OMB Approval No. 2506-0133
exp. 12/31/2017
Application Budget Summary (ali applicants)
Applicant | City of Nashua, NH Number of | 2 Plan dates for 5/1/2018-4/30/2021
Name Project grant agreement
Sponsors and activities (mo./yr.)
A. Eligible Activity HOPWA Request Leveraged Funds
A. Year 1
IB. Year 2 iC. Year 3 ID. Total
1. Acquisition
2. Rehabilitation, Repair & Conversion
3, New Construction (for Community
Residences and SRO dwellings only)
Facility Development
(new applications
only)
(total of lines 13-15)
Insert application package page number
g 14. Operating Costs for Housing Facility
£s
a:
im & |5. Leasing
°
a 6. Tenant-based Rental Assistance $309,677 $309,678 $309,678 $929,033
ea
&
=) 7. Short-term Rent, Mortgage, & Utility
a Payments to Prevent Homelessness
fa
e g 8. Supportive Services $114,995 $114,996 $114,996 $344,987 $532,984
aS
= 5
awn
, 9: Housing Information Services
vo
10. Permanent Housing Placement $8,660 $8,660 $8,660 $25,980
x
fl 111. Resource Identification to Establish,
g Coordinate & Develop Housing
i Assistance
A, 12. Other Housing Costs (please
5 specify in narrative; requires HUD
5 approval)
13. Total Program Costs: 1,300,000
(total of lines 1-12)
2 14. Grantee’s Administrative $39,000
ag
$s
= es 15. Project Sponsor’s Administrative $9 1,000
5 jCosts
<
16. Total HOPWA Request $1,430,000
Form HUD-40110-B (Expiration Date 12/31/2010)
