pay their rent while attending any university in the state. It might highlight that this program is designed to assist tribal members who wish to become certified teachers or medical professionals, because these professions are needed within the tribal community. The description might also state that the assistance is to be used to pay rent in private-market rental units in the areas surrounding the educational institution, and that the purpose of the program is to enable low-income tribal members to better afford higher education in professional fields that are important to the tribe’s continued well being. The One-Year Plan program descriptions should include any program that will receive IHBG funding (grant, program income, or Title VI) during the upcoming 12-month program year, even if some of the program tasks will take longer than 12 months to complete. In many cases, the recipient may be funding programs on an on-going basis year after year. • For example, some recipients have an on-going program to modernize their 1937 Act rental units. In these instances, the activity should be listed in each One-Year Plan over the entire period of the program. • In some cases, the program will stay the same year to year. In these cases the recipient can simply copy the program/activity description from one IHP to the next year’s IHP. • Be careful to update the budget (Section 5) and planned outputs table (Line 1.9) to reflect the actual volume of work anticipated in the coming year. 1.2. Program Description (This should be the description of the planned program.):






























































Select one outcome from the Intended Outcome drop-down menu for each identified program. Choose the intended outcome that most closely corresponds with the program description in Line 2. Another option for this line would be to choose one of the “other” activity categories listed in Line 1.3 (Activity Numbers 9, 15, 18 or 21) and use it to describe an intended outcome as described below. If the recipient is still unsure about how to categorize/describe an outcome for a program the recipient wishes to fund, the recipient should contact the Area ONAP for guidance. If a program meets more than one intended outcome, select the outcome that best matches the program type. All activities that will use IHBG funds must be eligible under the statute and regulations. The recipient should ensure that any planned “other” intended outcomes are eligible under NAHASDA if it intends to fund them with IHBG funds, which includes IHBG funds, IHBG program income, and Title VI funds. 1.4. Intended Outcome Number (Select one outcome from the Outcome list.):















Describe Other Intended Outcome (Only if you selected "Other" above):



























































Describe Other Actual Outcome (Only if you selected "Other" in above):




































































































































































































In completing this section of the IHP for activities related to unit construction, rehabilitation, or acquisition, the recipient should estimate the number IHBG-assisted units that will be completed during upcoming the 12-month program year. If the recipient estimates that the construction/rehab/acquisition will be started in the coming 12 months but will be completed in a future program year, that unit should not be listed on the anticipated results table. The recipient should enter the number of IHBG-assisted units ONLY. When estimating the number of IHBG-assisted units to be completed, identify whole units only. For example, if a project includes 5 units and half the project is IHBG-assisted, the number of IHBG-assisted units would be 3 rather than 2.5. Planned Number of Units to be Completed in Year Under this Program For assistance to households, the recipient should estimate the total number of households that will be assisted by that particular activity during the upcoming12-month program year. In some cases, these households may also be assisted by other programs offered by the recipient and listed in the IHP. Each program should be counted separately and the recipient is not required to deduct the number of households assisted under more than one program. Planned Number of Households To Be Served in Year Under this Program Enter the number of acres the recipient intends to purchase under this program. Planned Number of Acres To Be Purchased in Year Under this Program
















































On the APR side of Line 1.9, enter the actual number of IHBG-assisted units completed, households assisted, and/or acres purchased for IHBG-assisted housing development during the 12-month program year. Use the same guidelines described in the bulleted items above when defining the actual number of outputs. NOTE: If the actual output is dollars spent (i.e., Crime Prevention and Safety, Model Activities, Self-Determination Program, or Infrastructure to Support Housing), skip Line 1.9 and enter these actual expenditures in Column O of the Uses of Funding Table in Section 5. NOTE: Do not include actual outputs associated with your Native American Housing Block Grant (as funded under the Recovery and Reinvestment Act); instead, those outputs should be included in a separate APR. APR: Actual Number of Units Completed in Program Year APR: Actual Number of Households Served in Program Year APR: Actual Number of Acres Purchased in Program Year
















































If applicable, the recipient must explain why the IHBG-funded activity is behind schedule, or completed fewer units than anticipated. There may have been circumstances beyond the recipient’s control that affected the program. If this is so, the recipient should describe those issues and the actions taken to address the problem(s). • For example, severe weather or natural disasters can cause significant delays in project schedules. Explain the situation and how it affected planned programs. • Sometimes programs simply do not turn out as planned. Perhaps demand for the housing was not at the level the recipient expected, or perhaps it took more time to design the needed administrative procedures, and thus the project is behind schedule. Explain these delays and actions taken to address any issues. If desired, use the "Add Bullet" button for explaining why the program is behind schedule. 1.10: APR: If the program is behind schedule, explain why. (24 CFR § 1000.512(b)(2))


































































Sheet 5: Section 4
The purpose of this section is to identify how the recipient intends to maintain and operate its 1937 Act housing units and whether it intends to demolish or sell any of those units during the upcoming 12-month period. If the recipient does not have any 1937 Act housing units in its inventory, enter N/A on Lines 1 and 2 and proceed to Section 5. SECTION 4: MAINTAINING 1937 ACT UNITS, DEMOLITION, AND DISPOSITION

NAHASDA §§ 102(b)(2)(A)(v), 102(b)(2)(A)(iv)(I-III)







Describe specifically how the recipient will maintain and operate 1937 Act housing units in order to ensure that these units will remain viable. The description could include how the recipient intends to adhere to its maintenance and inspections policies during the upcoming 12-month period, and the relationship between the planned budget for maintaining and operating 1937 Act housing units to the planned maintenance and operation expenditures. The recipient can use this space to describe any special initiatives to improve the viability of 1937 Act housing units through targeted or intensified the maintenance. If desired, use the "Add Bullet" button for describing planned maintenance of 1937 Act units. (1)   Maintaining 1937 Act Units (NAHASDA § 102(b)(2)(A)(v)) (Describe specifically how you will maintain and operate your 1937 Act housing units in order to ensure that these units will remain viable.):

a



Describe any planned demolition or sale of 1937 Act housing units. If the recipient is planning on demolition or disposition of 1937 Act housing units, be certain to include the timetable for any planned demolition or disposition and any other information that is required by HUD with respect to the demolition or disposition. If desired, use the "Add Bullet" button for describing planned demolition and disposition of 1937 Act units. (2)   Demolition and Disposition (NAHASDA § 102(b)(2)(A)(iv)(I-III), 24 CFR 1000.134) (Describe any planned demolition or disposition of 1937 Act housing units. Be certain to include the timetable for any planned demolition or disposition and any other information required by HUD with respect to the demolition or disposition.):







Sheet 6: Section 5
SECTION 5: BUDGETS
The purpose of this section is to describe the sources and uses of the recipient’s funds for eligible housing activities. In the IHP portion of this section, the recipient identifies the anticipated or planned sources and uses of the funds. In the APR portion of this section, the recipient describes the actual sources and uses of the funds.












NAHASDA §§ 102(b)(2)(C), 404(b)




























For the IHP, the tables at Line 2 (Estimated Sources of Funding) and Line 3 (Uses of Funding) show the estimated sources of funding and then the planned uses of funding. The recipient must fill out these two tables to show the amount of IHBG, IHBG program income, and Title VI funds that are expected, and how these funds are planned to be spent. The recipient is also required to report on other sources of funds if those funds will be used in combination with IHBG, IHBG program income, and Title VI for a project or program. If other sources of funds are not combined with IHBG, IHBG program income, and Title VI funds, reporting on them is optional. (1) Sources of Funding (NAHASDA § 102(b)(2)(C)(i)) (Complete the non-shaded portions of the chart below to describe your estimated or anticipated sources of funding for the 12-month program year. APR Actual Sources of Funding -- Please complete the shaded portions of the chart below to describe your actual funds received. Only report on funds actually received and under a grant agreement or other binding commitment during the 12-month program year.)



















For the IHP, this table identifies the estimated or anticipated sources of funding for the upcoming 12-month program year. The table is intended to cover all of the funds to be expended on IHBG-assisted activities during the One-Year Plan period. As noted above, the recipient is not required to list other sources of funds (beyond IHBG, IHBG program income, and Title VI) unless those funds will be combined with IHBG in a project. The Estimated Sources of Funding table must include the amounts of private loans or tribal loans that will be used for NAHASDA-eligible activities, which will later be reimbursed with IHBG funds. For example, assume that a tribe lends $100,000 for the acquisition of land that will be used to develop affordable housing for low-income Native American families. At a later time, the recipient will use its IHBG grant to repay this loan. The $100,000 of assistance must be listed as a source of funds in the chart as “non-federal funds.” The recipient is cautioned that all such transactions must follow all applicable NAHASDA and other federal rules, such as environmental review, labor standards, relocation/acquisition, etc. For the IHP, fill Columns A, B, C, D, and E. IHP For the APR, the recipient reports on the actual sources of funding received and expended during the program year. Fill Columns F, G, H, I, J, and K. APR
SOURCE This column should show the amount of funds already sitting in an account for the recipient (whether at U.S. Treasury or in a local investment account). This includes all “carry over” IHBG funds from previous years. The recipient is required to include all sources that will be used to leverage IHBG, IHBG program income, or Title VI projects or programs. In addition, the recipient is required to include 1937 Act program funds that remain with the TDHE or tribe and have not yet been spent, as well as remaining 1937 Act reserves, both of which must be used for eligible affordable housing activities. The types of leveraged non-IHBG funds include: • “ICDBG,” the Indian Community Development Block Grant is a competitive grant program available to tribes and administered by HUD; • “Other Federal Program Funds” might include funds from the U.S. Department of Agriculture, Indian Health Service, Bureau of Indian Affairs or any other federal agency; • “LIHTC,” the Low Income Housing Tax Credit is an IRS program that works through state agencies and provides developers with tax credits in return for funding affordable housing; and • “Non-Federal Funds” could be any other type of funds that will be used for projects or programs in combination with funds from IHBG, IHBG program income, or Title VI, including tribal contributions, tribal loans, private funds, or assistance from nonprofits. • Note: Estimated, expected leveraged funding must be described in Line 4. Hypothetical exampled continued: The decision to invest an additional $300,000 of IHBG funds would have no effect on Column A. The estimated amount of IHBG on hand at the beginning of the year would be $450,000 ($250,000 in LOCCS and $200,000 in investments), regardless of whether these funds are in LOCCS, or in an approved investment. (A) This column should show the new funding to be received, including the total of the new IHBG grant for the FFY and any funds that are expected to be received at any point during the 12 months, if those funds are associated with a program or activity outlined in the plan. For IHBG program income, the recipient may estimate the amount to be received during the upcoming 12-month program year or may opt to wait until program income is actually realized and, at that time, the recipient should update this table, as needed. Estimated, expected leveraged funding must be described in Line 4. Hypothetical example continued: The amount of funds expected to be received during the program year at Column B, Row 1 would be the $800,000 in new IHBG grants. Any interest anticipated or actually earned on the investments during the program year would be reported on the Row 2 for “IHBG Program Income.” (B) This column should show the sum of the funds on hand from Column A and the new funds received from Column B. Hypothetical example continued: The estimated total sources of IHBG funds at Column C would be $1,250,000 ($800,000 plus $450,000). (C) This column should show the amount of funds from Column C that the recipient anticipates expending during the upcoming 12-month program year. The amount in Column D must never exceed the amount in Column C. The amount in Column D should be directly related to the 12-month activities listed in the One-Year Plan. Note: The total for Column D should match the total of Column N in Line 3 (Uses of Funding table). Hypothetical exmple continued: In Column D the recipient would indicate the $700,000 IHBG funds it intends to expend on eligible activities during the program year, regardless of whether the funds are drawn from LOCCS or from an investment account. Regardless of the decisions regarding investments, the recipient’s IHP must clearly indicate how the $700,000 will be used during the upcoming 12-month program year. (D) This column should show the amount of funds that the recipient anticipates will be left over at the end of the 12-month program year. The calculation is based on the amount of available funds and the amount budgeted to be spent, or the amount in Column C minus the amount in Column D. Hypothetical example continued: In this example, the IHBG carryover would be $550,000 ($1,250,000 - $700,000). Of this amount, the recipient would know that $400,000 is in an investment account ($200,000 originally invested, minus $100,000 of investments withdrawn, plus $300,000 of new investments) and $150,000 will remain in its LOCCS account ($1,250,000 total available, minus $700,000 expended, minus $400,000 in investments), but this would not be separately listed in the Estimated Sources of Funding table. In Column E, if the recipient plans to leave funds in an approved investment and plans that those funds will remain at the end of the program year, or if the recipient plans to add new investments during the year, then those would be indicated together with the other IHBG funds as a part of the estimated unexpended funds, in Column E. (E) This column should show the amount of funds actually on-hand at the beginning of the program year covered by the APR. Examples of “funds on hand” would be funds undisbursed from the recipient’s LOCCS account, funds that are in the recipient’s bank account, or any funds that are available to the recipient that have not yet been expended. In addition, “funds on hand” includes any IHBG amounts invested pursuant to 24 CFR 1000.58. (F) This column should show the funds that were actually received under a grant agreement or other firm commitment during the previous 12-month program year. The recipient must report on any funds received that were used in conjunction with IHBG funds, IHBG program income, or Title VI. Describe actual leveraged funding received in Line 5. Note that the IHBG program income was an estimate in the IHP; for the APR it should be an accurate accounting of the entire amount of program income received in the previous12-month program year. Thus, the recipient must track the receipt and expenditure of program income throughout the year so that it can provide an accurate accounting of the total amount received in Row 2. It is not sufficient to only report on the program income “on hand” at the end of the program year. Rather, the recipient must account for all program income earned throughout the year, including that program income that has already been disbursed for an activity. (G) This column should show the total amount of actual funding available during the previous 12-month program year or the sum of Columns F and G. (H) This column should show the actual funds expended during the previous 12-month program year. The amount should include any funds actually drawn down from LOCCS or other accounts, but not commitments or obligations for which funds have not yet been spent. Do not include IHBG deposits to HUD-approved investment accounts. Note: The total of Column I should match the total of Column Q in Line 3 (Uses of Funding table) (I) This column should show the amount of unspent funds based on the amount of funds actually available less the amount spent during the program year, or the amount in Column H minus the amount in Column I. (J) This column should show the amount of funds that have been obligated through a signed contract or other legally binding agreement but have not yet been expended in the previous 12-month program year. For a definition of fund obligation, see Notice PIH 2000-26 (TDHEs) at http://www.hud.gov/offices/pih/publications/notices/00/pih2000-26.pdf. This notice provides recipients with guidance regarding what constitutes an obligation of grant funds. (K)
Estimated amount on hand at beginning of program year Estimated amount to be received during 12-month program year Estimated total sources of funds (A+B) Estimated funds to be expended during 12-month program year Estimated unexpended funds remaining at end of program year (C-D) Actual amount on hand at beginning of program year Actual amount received during 12-month program year Actual total sources of funding (F+G) Actual funds expended during 12-month program year Actual unexpended funds remaining at end of 12-month program year (H - I) Actual unexpended funds obligated but not expended at end of 12-month program year
With HUD approval, the recipient is permitted to draw down IHBG funds and invest those funds for a maximum 2-year period in a secure, approved type of investment. (For additional information, see Notice PIH 2010-33.) The Estimated Sources of Funding table does not have a separate row for IHBG investments as a source of funds. For the purposes of the IHP, invested IHBG funds are treated exactly the same as if the IHBG funds were in the recipient’s LOCCS account. Hypothetical example to help explain the data for each column: Assume that a recipient has $200,000 of IHBG funds currently in an investment account, it has another $250,000 of existing IHBG assistance in its LOCCS account at HUD and it anticipates receiving another $800,000 in IHBG grant funds during the year. It intends to expend $100,000 of the existing investments in the next program year and it will invest another $300,000 during the program year. In total, the recipient plans to expend $700,000 on eligible affordable housing activities during its program year, of which $100,000 will come from the investment account and $600,000 will come from its LOCCS account. 1. IHBG Funds

$0
$0

$0
$0

2. IHBG Program Income

$0
$0

$0
$0

3. Title VI

$0
$0

$0
$0

4. Title VI Program Income

$0
$0

$0
$0

5. 1937 Act Operating Reserves

$0
$0

$0
$0

6. Carry Over 1937 Act Funds

$0
$0

$0
$0

For the IHP, describe any estimated leverage in Line 4 below (Estimated Sources or Uses of Funding). For the APR, describe actual leverage in Line 5 below. LEVERAGED FUNDS






7. ICDBG Funds

$0
$0

$0
$0

8. Other Federal Funds

$0
$0

$0
$0

9. LIHTC

$0
$0

$0
$0

10. Non-Federal Funds

$0
$0

$0
$0

TOTAL $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
TOTAL Columns C & H, 2 through 10

$0



$0



Notes:













a. For the IHP, fill in columns A, B, C, D, and E (non-shaded columns). For the APR, fill in columns F, G, H, I, J, and K (shaded columns).













b. Total of Column D should match the total of Column N from the Uses of Funding table below.













c. Total of Column I should match the Total of Column Q from the Uses of Funding table below.













d. For the IHP, describe any estimated leverage in Line 4 below (Estimated Sources or Uses of Funding table). For the APR, describe actual leverage in Line 5 below











































NOTE: For the purposes of the Uses of Funding table, IHBG (only) refers to the grant amount. Any IHBG program income or Title VI funds should be included with ‘All Other Funds’ in Column M. (2) Uses of Funding (NAHASDA § 102(b)(2)(C)(ii)) (Note that the budget should not exceed the total funds on hand and insert as many rows as needed to include all the programs identified in Section 3. Actual expenditures in the APR section are for the 12-month program year.)


















For the IHP, this table shows how the anticipated funds are planned to be used during the upcoming 12-month program year. The table is organized by the programs identified in Section 3. Each intended program name and unique identifier from Section 3, Line 1.1 should appear as a row on this table. • It is not acceptable to show a use of funds that does not correspond to a planned one-year program. • If the Area ONAP cannot readily tie a planned use of funds to a stated one-year program, HUD will notify the recipient that the IHP must be revised prior to a determination that the IHP is in compliance with NAHASDA. • For the purposes of the Uses of Funding table, IHBG (only) refers to the grant amount. Any IHBG program income or Title VI funds should be included with “All Other Funds” in Column M. If the recipient plans to use some of its IHBG funds during the upcoming 12-month program year to repay an existing Title VI loan or a private loan, then that planned repayment must be listed on the Uses of Funding table. If the recipient lists a loan repayment, it must describe the associated loan and the eligible activity at Line 4. The recipient must ensure that all IHBG and other federal requirements were followed at the time that the project was initially funded. The recipient should not repay any loan if the program was not previously listed in an IHP that HUD determined to be in compliance with NAHASDA. Remember that funds for Planning and Administration cannot exceed 20 percent of the annual IHBG allocation. A recipient may exceed the 20 percent cap by budgeting unspent, carryover planning and administration funds from prior grants; however, the recipient will need to document to HUD that any amount over the 20 percent cap is budgeted from carryover funds. For the IHP, enter each program name and associated unique identifier (Line 1.1.) from Section 3 (Program Descriptions) and fill Columns L, M, and N, as described below. IHP For the APR, the recipient reports on the actual expenditures during the program year by program. This section should only include actual funds expended, not commitments or planned draws. It would not include amounts drawn down and placed in investments. For the APR, the recipient will report on the actual uses of funding received during the previous 12-month program year. Fill Columns O, P, and Q. NOTE: For the purposes of the Uses of Funding table, IHBG (only) refers to the grant amount. Any IHBG program income or Title VI funds should be included with “All Other Funds” in Column P. Remember that funds for Planning and Administration cannot exceed 20 percent of the annual IHBG allocation. A recipient may exceed the 20 percent cap by expending unspent, carryover planning and administration funds from prior grants; however, the recipient will need to document to HUD that any amount over the 20 percent cap was expended from carryover funds. APR


This column should show the cumulative, previous FFY allocations of IHBG funds plus the current year IHBG funds that are dedicated to the planned activities. The total in Column L must not exceed the IHBG funds from Columns A and B, Row 1 in Line 2 (Estimated Sources of Funding table). If the recipient plans to exceed the 20 percent cap on its planning and administration budget, the amount of unspent planning and administration funds from prior years must be included in this column. (L) This column should show the planned expenditure of other, non-IHBG funds during the upcoming 12-month period. The total of Column M must not exceed the total from Column C, Rows 2-10 in Line 2 (Estimated Sources of Funding table). (M) This column should show the sum of the IHBG-budgeted expenditures and the non-IHBG budgeted expenditures over the upcoming 12-month program year, or Column L plus Column M. The total of Column N should equal the total of Column D in Line 2 (Estimated Sources of Funding table). (N) This column should show the IHBG funds that were expended in the previous 12-month program year. Exclude from the Loan Repayment line in this column, the repayment of bridge loans that were borrowed and repaid in the same year. The total amount of IHBG funds expended cannot exceed the total amount in Column H, Row 1 of Line 2 (Sources of Funding table). (O) This column should show all other funds that were expended in the previous 12-month program year. Other funds include any program income, Title VI, and all non-IHBG funds used to leverage IHBG projects, such as any LIHTC or ICDBG funds in an IHBG-funded project. The total of Column P cannot exceed the total of Column H, Rows 2-10 in Line 2 (Sources of Funding table). (P) This column should show the total funds expended during the previous 12-month program year. It is the sum of Column O and Column P. The total for Column Q should equal the total of Column I in Line 2 (Sources of Funding table). (Q)
PROGRAM NAME Prior and current year IHBG (only) funds to be expended in 12-month program year Total all other funds to be expended in 12-month program year Total funds to be expended in 12-month program year (L+M) Total IHBG (only) funds expended in 12-month program year Total all other funds expended in 12-month program year Total funds expended in 12-month program year (O+P)



$0

$0 Section 3 (1)
Planning and Administration

$0

$0
Loan repayment - describe in 4 & 5 below

$0

$0
TOTAL $0 $0 $0 $0 $0 $0
Notes:













a. Total of Column L cannot exceed the IHBG funds from Column C, Row 1 from the Estimated Sources of Funding table in Line 2 above.













b. Total of Column M cannot exceed the total from Column C, Rows 2-10 from the Estimated Sources of Funding table in Line 2 above.













c. Total of Column O cannot exceed total IHBG funds received in Column H, Row 1 from the Estimated Sources of Funding table in Line 2 above.













d. Total of Column P cannot exceed total of Column H, Rows 2-10 of the Estimated Sources of Funding table in Line 2 above.













e. Total of Column Q should equal total of Column I of the Estimated Sources of Funding table in Line 2 above.




























This text box must be used to further explain any estimated amounts in the budget, including leverage. If IHBG funds, IHBG program income, or Title VI funds will be leveraged with other funds in the same projects or programs, the recipient must describe that planned leveraging in this box. The recipient also must use this box if it has stated that it plans to use IHBG grant funds or IHBG program income to repay an existing loan. In that case, describe the loan and the associated eligible activity and the IHP program number. If desired, use the "Add Bullet" button for listing estimated sources or uses of funding. (3) Estimated Sources or Uses of Funding (NAHASDA § 102(b)(2)(C)). (Provide any additional information about the estimated sources or uses of funding, including leverage (if any). You must provide the relevant information for any planned loan repayment listed in the Uses Table on the previous page. This planned loan repayment can be associated with Title VI or with private or tribal funding that is used for an eligible activity described in an IHP that has been determined to be in compliance by HUD. The text must describe which specific loan is planned to be repaid and the NAHASDA-eligible activity and program associated with this loan):



























































This text box can be used to further describe any actual expenditure during the previous 12-month program year. This box must be used if a loan repayment has been listed on the Uses of Funding table. The text must describe how the repayment was used, including listing the IHP program number associated with the repayment. In addition, this box should be used to describe any leveraged funds that were received during the previous 12-month program year and expended in conjunction with IHBG funds. If desired, use the "Add Bullet" button for listing actual sources or uses of funding. (4) APR (NAHASDA § 404(b)) (Enter any additional information about the actual sources or uses of funding, including leverage (if any). You must provide the relevant information for any actual loan repayment listed in the Uses Table on the previous page. The text must describe which loan was repaid and the NAHASDA-eligible activity and program associated with this loan.):












































Sheet 7: Section 6
SECTION 6: OTHER SUBMISSION ITEMS
This section covers several IHP and APR sections required by NAHASDA or its regulations. Some of the sections must be submitted by all recipients, and others may not be applicable to a particular recipient. See the text below for more information on required submissions.





NAHASDA §§ 102(b)(2)(C)(ii), 201(b)(5), 202(6), 205(a)(2), 209














There are two options for how the recipient may define the useful life of a unit. The recipient may determine the period to be the length of time the unit is likely to remain structurally viable within the housing stock. Alternately, the recipient may define a different (shorter or longer) affordability period for these units based on relevant factors such as the amount of IHBG assistance in the unit. Larger amounts of IHBG assistance should indicate a longer affordability period and the affordability period for any individual unit should be based on an established schedule. For example, the recipient may adopt and describe a schedule such as this: Rehabilitation $0 – $14,999: 5 years $15,000 - $40,000: 10 years >$40,000: 15 years Refinancing associated with rental rehabilitation Any amount: 15 years Acquisition $0 – $14,999:5 years $15,000 - $40,000:10 years >$40,000: 15 years New Construction Any amount: 20 years Acquisition of newly constructed units Any amount: 20 years If desired, use the "Add Bullet" button for listing useful life/affordability periods. (1)   Useful Life/Affordability Period(s) (NAHASDA § 205, 24 CFR § 1000.142) (Identify the useful life of each housing unit constructed, acquired, or rehabilitated with IHBG funds, including housing units to be constructed, acquired, or rehabilitated with IHBG funds in the 12 month period. Exclude Mutual Help units.











A Model Activity is one that is related to affordable housing, but is not specifically described as eligible in NAHASDA. See NAHASDA Section 202(6). Line 2 is only applicable if the recipient intends to fund a Model Activity or if it wishes to serve Native American households whose incomes exceed 100 percent of the median income or anticipates expending more than 10 percent of its IHBG to serve families whose incomes fall between 80 percent and 100 percent of the median. The recipient must get HUD approval if it wants to serve households above 100 percent of median or if it wants to spend more than 10 percent of its IHBG funds to assist households at between 80 percent and 100 percent of median income. If the recipient wishes to implement a Model Activity under Section 202(6) of NAHASDA, or if it wishes to serve non-low-income households (as identified in Section 201(b)) of NAHASDA and 24 CFR § 1000.108), the activity must be described in detail in the IHP or in a separate submission to HUD. Any proposed Model Activity must be approved by HUD before incurring any expenses and beginning any work on that activity. If desired, use the "Add Bullet" button for listing model housing and over-income activities. (2)   Model Housing and Over-Income Activities (24 CFR § 1000.108) ( If you wish to undertake a model housing activity or wish to serve non-low-income households during the 12-month program year, those activities may be described here, in the program description section of the 1-year plan, or as a separate submission.):














(3)   Tribal and Other Indian Preference (NAHASDA § 201(b)(5), 24 CFR § 1000.120)


This section is only required if the recipient will offer a preference in housing for tribal members over all other Native American households. Section 201(b)(5) of NAHASDA and 24 CFR § 1000.120 allow preference for tribal members and other Indian families. If preference will be given to tribal members or other Indian families, the preference policy must be described in the text box. If desired, use the "Add Bullet" button for listing preferences.



If preference will be given to tribal members or other Indian families, the preference policy must be






described. This information may be provided here or in the program description section of the 1-year plan.














Does the Tribe have a preference policy?









If yes, describe the policy.
















(4)   Anticipated Planning and Administration Expenses (NAHASDA § 102(b)(2)(C)(ii), 24 CFR § 1000.238)



The IHBG regulations at 24 CFR § 1000.238 require that a recipient’s planning and administrative expenses be capped at 20 percent of the annual grant amount. A recipient may exceed the 20 percent cap by budgeting unspent, carryover planning and administration funds from prior grants; however, the recipient will need to document to HUD that any amount over the 20 percent cap is budgeted from carryover funds. In Line 4 the recipient must state whether it plans on spending more than 20 percent of its anticipated grant on planning for and administering its IHBG activities. For example, if the recipient intends to spend $1,000,000 of IHBG funds in FFY 2012, and of this, it intends to spend $100,000 on planning and administration during its FFY 2012 program year, the recipient would list 10 percent in this section.


Do you intend to use more than 20% of your current grant for Planning and Administration?








If yes, describe why the additional funds are needed for Planning and Administration.



If the recipient wants approval to expend more than 20 percent of its IHBG grant on planning and administration, it must explain why these extra funds are required. If desired, use the "Add Bullet" button for listing why additional funds are needed for administration.












(5)   Actual Planning and Administration Expenses (NAHASDA § 102(b)(2)(C)(ii), 24 CFR § 1000.238)



The recipient must state whether it expended more than 20 percent of its annual grant amount on planning and administration. A recipient may exceed the 20 percent cap by expending carryover planning and administration funds from prior grants; however, the recipient will need to document to HUD that any amount over the 20 percent cap was expended from carryover funds. If the recipient did expend more than 20 percent on planning and administration, identify whether the recipient received HUD approval to exceed the cost cap.


Did you expend more than 20% of your current grant for Planning and Administration?









If yes, did you receive HUD approval to exceed the 20% cap on Planning and Administration costs?








If HUD did not issue an approval, the recipient must describe the reason(s) for exceeding the 20 percent cost cap. Failure to secure HUD approval may be considered a violation of a NAHASDA requirement. If desired, use the "Add Bullet" button to list reasons for exceeding the 20% cap. If you did not receive approval for spending more than 20% of your current grant on planning and administration costs, describe the reason(s) for exceeding the 20% cap. (See Section 6, Line 5 of the Guidance for information on carry-over of unspent planning and administration expenses.)





This section is only required if the recipient has expanded its formula area by demonstrating that it provides substantial housing services in that expanded area. In this IHP section, the recipient must define its expanded formula area boundaries. For example, if an expansion of the formula area has been approved by HUD to include an adjacent county, this box must indicate the name of the county. The recipient must then indicate the amount of IHBG funds it has budgeted for that expanded area. This should be the total amount of IHBG funds that the recipient plans to spend in the expanded service area during the upcoming 12-month program year. If there is no expansion in the formula area, there is no need to complete the remainder of this line and, instead, go to Section 7. (6) Expanded Formula Area - Verification of Substantial Housing Services (24 CFR § 1000.302(3)) If your tribe has an expanded formula area (i.e., an area that was justified based on housing services provided rather than the list of areas defined in 24 CFR § 1000.302 Formula Area (1)), the tribe must demonstrate that it is continuing to provide substantial housing services to that expanded formula area. Does the tribe have an expanded formula area?







If no, proceed to Section 7.












If desired, use the "Add Bullet" button for listing geographic areas added to the formula area. If yes, list each separate geographic area that has been added to the Tribe’s formula area and the documented number of Tribal members residing there.











For each separate formula area expansion, list the budgeted amount of IHBG and other funds to be provided to all American Indian and Alaska Native (AIAN) households and to only those AIAN households with incomes 80% of median income or lower during the recipient’s 12-month program year:









Total Expenditures on Affordable Housing Activities for:





All AIAN Househods AIAN Households with Incomes 80% or Less of Median Income



IHBG Funds:





Funds from Other Sources:













For each approved formula area expansion, list the actual amount of IHBG and other funds expended for all American Indian and Alaska Native (AIAN) households and for only AIAN households with incomes 80 percent of median income or lower during the recipient’s previous 12-month program year. In other words, the recipient must indicate what it actually spent in the expanded area during the previous 12-month program year. (7) APR: If answered "Yes" in Line 6, for each separate formula area, list the actual amount of IHBG and other funds expended for all AIAN households and for only AIAN households with incomes 80% of median income or lower during the recipient's 12-month program year.



















Total Expenditures on Affordable Housing Activities for:





All AIAN Househods AIAN Households with Incomes 80% or Less of Median Income



IHBG Funds:





Funds from Other Sources:





Sheet 8: Section 7
SECTION 7: INDIAN HOUSING PLAN CERTIFICATION OF COMPLIANCE







By signing the IHP, the recipient certifies its compliance with Title II of the Civil Rights Act, and ensures that the recipient has all appropriate policies and procedures in place to operate its planned programs. The recipient should not assert that it has the appropriate policies and procedures in place if these documents do not exist in its files, as this will be one of the items verified during any HUD monitoring view.
NAHASDA § 102(b)(2)(D)


















By signing the IHP, you certify that you have all required policies and procedures in place in order to operate any planned IHBG programs.




















(1) In accordance with applicable statutes, the recipient certifies that:





A recipient must certify whether it will comply with the Civil Rights Act of 1968 and other federal statutes, to the extent that they apply to tribes and TDHEs.


It will comply with title II of the Civil Rights Act of 1968 in carrying out this Act, to the extent that such title is applicable, and other applicable federal statutes.










A recipient receiving less than $200,000 under Formula Current Assisted Stock must certify whether there are households within its jurisdiction at or below 80 percent of median income. (2) In accordance with 24 CFR 1000.328, the recipient receiving less than $200,000 under FCAS certifies that:
There are households within its jurisdiction at or below 80 percent of median income.










(3) The following certifications will only apply where applicable based on program activities.







The recipient must certify whether certain policies are in effect and available for HUD review. Note that some of the policies may not be applicable to a particular recipient, depending on program design. For example, some recipients only operate homeownership programs, not rental programs, and so they should indicate “Not Applicable” on the form next to the items that are related to rental housing policies.
a. It will maintain adequate insurance coverage for housing units that are owned and operated or assisted with grant amounts provided under NAHASDA, in compliance with such requirements as may be established by HUD;










b. Policies are in effect and are available for review by HUD and the public governing the eligibility, admission, and occupancy of families for housing assisted with grant amounts provided under NAHASDA;










c. Policies are in effect and are available for review by HUD and the public governing rents charged, including the methods by which such rents or homebuyer payments are determined, for housing assisted with grant amounts provided under NAHASDA; and










d. Policies are in effect and are available for review by HUD and the public governing the management and maintenance of housing assisted with grant amounts provided under NAHASDA.

Sheet 9: Section 8
If the tribe is submitting the IHP, there is no need to complete this certification. This certification is used when a TDHE prepares the IHP on behalf of a tribe. The certification must be executed by the recognized tribal government covered under the IHP. If applicable, this form must be signed and dated by the proper tribal authority. If a TDHE is submitting the IHP and the form is not signed by an authorized official of the tribe, HUD will notify the TDHE that this must be corrected before the plan can be determined to be in compliance. A plan submitted by a TDHE cannot be processed without tribal approval. For cases in which a TDHE prepares an IHP that covers more than one tribe, a separate certification for each tribe covered by the IHP must be included. SECTION 8: IHP TRIBAL CERTIFICATION




NAHASDA § 102(c)















This certification is used when a Tribally Designated Housing Entity (TDHE) prepares the IHP on behalf of a tribe.









This certification must be executed by the recognized tribal government covered under the IHP.









(1) The recognized tribal government of the grant beneficiary certifies that:





Check only one box below. The tribe certifies that either it had an opportunity to review the IHP and has authorized the TDHE to submit the plan or the tribe allows the TDHE to submit the IHP on behalf of the tribe, without prior review by the tribe.



(2) It had an opportunity to review the IHP and has authorized the submission of the IHP by the TDHE; or
(3) It has delegated to such TDHE the authority to submit an IHP on behalf of the Tribe without prior review by the Tribe.
Identify the name of the tribe. (4) Tribe:
Identify the name and title of the official authorized to sign the certification. (5) Authorized Official’s Name and
Title:
The official must sign and date the certification. (6) Authorized Official’s Signature:
(7) Date (MM/DD/YYYY):

Sheet 10: Section 9
SECTION 9: TRIBAL WAGE RATE CERTIFICATION




A recipient is allowed to adopt and use tribally determined wage rates instead of Davis-Bacon and HUD determined wage rates for IHBG-assisted construction or maintenance. For additional information, see Program Guidance 2003-04 (Application of Tribal Laws Pertaining to the Use of Tribally Determined Wages) at http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_8221.pdf. By signing the IHP, the recipient informs HUD of its wage rate decision, and if it has decided to use tribally determined wage rates, it must adopt the appropriate tribal laws and regulations establishing tribally determined wage rates. Note that the certification allows for three options and only one option may be selected.






NAHASDA §§ 102(b)(2)(D)(vi), 104(b)


















By signing the IHP, you certify whether you will use tribally determined wages, Davis-Bacon wages, or HUD











determined wages. Check only the applicable box below.











Check this box if the recipient will use tribally determined wage rates for all construction and maintenance activities involving IHBG funds. (1) You will use tribally determined wage rates when required for IHBG-assisted construction or maintenance activities. The Tribe has appropriate laws and regulations in place in order for it to determine and distribute prevailing wages.

Check this box if the recipient will use Davis-Bacon or HUD determined wage rates for all construction and maintenance activities involving IHBG funds. (2) You will use Davis-Bacon or HUD determined wage rates when required for IHBG-assisted construction or maintenance activities.

Check this box if the recipient will use Davis-Bacon and/or HUD determined wage rates for some types of construction involving IHBG funds and tribally determined wage rates for other types of construction involving IHBG funds. (3) You will use Davis-Bacon and/or HUD determined wage rates when required for IHBG-assisted construction except for the activities described below.














(4) List the activities using tribally determined wage rates:








If the box on Line 3 was checked, identify the specific IHBG-funded activities that will use tribally determined wage rates. If desired, use the "Add Bullet" button for listing activities using tribally determined wage rates.















Sheet 11: Section 10
SECTION 10: SELF-MONITORING


This section provides additional monitoring information for HUD. The recipient must describe whether and how it conducted self monitoring or an annual compliance assessment. The recipient must then describe the monitoring or assessment results and planned corrections of the issues identified. Recipient self-monitoring or annual compliance assessment must include any sub-recipients, if applicable. If the recipient has executed a Self-Monitoring Mutual Agreement with its Area ONAP, then the recipient should submit the annual independent assessment of the recipient’s program(s) with the APR to the Area ONAP. This would include any deficiencies that were identified during the assessment and the actions to be taken to correct the deficiencies. If the self-monitoring plan and/or policy have changed since the last year, the recipient should also submit a copy of the revised plan and/or policy. For additional information, see Program Guidance 2007-08 at http://www.hud.gov/offices/pih/ih/codetalk/nahasda/2008/2007-08sm.pdf








NAHASDA § 403(b), 24 CFR §§ 1000.26, 85.37, 85.40
























(1)   Do you have a procedure and/or policy for self-monitoring?








Indicate whether the recipient has a self-monitoring procedure and/or policy.































If the recipient is a TDHE, indicate whether the tribe conducted formal monitoring of the TDHE’s compliance with IHBG requirements. (2)   Pursuant to 24 CFR § 1000.502 (b) where the recipient is a TDHE, did the TDHE provide periodic progress reports including the self-monitoring report, Annual Performance Report, and audit reports to the Tribe?



























Indicate whether the recipient completed the annual compliance assessment of its IHBG activities, including monitoring of its sub-recipients, as required. For more information, see Program Guidance 2005-04 (Recipient Self-Monitoring) at: http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_8194.pdf


(3)   Did you conduct self-monitoring, including monitoring sub-recipients?




Indicate whether the recipient completed the annual compliance assessment of its IHBG activities, including monitoring of its sub-recipients, as required. For more information, see Program Guidance 2005-04 (Recipient Self-Monitoring) at: http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_8194.pdf





























































Describe the self-monitoring activities conducted during the previous 12-month program year, including housing inspections conducted. Identify the corrective actions taken or planned to improve performance and ensure compliance with IHBG requirements. If desired, use the "Add Bullet" button for describing self-monitoring results. (4) Self-Monitoring Results. (Describe the results of the monitoring activities, including inspections for this program year.):















Sheet 12: Section 11
SECTION 11: INSPECTIONS
The Inspection of Units table is used to record the results of the inspections of the recipient’s HUD-assisted housing. The requirement to periodically inspect units applies to all units under the recipient’s control. The recipient is not required to inspect every assisted unit every year; however, over time, all units should be inspected. The recipient may take a representative sample of its units and rotate which units are inspected each year. This would include any 1937 Act units, as well as IHBG-assisted units owned by the tribe or TDHE. Because the tribe or TDHE holds the title to Mutual Help units until they are conveyed to the homebuyer, these units need to be inspected as long as they are within the recipient’s control. This does not include units that were assisted under the 1937 Act or NAHASDA, but which are now privately owned, such as private homeownership units. For more information on the inspection requirements, see Notice PIH 2010-36 (Recipient Inspection of Housing Units Assisted under the Native American Housing Assistance and Self Determination Act of 1996 (NAHASDA) and Those Assisted Under the United States Housing Act of 1937) at http://www.hud.gov/offices/pih/publications/notices/10/pih2010-36.pdf.






NAHASDA § 403(b)
















(1)   Inspection of Units (Use the table below to record the results of recurring inspections of assisted housing.)








Lists the types of HUD assistance; namely, units funded under the 1937 Act and those assisted by NAHASDA. Activity Enter the total number of units in the recipient’s inventory by the types of HUD assistance provided. Total Number of Units As a result of the inspections, enter the number of units that are determined to be in standard condition. The definition of “standard” is based on local tribal policy. Units in standard condition As a result of the inspections, enter the number of units that are in need of rehabilitation. The need for rehabilitation is based on local tribal policy. Units needing rehabilitation As a result of the inspections, enter the number of units that need to be replaced. The need for replacement is based on local tribal policy. Units needing to be replaced Enter the total number of units inspected. This number should be the total of Columns C, D and E. Total number of units inspected

(a) (b) (c) (d) (e) (f)

1 1937 Housing Act Units:



a. Rental



0


b. Homeownership



0


c. Other



0

1937 Act Subtotal 0 0 0 0 0

2 NAHASDA assisted units:



a. Rental



0


b. Homeownership



0


c. RentalAssistance



0


d. Other



0

NAHASDA Subtotal 0 0 0 0 0

Total 0 0 0 0 0










(2)   Did you comply with your inspection policy:













If the recipient answered “no” in Line 2, it must explain why these inspections did not occur during the previous 12-month period, as described in the recipient’s inspection policy. (3)    If no, why not:





Sheet 13: Section 12
SECTION 12: AUDITS
An IHBG recipient must comply with the requirements of the Single Audit Act and Office of Management and Budget (OMB) Circular A-133. These requirements mandate that the recipient conduct an audit if it expended $500,000 or more in federal funds during the previous 12-month program year.








24 CFR § 1000.544




















This section is used to indicate whether an audit is required, based on a review of your financial records.








If the recipient’s financial records document that it did not reach this expenditure threshold and an audit is not required, check the Yes box. If the recipient did reach or exceed the expenditure threshold, check the No box. If the No box is checked, the recipient is required to submit an audit, compliant with OMB Circular A-133, to the Federal Audit Clearinghouse and the recipient’s Area ONAP.











Did you expend less than $500,000 in total Federal awards for the reporting period covered by the APR?
































If Yes, an audit is not required. If No, an audit is required to be submitted to the Federal Audit Clearinghouse and your Area Office of Native American Programs.

Sheet 14: Section 13
SECTION 13: PUBLIC AVAILABILITY



The IHBG regulations require that the recipient make the APR available to citizens in its jurisdiction for public review and comment. In addition, if the recipient is a TDHE, it must submit the APR to the tribe for its review and comment.







NAHASDA § 408, 24 CFR § 1000.518
























(1).  Did you make this APR available to the citizens in your jurisdiction before it was submitted to HUD








Indicate whether the recipient made this APR available for public review and comment before it was submitted to HUD.


(24 CFR § 1000.518)?





































If the recipient is a TDHE, did it submit the APR to the tribe for review and comment before it was submitted to HUD?


(2)   If you are a TDHE, did you submit this APR to the Tribe (24 CFR § 1000.512)?





















































If the recipient did not make the APR available to the public or to the tribe and answered “No” in Line 1 or 2, it must explain why not and when it plans to make the APR available. If desired, use the "Add Bullet" button for describing public accountability. (3)    If you answered “No” to question #1 and/or #2, provide an explanation as to why not and indicate when you will do so.
















The recipient must summarize the comments it received and how it addressed these comments. The recipient does not have to provide each and every comment, but it should generally summarize all comments and describe its plan for addressing any significant issues. If desired, use the "Add Bullet" button for listing comment summaries. (4) Summarize any comments received from the Tribe and/or the citizens (NAHASDA § 404(d)).





Sheet 15: Section 14
SECTION 14: JOBS SUPPORTED BY NAHASDA




The purpose of this table is to provide HUD with the estimated number of temporary and full-time jobs that are paid each year in whole or in part with IHBG funds. This estimated should include the number of recipient staff positions, sub-recipient staff positions, and related construction jobs. Unlike in the past, this information is no longer optional.





NAHASDA § 404(b)






















Use the table below to record the number of jobs supported with IHBG funds.






















Indian Housing Block Grant Assistance (IHBG)

Enter the number of permanent jobs funded with IHBG funds each year. (1) Number of Permanent Jobs Supported


Enter the number of temporary jobs funded with IHBG funds each year. If the recipient has reliable information about jobs supported through contracts with construction companies or the like, identify the number of temporary construction jobs. (2) Number of Temporary Jobs Supported














The recipient may provide additional information about the nature of these jobs if it wishes. If desired, use the "Add Bullet" button for describing permanent and/or temporary jobs supported by IHBG funds. (3) Narrative (optional):




Sheet 16: Section 15
SECTION 15: IHP WAIVER REQUESTS



This section of the IHP is only required if the recipient is requesting a waiver of an IHP section or of the IHP submission date. If granted, a waiver is valid for a period not to exceed 90 days. This is not a waiver of IHBG requirements.







NAHASDA § 101(b)(2)
























THIS SECTION IS ONLY REQUIRED IF THE RECIPIENT IS REQUESTING A WAIVER OF AN IHP SECTION OR A WAIVER OF THE IHP SUBMISSION DUE DATE.

A waiver is valid for a period not to exceed 90 days. Fill out the form below if you are requesting a waiver of one or more sections of the IHP. NOTE: This is NOT a waiver of the IHBG program requirements but rather a request to waive some of the IHP submission items.














If the recipient needs a waiver of any sections of the IHP, identify those sections by name and section number. If the recipient needs a waiver for the IHP submission date, enter the request. If desired, use the "Add Bullet" button for listing IHP sections. (1) List below the sections of the IHP where you are requesting a waiver and/or a waiver of the IHP due date.

(List the requested waiver sections by name and section number):
















Describe the reason(s) that the recipient is requesting the waiver(s) from Line 1. If desired, use the "Add Bullet" button for describing reason(s). (2) Describe the reasons that you are requesting this waiver (Describe completely why you are unable to complete a particular section of the IHP or could not submit the IHP by the required due date.):
















Describe the specific actions the recipient will take to ensure that it will be able to submit a complete IHP in the future and/or submit the IHP by the required due date. Identify the administrative corrections the recipient intends to implement so that future IHPs will be complete and submitted no later than 75 days prior to the start of the recipient’s 12-month program year. If desired, use the "Add Bullet" button for listing actions. (3) Describe the actions you will take in order to ensure that you are able to submit a complete IHP in the future and/or submit the IHP by the required due date. (This section should completely describe the procedural, staffing or technical corrections that you will make in order to submit a complete IHP in the future and/or submit the IHP by the required due date.):
















Identify the name of the recipient. (4) Recipient:


Identify the name and title of the official authorized to sign the waiver request. (5) Authorized Official’s Name and


Title:

The official must sign and date the waiver request. (6) Authorized Official’s Signature:


(7) Date (MM/DD/YYYY):


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