Fillable New Hampshire Housing HOME Compliance Monitoring Report (New Hampshire Housing)

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New Hampshire Housing HOME Compliance Monitoring Report (New Hampshire Housing)

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New Hampshire Housing HOME Compliance Monitoring Report
Project Name: ________________________ Management Agent: ____________________Owner: _______________________
Report Date___________ Reporting Period: from__________ to ____________
Total # of Units in the project: ____ Total # of HOME Units in Project: ____ Total High Home: ____ Total Low HOME: ____
Report prepared by: ______________________________ Phone #: ______________________ Page #_____ of _____
Subsidy Type: N/A=Not Applicable; RD=Rural Development; PBA=Project Based Assistance (Section 8); PBV= Project Based Voucher (Section 8); TBA=Tenant Based
Assistance (Section 8)
Unit
#
Low or
High
HOME
unit
# of
BRs
Resident Name
# in
HH
Move
In Date
Move In
Gross
Income
Date of
Last
Income
Cert.
Subsidy
Type
Max
HOME
rent
Contract
Rent
UA
Gross
Rent
Revised 1/2017
Unit
#
Low or
High
HOME
unit
# of
BRs
Resident Name
# in
HH
Move
In Date
Move In
Gross
Income
Date of
Last
Income
Cert.
Subsidy
Type
Max
HOME
rent
Contract
Rent
UA
Gross
Rent
CERTIFICATION OF COMPLIANCE
__________________________________________________ hereby certifies to the New Hampshire Housing Finance Authority that each building and all
HOME-assisted units in the property are suitable for occupancy, and in compliance with all State and local health, safety and other
applicable codes, ordinances and requirements, and with the Uniform Physical Condition Standards (UPCS).
__________________________________________________
(Owner’s Signature or Duly Authorized Agent)
(Owner’s Name)
Revised 1/2017
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New Hampshire Housing HOME Compliance Monitoring Report (New Hampshire Housing)

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Completed 30 August 2020

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