HCD 820, 12/89
RHCP ANNUAL SPONSOR CERTIFICATION FISCAL YEAR _______________
___________________________
Contract:
___________________________
Development name:
___________________________
Sponsor:
The sponsor must send the Audit and Sponsor Certification to HCD within ninety (90) days after the fiscal year ends. Send one copy of the Audit and Sponsor Certification with original signatures, plus an additional copy of the Sponsor Certification.
Check here for forms included:
___ | RHCP Annual Sponsor Certification (all projects) | Page 1 | |
___ | Report of Actual Income (all projects) | Page 2 | |
___ | Report of Actual Expenses (all projects) | Page 3 and 4 | |
___ | Calculation of Assisted Unit Expenses (all projects) | Page 5 and 6 | |
___ | Calculation of Commercial Space Expenses (with commercial space only projects) | Page 7 and 8 | |
___ | Uses of Net Operating Income (all projects) | Page 9 | |
___ | Report of RHCP Loan Payment Balances (all projects) | Page 10 | |
___ | Report of Vacancy Loss and Uncollectible Rents (all projects) | Page 11 | |
___ | Report on Replacement Reserve Account (all projects) | Page 12 | |
___ | Report on Operating Reserve Account (all projects) | Page 13 |
Sponsor Certification
It is hereby certified that all of the representations made by the Sponsor in the Regulatory Agreement and the financial disclosures contained in this report are true and correct, and that there is not any condition, event, or act which would constitute an event of default thereunder, or which with notice, passage of time, or both, would constitute such an event of default.
___________________________ | ||
Sponsor | ||
___________________________ | ||
Signature | ||
___________________________ | ||
Title | Date |
REPORT OF ACTUAL INCOME FISCAL YEAR _______________
Contract: ___________________________ | Development name: ___________________________ | |
Units -- Assisted/Total:___________________________ | Prepared by:___________________________ |
BUDGET (A) | ACTUAL (B) | HCD APPROVED (C) | ||
Assisted Units: | ||||
1. Net Rental Income | ||||
2. Prorated Interest Income | ||||
3. Prorated Laundry Income | ||||
4. Resident Collections | ||||
5. Operating Reserve Withdrawals | ||||
6. Prorated Other Project Income | ||||
7. Subtotal Income -- Assisted Units | ||||
8. Uncollectible Rents | ||||
9. Uncollectible Resident Damage | ||||
10. Total Income -- Assisted Units | ||||
Nonassisted Units: | ||||
11. Sponsor Contributions | ||||
12. Net Rental Income | ||||
13. Prorated Interest Income | ||||
14. Prorated Laundry Income | ||||
15. Resident Collections | ||||
16. Operating Reserve Withdrawals | ||||
17. Prorated Other Project Income | ||||
18. Subtotal Income -- Nonassisted Units | ||||
19. Uncollectible Rents | ||||
20. Uncollectible Resident Damage | ||||
21. Total Income -- Nonassisted Units | ||||
22. Commercial Income | ||||
23. Total Project Income |
REPORT OF ACTUAL EXPENSES FISCAL YEAR _______________
Contract:___________________________ | Development name:___________________________ | |
Units -- Assisted/Total:___________________________ | Prepared by: ___________________________ |
ACCOUNT NAME | TOTAL EXPENSES | |||
BUDGET (A) | ACTUAL (B) | HCD APPROVED (C) | ||
MANAGEMENT FEE: | ||||
1. Sponsor Overhead | ||||
2. Contract Management Fee | ||||
3. TOTAL MANAGEMENT FEES: | ||||
ADMINISTRATION: | ||||
4. Marketing | ||||
5. Audit | ||||
6. Legal | ||||
7. Misc. Administrative Expenses | ||||
8. TOTAL ADMINISTRATION: | ||||
SALARIES: | ||||
9. On-Site or Off-Site Manager | ||||
10. Assistant Manager | ||||
11. Grounds and Maintenance Personnel | ||||
12. Desk Clerks | ||||
13. Janitorial Personnel | ||||
14. Housekeepers | ||||
15. Services Staff | ||||
16. Other ___________________________ | ||||
17. TOTAL SALARIES: | ||||
MAINTENANCE: | ||||
18. Supplies | ||||
19. Elevator Maintenance | ||||
20. Pest Control | ||||
21. Grounds Contracts | ||||
22. Interior Painting and Decorating | ||||
23. Other ___________________________ | ||||
24. TOTAL MAINTENANCE: | ||||
UTILITIES: | ||||
25. Trash Removal | ||||
26. Electricity | ||||
27. Water and Sewer | ||||
28. Gas | ||||
29. HCD Use Only | ||||
30. TOTAL UTILITIES: | ||||
INSURANCE: | ||||
31. Property & Liability Insurance | ||||
32. TOTAL INSURANCE: | ||||
TAXES: | ||||
33. Real Estate Taxes/PILOTS | ||||
34. Business License | ||||
35. TOTAL TAXES: | ||||
OTHER: | ||||
36. Food | ||||
37. Support Services | ||||
38. Co-op Member Training/Education | ||||
39.___________________________ | ||||
40.___________________________ | ||||
41. TOTAL OTHER: | ||||
42. SUBTOTAL OPERATING EXPENSES: | ||||
DEPOSITS TO RESERVE ACCOUNTS: | ||||
43. Replacement Reserve | ||||
44. Operating Reserve | ||||
45. TOTAL DEPOSITS TO RESERVE ACCOUNTS: | ||||
FINANCIAL EXPENSES (NON-RHCP): | ||||
46. Debt Service (1st) | ||||
47. Debt Service (2nd) | ||||
48.Other ___________________________ | ||||
49. Other___________________________ | ||||
50. Other___________________________ | ||||
51. TOTAL FINANCIAL EXPENSES: | ||||
DISTRIBUTIONS: | ||||
52. Distributions | ||||
53. TOTAL EXPENSES: |
CALCULATION OF ASSISTED UNIT EXPENSES FISCAL YEAR __________
Contract:___________________________ | Development name:___________________________ | |
Units -- Assisted/Total: ___________________________ | Prepared by:___________________________ |
ACCOUNT NAME | ASSISTED EXPENSES | ||||
TOTAL ACTUAL EXPENSES (D) | APPROVED PRORATION FACTOR (E) | ASSISTED UNIT ACTUALS (F) | ASSISTED UNIT BUDGET (G) | ||
MANAGEMENT FEE: | |||||
1. Sponsor Overhead | |||||
2. Contract Management Fee | |||||
3. TOTAL MANAGEMENT FEES: | |||||
ADMINISTRATION: | |||||
4. Marketing | |||||
5. Audit | |||||
6. Legal | |||||
7. Misc. Administrative Expenses | |||||
8. TOTAL ADMINISTRATION: | |||||
SALARIES: | |||||
9. On-Site or Off-Site Manager | |||||
10. Assistant Manager | |||||
11. Grounds and Maintenance Personnel | |||||
12. Desk Clerks | |||||
13. Janitorial Personnel | |||||
14. Housekeepers | |||||
15. Services Staff | |||||
16. Other | |||||
17. TOTAL SALARIES: | |||||
MAINTENANCE: | |||||
18. Supplies | |||||
19. Elevator Maintenance | |||||
20. Pest Control | |||||
21. Grounds Contracts | |||||
22. Interior Painting and Decorating | |||||
23. Other___________________________ | |||||
24. TOTAL MAINTENANCE: | |||||
UTILITIES: | |||||
25. Trash Removal | |||||
26. Electricity | |||||
27. Water and Sewer | |||||
28. Gas | |||||
29. HCD Use Only | |||||
30. TOTAL UTILITIES: | |||||
INSURANCE: | |||||
31. Property & Liability Insurance | |||||
32. TOTAL INSURANCE: | |||||
TAXES: | |||||
33. Real Estate Taxes/PILOTS | |||||
34. Business License | |||||
35. TOTAL TAXES: | |||||
OTHER: | |||||
36. Food | |||||
37. Support Services | |||||
38. Co-op Member Training/Education | |||||
39.___________________________ | |||||
40.___________________________ | |||||
41. TOTAL OTHER: | |||||
42. SUBTOTAL OPERATING EXPENSES: | |||||
DEPOSITS TO RESERVE ACCOUNTS: | |||||
43. Replacement Reserve | |||||
44. Operating Reserve | |||||
45. TOTAL RESERVES: | |||||
FINANCIAL EXPENSES (NON-RHCP): | |||||
46. Debt Service (1st) | |||||
47. Debt Service (2nd) | |||||
48. Other___________________________ | |||||
49. Othe___________________________r | |||||
50. Other ___________________________ | |||||
51. TOTAL FINANCIAL EXPENSES: | |||||
DISTRIBUTIONS: | |||||
52. Distributions | |||||
53. TOTAL EXPENSES: |
CALCULATION OF COMMERCIAL SPACE EXPENSES FISCAL YEAR _______________
Contract:___________________________ | Development name:___________________________ | |
Units -- Assisted/Total:___________________________ | Prepared by: ___________________________ |
ACCOUNT NAME | COMMERCIAL SPACE EXPENSES | ||||
TOTAL ACTUAL EXPENSES (D) | APPROVED PRORATION FACTOR (E) | COMMERCIAL SPACE ACTUALS (F) | COMMERCIAL SPACE BUDGET (G) | ||
MANAGEMENT FEE: | |||||
1. Sponsor Overhead | |||||
2. Contract Management Fee | |||||
3. TOTAL MANAGEMENT FEES: | |||||
ADMINISTRATION: | |||||
4. Marketing | |||||
5. Audit | |||||
6. Legal | |||||
7. Misc. Administrative Expenses | |||||
8. TOTAL ADMINISTRATION: | |||||
SALARIES: | |||||
9. On-Site or Off-Site Manager | |||||
10. Assistant Manager | |||||
11. Grounds and Maintenance Personnel | |||||
12. Desk Clerks | |||||
13. Janitorial Personnel | |||||
14. Housekeepers | |||||
15. Services Staff | |||||
16. Other | |||||
17. TOTAL SALARIES: | |||||
MAINTENANCE: | |||||
18. Supplies | |||||
19. Elevator Maintenance | |||||
20. Pest Control | |||||
21. Grounds Contracts | |||||
22. Interior Painting and Decorating | |||||
23. Other | |||||
24. TOTAL MAINTENANCE: | |||||
UTILITIES: | |||||
25. Trash Removal | |||||
26. Electricity | |||||
27. Water and Sewer | |||||
28. Gas | |||||
29. HCD Use Only | |||||
30. TOTAL UTILITIES: | |||||
INSURANCE: | |||||
31. Property & Liability Insurance | |||||
32. TOTAL INSURANCE: | |||||
TAXES: | |||||
33. Real Estate Taxes/PILOTS | |||||
34. Business License | |||||
35. TOTAL TAXES: | |||||
OTHER: | |||||
36. Food | |||||
37. Support Services | |||||
38. Co-op Member Training/Education | |||||
___________________________39. | |||||
___________________________40. | |||||
41. TOTAL OTHER: | |||||
42. SUBTOTAL OPERATING EXPENSES: | |||||
DEPOSITS TO RESERVE ACCOUNTS: | |||||
43. Replacement Reserve | |||||
44. Operating Reserve | |||||
45. TOTAL RESERVES: | |||||
FINANCIAL EXPENSES (NON-RHCP): | |||||
46. Debt Service (1st) | |||||
47. Debt Service (2nd) | |||||
48. Other___________________________ | |||||
49. Other___________________________ | |||||
50. Other___________________________ | |||||
51. TOTAL FINANCIAL EXPENSES: | |||||
DISTRIBUTIONS: | |||||
52. Distributions | |||||
53. TOTAL EXPENSES: |
USES OF NET OPERATING INCOME FISCAL YEAR __________
Contract:___________________________ | Development name: ___________________________ | |
Units -- Assisted/Total: ___________________________ | Prepared by: ___________________________ |
ASSISTED UNITS | NONASSISTED UNITS | RESIDENTIAL TOTAL | COMMERCIAL SPACE | ||
1. Actual Income | |||||
2. Approved Budgeted Operating Expenses | |||||
3. Actual Operating Expenses | |||||
4. Lesser of Line 2 or 3 | |||||
5. Net Operating Income | |||||
6. Deposits to Reserve Accounts | |||||
7. Financial Expenses | |||||
8. Sponsor Distributions | |||||
9. RHCP Interest Payments | |||||
10. RHCP Principal Payments | |||||
11. Sponsor Incentive Payments | |||||
12. Amount to Deposit in HCD Emergency Reserve Fund |
REPORT OF RHCP LOAN PAYMENT BALANCES FISCAL YEAR __________
Contract: ______________________________________________________________________
Units -- Assisted/Total: __________________________________________________
Development name: _______________________________________________________
Prepared by: _________________________________________________________________
AMOUNT | ||
1. Original Principal Amount | ||
2. Total Principal Paid in Previous Years | ||
3. Principal Paid in This Fiscal Year | ||
4. Outstanding Principal Balance | ||
5. Total Interest Due in Previous Years | ||
6. Interest Due in This Fiscal Year | ||
7. Total Interest Due | ||
8. Total Interest Paid in Previous Years | ||
9. Interest Paid in This Fiscal Year | ||
10. Total Interest Paid | ||
11. Outstanding Interest Balance |
REPORT OF VACANCY LOSS AND UNCOLLECTIBLE RENTS FISCAL YEAR _____
Contract:___________________________ | Development name:___________________________ | |
Units -- Assisted/Total:___________________________ | Prepared by:___________________________ |
PROPOSED (A) | APPROVED (B) | ||
Assisted Units: | |||
1. Rent Loss Due to Vacancy | |||
2. Uncollectible Rents | |||
3. Total Rent Loss -- Assisted Units | |||
Nonassisted Units: | |||
4. Rent Loss Due to Vacancy | |||
5. Uncollectible Rents | |||
6. Total Rent Loss -- Nonassisted Units | |||
Commercial Space: | |||
4. Rent Loss Due to Vacancy | |||
5. Uncollectible Rents | |||
6. Total Rent Loss -- Commercial Space | |||
7. TOTAL PROJECT RENT LOSS |
REPORT OF REPLACEMENT RESERVE ACCOUNT FISCAL YEAR _______________
Contract:___________________________ | Development name:___________________________ | |
Units -- Assisted/Total:___________________________ | Prepared by:___________________________ |
PROPOSED (A) | APPROVED (B) | |||
1. | Beginning Balance | |||
2. | Deposits | |||
3. | Withdrawals | |||
4. | Ending Balance | |||
5. | Summary Withdrawals | |||
___________________________ | ||||
___________________________ | ||||
___________________________ | ||||
___________________________ | ||||
6. | TOTAL WITHDRAWALS | |||
FOOTNOTES:___________________________ | ||||
___________________________ | ||||
___________________________ | ||||
___________________________ |
REPORT ON OPERATING RESERVE ACCOUNT FISCAL YEAR __________
Contract:___________________________ | Development name:___________________________ | |
Units -- Assisted/Total:___________________________ | Prepared by:___________________________ |
PROPOSED (A) | APPROVED (B) | |||
1. | Beginning Balance | |||
2. | Deposits | |||
3. | Withdrawals | |||
4. | Ending Balance | |||
5. | Summary of Withdrawals | |||
___________________________ | ||||
___________________________ | ||||
___________________________ | ||||
___________________________ | ||||
6. | TOTAL WITHDRAWALS | |||
FOOTNOTES:___________________________ | ||||
___________________________ | ||||
___________________________ | ||||
___________________________ |
Cal. Code Regs. Tit. 25, § 8101
2. New section refiled 4-26-90 as an emergency; operative 4-26-90 (Register 90, No. 23). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 8-24-90.
3. New section refiled 8-27-90 as an emergency; operative 8-27-90 (Register 90, No. 42). A Certificate of Compliance must be transmitted to OAL by 12-26-90 or emergency language will be repealed by operation of law on the following day.
4. New section refiled 12-19-90 as an emergency pursuant to Health and Safety Code section 50771.3; operative 12-19-90 (Register 91, No. 4). A Certificate of Compliance must be transmitted to OAL by 4-18-91 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 12-19-90 order transmitted to OAL 1-4-91; disapproved by OAL 2-4-91 (Register 91, No. 13).
6. New section refiled 2-20-91 as an emergency; operative 2-20-91 (Register 91, No. 13). A Certificate of Compliance must be transmitted to OAL by 6-17-91 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 6-14-91 order including amendment of subsections (a) and (c) and form transmitted to OAL 5-15-91 and filed 6-14-91 (Register 91, No. 38).
Note: Authority cited: Section 50771.1, Health and Safety Code. Reference: Section 50771.1, Health and Safety Code.
1. New section filed 12-29-89 as an emergency; operative 12-29-89 (Register 90, No. 3). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 4-30-90.
2. New section refiled 4-26-90 as an emergency; operative 4-26-90 (Register 90, No. 23). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 8-24-90.
3. New section refiled 8-27-90 as an emergency; operative 8-27-90 (Register 90, No. 42). A Certificate of Compliance must be transmitted to OAL by 12-26-90 or emergency language will be repealed by operation of law on the following day.
4. New section refiled 12-19-90 as an emergency pursuant to Health and Safety Code section 50771.3; operative 12-19-90 (Register 91, No. 4). A Certificate of Compliance must be transmitted to OAL by 4-18-91 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 12-19-90 order transmitted to OAL 1-4-91; disapproved by OAL 2-4-91 (Register 91, No. 13).
6. New section refiled 2-20-91 as an emergency; operative 2-20-91 (Register 91, No. 13). A Certificate of Compliance must be transmitted to OAL by 6-17-91 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 6-14-91 order including amendment of subsections (a) and (c) and form transmitted to OAL 5-15-91 and filed 6-14-91 (Register 91, No. 38).
REPORT OF VACANCY LOSS AND UNCOLLECTIBLE RENTS
FISCAL YEAR ___________
Contact: ________________ Development name: _________________
Units-Assisted/Total:_______________ Prepared by: ____________
PROPOSED (A) | APPROVED (B) |
Assisted Units: | |
1. Rent Loss Due to Vacancy | |
2. Uncollectible Rents | |
3. Total Rent Loss-Assisted Units | |
Nonassisted Units: | |
4.Rent Loss Due to Vacancy | |
5. Uncollectible Rents | |
6. Total Rent Loss-Nonassisted Units | |
Commercial Space: | |
4. Rent Loss Due to Vacancy | |
5. Uncollectible Rents | |
6. Total Rent Loss-Commercial Space | |
7. TOTAL PROJECT RENT LOSS |
REPORT OF REPLACEMENT RESERVE ACCOUNT
FISCAL YEAR ___________
Contact: ________________ Development name: _________________
Units-Assisted/Total:_______________ Prepared by: ____________
PROPOSED (A) | APPROVED (B) |
1. Beginning Balance | |
2. Deposits | |
3. Withdrawals | |
4.Ending Balance | |
5. Summary Withdrawals | |
6. TOTAL WITHDRAWALS |
FOOTNOTES:______________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Note: Authority cited: Section 50771.1, Health and Safety Code. Reference: Section 50771.1, Health and Safety Code.
1. New section filed 12-29-89 as an emergency; operative 12-29-89 (Register 90, No. 3). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 4-30-90.
2. New section refiled 4-26-90 as an emergency; operative 4-26-90 (Register 90, No. 23). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 8-24-90.
3. New section refiled 8-27-90 as an emergency; operative 8-27-90 (Register 90, No. 42). A Certificate of Compliance must be transmitted to OAL by 12-26-90 or emergency language will be repealed by operation of law on the following day.
4. New section refiled 12-19-90 as an emergency pursuant to Health and Safety Code section 50771.3; operative 12-19-90 (Register 91, No. 4). A Certificate of Compliance must be transmitted to OAL by 4-18-91 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 12-19-90 order transmitted to OAL 1-4-91; disapproved by OAL 2-4-91 (Register 91, No. 13).
6. New section refiled 2-20-91 as an emergency; operative 2-20-91 (Register 91, No. 13). A Certificate of Compliance must be transmitted to OAL by 6-17-91 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 6-14-91 order including amendment of subsections (a) and (c) and form transmitted to OAL 5-15-91 and filed 6-14-91 (Register 91, No. 38).