Signature: . Date: .
CITY OF MASSILLON COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM
Sub-recipient Report: Direct Benefit Activities
Project Activity: .
Agency Name: .
Agency Address: .
Contact Person (Name/Title): ..
Report Period: From: To: .
HUD PERFORMANCE OUTCOME MEASUREMENT SYSTEM
HUD Required Performance Output Indicators
Amount of Money Leveraged by CDBG-Funded Activity
Other Federal Funds Leveraged
State Funds Leveraged
Local (City) Funds Leveraged
Private Funds Leveraged
Total Funds Leveraged
Persons Assisted by this CDBG-funded Activity
Total Number of Unduplicated Persons Assisted
Total Number of Disabled Persons Assisted
Income Status (% of Median Family Income “MFI”) Total
Total Persons Assisted (0-30% MFI)
Total Persons Assisted (31-50% MFI)
Total Persons Assisted (51-80% MFI)
Total Persons Assisted (>80% MFI)
Race / Ethnicity of Persons Assisted
SINGLE RACE PERSONS
Black or African American
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native & White
Asian & White
Black or African American & White
American Indian or Alaska Native & Black
Total Number of Persons Assisted: