OMB Approval No. 2506-0133
exp. 12/31/2017
Detailed Project Budget & Housing Outputs (each organization)
supportive housing O
Name of City of Nashua, NH
organization:
Type: Grantee: D4; Project Sponsor: [_] | If applicable: _[ Faith based: |] | Grassroots: L_]
B. Eligible Activity HOPWA Request
| Yr. 1 Yr. 2 Yr. 3 Totals:
1. Acquisition Budget
+ & |Description:
By ' » H# of Units
5 ge i. Rehabilitation/Repair/Conversion Budget
2s ve
2 a Bescuptian: # of Units
a = 3. New Construction (Community Residences & SRO dwellings Budget
#F only) Description: .
Se # of Units
So
& & lType of Facility: Short-term shelter LJ; transitional housing LI: Community residence CL; SRO dwelling [_]; or other permanent
4. Operating Costs for Housing Facility
Note: Service delivery costs such-as salary and overhead costs to deliver a particular budget line item
should be represented in the funding amount requested for that particular budget line item.
insert application package page number 3
2 — Budget
& 6 |Description: -
zs # of Units
oe :
& = 5, Leasing Budget
© |Description: # af Units
6. Tenant-Based Rental Assistance Payments Budget
Description:
s 2 i# of Households
6 2 3. Short-Term Rent, Mortgage & Utility Payments to Prevent Budget
— fm [Homelessness
Description:
# of Households
7 Budget
£ Ss . :
g 3 8. Supportive Services Costs
2 & Pescription:
AN
# of Households
9, Housing Information Services Budget
g Description: # of Households
@ 10. Permanent Housing Placement Services Budget
6 (Description:
Eg # of Househalds|
5 11. Resource Identification to Establish, Coordinate, & Develop
© [Housing Assistance
a Description: Budget
a
= 12. Other Housing Costs (approved by HUD) Budeet
Description: 4 of Units
2 13. Grantee's Administrative Costs $13,000 {$13,000 $13,000 $39,000
S g Description: Budget
% g |14. Project Sponsor's Administrative Costs
: a Description:
< Budget
15. Total HOPWA Request for this Organization
$39,000
Form HUD-40110-B (Expiration Date 12/31/2010)
