Instructions for Preparation of Form HUD-50075.2, Capital Fund Program
-- Five-Year Action Plan

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This information collection is authorized by Section 511 of the Quality
Housing and Work Responsibility Act, which added a new section 5A to the
U.S. Housing Act of 1937, as amended, which introduced 5-Year and Annual
PHA Plans. The 5-Year and Annual PHA plans provide a ready source for
interested parties to locate basic PHA policies, rules, and requirements
concerning the PHA's operations, programs, and services, and informs
HUD, families served by the PHA, and members of the public of the PHA's
mission and strategies for serving the needs of low-income and very
low-income families. This form is to be used by all PHA types for
submission of the 5-Year and Annual Plans to HUD. Public reporting
burden for this information collection is estimated to average 3 hours
per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. HUD may not
collect this information, and respondents are not required to complete
this form, unless it displays a currently valid OMB Control Number.

**Privacy Act Notice.** The United States Department of Housing and
Urban Development is authorized to solicit the information requested in
this form by virtue of Title 12, U.S. Code, Section 1701 et seq., and
regulations promulgated thereunder at Title 12, Code of Federal
Regulations. Responses to the collection of information are required to
obtain a benefit or to retain a benefit. The information requested does
not lend itself to confidentiality\
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Prepare a separate Form HUD-50075.2 for each annual formula grant,
describing the activities, which are planned to be undertaken with the
current year's Capital Fund Program Grant and Capital Fund Financing
Program (CFFP) financing. Submit this form to HUD electronically as part
of each Annual Plan submission. On an as-needed basis, submit a revised
form when there are significant deviation or significant
amendment/modifications to the approved CFP Five-Year Action Plan.

**Natural disasters and emergencies:**

Prepare a separate Form HUD-50075.2 for each funding request from the
reserve for natural disasters and emergencies.

**Report Submission For the CFP Five --Year Action Plan.**

At the end of the PHA's fiscal year end, complete the sections as
delineated. Submit the form(s) to HUD electronically together with other
required documents. Continue reporting at the end of each program year,
until the program is completed or all funds are expended.

**Revisions to the Capital Fund Program -- Five-Year Action Plan**,
which are not significant deviation or significant
amendment/modifications to the PHA Plan, (e.g. expenditures for
emergency work, revisions resulting from the PHA's application of
fungibility) shall be reported on the Capital Fund Program -- Five-Year
Action Plan.

Upon completion or termination of the activities funded in a specific
grant year, complete the Capital Fund Program -- Five-Year Action Plan
and submit to HUD with the next Annual Plan submission.

**Part I: Summary.**

  ---------------------- ------------------------------------------------
  PHA Name/Number        Enter the Name and PHA number

  Locality               Enter City or County and State

  Original Five-Year     Check the appropriate box. Consecutively number
  Plan/Revision Number   each revision submitted.

  Row A: Development     Group the planned capital projects by
  Number/Name (PHA Wide) development first. List the PHA-wide projects
                         last.

  Work Statement for     Enter the Federal Fiscal Year (FFY) only. Do not
  Year 1                 enter any other information on Year 1. That
                         information is already available on the Annual
                         Statement.

  Work Statement for     Enter the FFY for Years 2-5.
  Years 2-5              

  Row B: Physical        Total the planned capital projects for each
  Improvements subtotal  individual development by the corresponding
                         year.

  Row C: Management      Total the planned management projects for each
  Improvements           individual development by the corresponding
                         year.

  Row D: PHA-Wide        Total the planned PHA-wide non-dwelling
  Non-dwelling           structures and equipment costs by the
  Structures and         corresponding year.
  Equipment              

  Row E: Administration  Total the planned administration costs by the
                         corresponding year.

  Row F: Other           Total the planned other costs by the
                         corresponding year.

  Row G: Operations      Total the planned operations costs by the
                         corresponding year

  Row H: Demolition      Total the planned demolition costs by the
                         corresponding year

  Row I.: Development    Total the planned development costs by the
                         corresponding year

  Row J: Capital Fund    Total the planned debt service costs by the
  Financing-Debt Service corresponding year

  Row K: Total CFP Funds Enter the total Capital Fund Program funding
  (estimated)            estimated for Years 2-5.

  Row L: Total Non-CFP   Enter the total non-capital funds anticipated
  Funds                  for Years 1-5.

  Row M: Grand Total     Total the grand total from rows B-K for Years
                         2-5.
  ---------------------- ------------------------------------------------

**Part I: Summary (Continuation for PHA-wide activities). See
instructions above under Part I, Summary**

**===========================================================================================================================**

**Part II: Supporting Pages -- Physical Needs Work Statements.**

+-------------+--------------------------------------------------------+
| Work        | Enter the Federal Fiscal Year (FFY) only. Do not enter |
| Statement   | any other information on Year 1. That information is   |
| for Year 1  | already available on the Annual Statement.             |
|             |                                                        |
| FFY\_       |                                                        |
+-------------+--------------------------------------------------------+
| Work        | Enter the corresponding Years 2-5 and add FFY years.   |
| Statement   |                                                        |
| for Years   |                                                        |
| 2-5         |                                                        |
+-------------+--------------------------------------------------------+
| Development | Enter the name and number of the developments with     |
| Number/Name | planned activities.                                    |
+-------------+--------------------------------------------------------+
| Major Work  | Identify the planned major work categories by          |
| Categories  | Development for Years 2-5. (Example: install new       |
|             | exterior doors, replace windows, etc.)                 |
+-------------+--------------------------------------------------------+
| Quantity    | List the number of planned work items such as replace  |
|             | 100 exterior doors, etc.                               |
+-------------+--------------------------------------------------------+
| Estimated   | Enter the estimated costs for work activities for      |
| Cost        | Years 2-5.                                             |
+-------------+--------------------------------------------------------+
| Subtotal of | A subtotal amount must be entered for all work items   |
| Estimated   | listed.                                                |
| Cost.       |                                                        |
+-------------+--------------------------------------------------------+

=============================================================================================================================

**Part III: Supporting Pages -- Management Needs Work Statements.**

+-------------+--------------------------------------------------------+
| Work        | Enter the Federal Fiscal Year (FFY) only. Do not enter |
| Statement   | any other information on Year 1. That information is   |
| for Year 1  | already available on the Annual Statement.             |
|             |                                                        |
| FFY\_       |                                                        |
+-------------+--------------------------------------------------------+
| Work        | Enter the corresponding Years 2-5 and add FFY years.   |
| Statement   |                                                        |
| for Years   |                                                        |
| 2-5         |                                                        |
+-------------+--------------------------------------------------------+
| Development | Enter the name and number of the developments with     |
| Number/Name | planned activities.                                    |
+-------------+--------------------------------------------------------+
| Major Work  | Identify the planned major work categories by          |
| Categories  | Development for Years 2-5. (Example: provide staff     |
|             | computer training; computer purchase, etc.)            |
+-------------+--------------------------------------------------------+
| Quantity    | List the number of planned work items such as replace  |
|             | 10 desktop computers, etc.                             |
+-------------+--------------------------------------------------------+
| Estimated   | Enter the estimated costs for work activities for      |
| Cost        | Years 2-5.                                             |
+-------------+--------------------------------------------------------+
| Subtotal of | A subtotal amount must be entered for all work items   |
| Estimated   | listed.                                                |
| Cost.       |                                                        |
+-------------+--------------------------------------------------------+