Tribal Annual Performance Report (TAPR) Excel workbook

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Overview

Instructions
Profile
Form
PriorityListForm
TribePartI
Tribe Part II
150 Per Cent
HIP Home

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Sheet 1: Instructions

	This workbook was created using Windows 7, Office Suite Excel 10. There may be some compatibility issues when trying to use this workbook with an earlier version of Excel.May not work with Microsoft Excel 5.0/95 Workbook version.
	You are using the Electronic VBA Version of the 2019 HIP Tribal Annual Performance Report. This version shall only be used for FY 2019.
	This workbook contains macros and formulas, to properly use this Excel Workbook, you must save as enabled Workbook or enable the security macros.
	To save for use with an older version of Excel,choose Office,then Save As and select one of these options from the Save As Type dropdown list:1)Excel 97-2003 Workbook;2)Save as type:Excel Enabled Workbook;3)Save by adding your tribe name to file;(e.g. 2019 HIP Tribal Annual Performance Report - Your Tribe name)
	The 2019 HIP Tribal Annual Performance Report is due to your respective region by COB December 31, 2018.
	Before submitting this workbook to your respective Regional Office, please save as type: Excel Workbook.
	Operating Systems: Windows 7 or recommended Windows Vista, or Windows xp Service pack 3
	Profile
	Item Number Instructions
	To properly populate the combo box, please make selection in the regions dropdown box twice.
1	Select Region from Dropdown box, twice.
2	Select Tribe/Consortium from Dropdown box.
3	Press the continue button.
4	Select member Tribe of Consortia from Dropdown Box
5	Provide four digit fiscal year (FY) that identifies fiscal year in which work plan will be implemented. (Fiscal year beginning in October 1, of the current calendar year).
6	Provide name of preparer in the event we may need to contact you.
7	Select position that you are currently holding from Dropdown Box.
8	Provide phone number.
9	Provide fax number.
10	Provide email address.
11	Digital signature, will Autofill when cell "D10" is filled. (Cell is protected)
12	Will Autofill when cell "D9" is filled. (Cell is protected)
	Form
	Portions of this worksheet are protected and has formulas.
1	Provide District or Member Tribe of consortia, if applicable.
2	Provide Last Name of Applicant.
3	Provide First Name of Applicant.
4	Select Suffix Name from Dropdown Box ( i.e. Sr. Jr. III. IV)
5	Provide Tribal Enrollment number of applicant.
6	Select Category of service, applicant is requesting from Dropdown Box. (i.e. A, B, C-1, C-2, D)
7a	Provide Last Name of Spouse
7b	Provide year to be served
7c	Provide date of when the application was signed
8	Provide First Name of Spouse.
9	Provide enrollment number of spouse.
10	Provide total amount of income for all family members.
11	Provide number of occupants in household.
12	Provide birthdate of 1st aged person. (i.e. 06/13/1950)
13	Provide degree of disability (i.e. 100%, 50%)
14	Provide number of dependents.
15	Select "Yes" if house is in dilapidated condition Select, "No" if house in in repairable condition.
16	Select "Yes" if applicant is a Native Veteran
17	Provide date when applicant signed application.
18	Select "Yes" if applicant received a letter of denial of service and is waiting list from Tribal Housing Authority. Select "Pending" if applicant will get a letter from Housing Authority at a later time. Select, "No" if applicant received housing assitance within the last 20 years. (Has Hyperlink)
19	Provide an Estimated Start Date. (i.e. 07/16/2013)
20	Provide an Estimated cost for project. (i.e. 130,000)
21	Click the "Transfer" button to print Priority Calculation sheet and transfer data to worksheets "Priority Calculation" and "Tribe Part I". Place printed calculation sheet in Applicant case file.
22	For extra sheets, Click the "Print" button to print the Calculation sheet .
23
24
	*Program Category: (A) Interim Improvements; (B) Renovations; (C-1) Replacement Housing (replacement of existing, substandard dwelling); (C-2) Replacement Housing (housing provided, no existing dwelling)
	Priority List Form
	Portions of this worksheet are protected and has formulas.
	Row "2", Cell "C2" will auto fill from information entered in worksheet "Form". (Cell is protected)
1	Row "2", Cell "M2" will auto fill from information entered in worksheet "Form". (Cell is protected)
2	Row "3", Cell "M3" will auto fill from information entered in worksheet "Form". (Cell is protected)
3	Row "4",Cell "M4" will auto fill from information entered in worksheet "Form". (Cell is protected)
4	Column B will auto fill from information entered in worksheet "Form".
5	Column C will auto fill from information entered in worksheet "Form".
6	Column D will auto fill from information entered in worksheet "Form".
7	Column E will auto fill from information entered in worksheet "Form".
8	Column F will auto fill from information entered in worksheet "Form".
9	Column G will auto fill from information entered in worksheet "Form".
10	Column H will auto fill from information entered in worksheet "Form".
11	Column I will auto fill from information entered in worksheet "Form".
12	Column J will auto fill from information entered in worksheet "Form".
13	Column K will auto fill from information entered in worksheet "Form".
14	Column L will auto fill from information entered in worksheet "Form".
15	Column M will auto fill from information entered in worksheet "Form".
16	Column N will auto fill from information entered in worksheet "Form".
17	Column O will auto fill from information entered in worksheet "Form".
18	Column P will auto fill from information entered in worksheet "Form".
19	Column Q will auto fill from information entered in worksheet "Form".
20	Column R will auto fill from information entered in worksheet "Form".
21	Column S will auto fill from information entered in worksheet "Form".
22	Column T will auto fill from information entered in worksheet "Form".
23	Column U will auto fill from information entered in worksheet "Form".
24	Column V will auto fill from information entered in worksheet "Form".
25	When printing Priority Calculation sheet, to prevent printing extra sheets, select file, select print, select active sheets and select the number of sheets you want to print.
	Tribe Part I
	Item Number Instructions
	Row "2", Cell "E2" will auto fill from information entered in worksheet "Form". (Cell is protected)
1	Row "2", Cell "K2" will auto fill from information entered in worksheet "Form". (Cell is protected)
	Row "3", Cell "E3" will auto fill from information entered in worksheet "Form". (Cell is protected)
2	Row "3", Cell "K3" will auto fill from information entered in worksheet "Form". (Cell is protected)
	Row "4",Cell "E4" will auto fill from information entered in worksheet "Form". (Cell is protected)
3	Row "4", Cell "K4" will auto fill from information entered in worksheet "Form". (Cell is protected)
	Row "5", Cell "E5" will auto fill from information entered in worksheet "Form". (Cell is protected)
4	Row "5", Cell "K5" will auto fill from information entered in worksheet "Form". (Cell is protected)
	Column B will auto fill from information entered in worksheet "Form".
5	Column C will auto fill from information entered in worksheet "Form".
	Column D will auto fill from information entered in worksheet "Form".
	Column E will auto fill from information entered in worksheet "Form".
6	Column F will auto fill from information entered in worksheet "Form".
7	Column G will auto fill from information entered in worksheet "Form".
	Column H will auto fill from information entered in worksheet "Form".
	Column I will auto fill from information entered in worksheet "Form".
	Column J will auto fill from information entered in worksheet "Form".
8a	Column K will auto fill from information entered in worksheet "Form".
8b	Column L will auto fill from information entered in worksheet "Form".
9a	Column M will auto fill from information entered in worksheet "Form".
	Column N will auto fill from information entered in worksheet "Form".
9b	When printing Tribe Part I, to prevent printing extra sheets, select file, select print,select print active sheets and select the number of sheets you want to print.
	Tribe Part II
	Item Number Instructions
	Portions of this worksheet areprotected and has formulas, it contains no macros.
	Will autofill (Cells are protected)
1a	Will autofill (Cells are protected)
1b	Will autofill (Cells are protected)
2a	Will autofill (Cells are protected)
2b	Will autofill (Cells are protected)
2c	For each recipient provided program service, within accomplishing reporting FY, enter last and first name of recipient.
3	Provide Name of the Tribe/Consortium for which information is being reported.
4	For each recipient listed in Item Number 3,enter the type of program assistance provided, by entering a digit (1) in the applicable Program Category column(s):
5	(A) Interim Improvements (Repairs)
	(B) Renovations
	(C-1) Replacement Housing (replacement of existing substandard housing).
	(C-2) New Housing (provision of housing for families without a home).
	(D) Down Payment Assistance (provision of housing in providing a grant for down payment).
	For each recipient listed in Item 6a, enter the Actual Start Date (MM/YY) of the construction project.
6a	For each recipient listed in Item 6, enter Actual Completion Date of the project.
6b	For each recipient listed in Item Number 7a, enter Actual Administrative Cost of the project.
7a	For each recipient listed in Item Number 7b, enter Actual Project Cost.
7b	Will autofill. (Cell is Protected)
7c

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Sheet 2: Profile

Housing Improvement Program
Tribal Annual Performance Report
Profile
1	Region
2	Tribe / Consortia
3	Agency
4	Fiscal Year
5	Name
6	Title
7	Phone #
8	Fax #
9	Email
	I certify that the information given is true, complete and correct to the best of my knowledge, belief, and they are made in good faith.
10	Signature
11	Date
PRIVACY ACT STATEMENT
25 CFR 265 and 25 U.S.C. 13 authorize the collection of this information. This information is covered by the system of record notice “Indian Housing Improvement Program, Interior, BIA-10.” The primary use of this information is to determine eligibility for assistance under the Housing Improvement Program. The records contained therein may only be disclosed in accordance with the routine uses and may not otherwise be disclosed by any means of communication to any person, or to another agency, except pursuant to a written request by, or with prior written consent of the individual to whom the record pertains. If the BIA uses the information furnished on this form for purposes other than those indicated above, it may provide you with an additional statement reflecting those purposes. Executive Order 9397 authorizes the collection of your Social Security number. Furnishing the information is voluntary but failure to do so may result in disapproval of your application.
PAPERWORK REDUCTION ACT STATEMENT
This information is being collected to select eligible families or individuals to participate in the Housing Improvement Program. Response to this request is required to obtain a benefit in accordance with 25 CFR 256. You are not required to respond to this collection of information unless it displays a currently valid OMB control number. This information will be used to determine the eligibility and the ranking of the applicant. Public reporting burden for this form is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to Information Collection Clearance Officer – Indian Affairs, 1849 C Street, NW, MS-4141, Washington, DC 20240.

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Sheet 3: Form

	See Instructions	PRIORITY CALCULATION FORM
	Region
1	ALASKA			Privacy Act Warning! Information on this sheet may pertain to the Privacy Act, all persons handing records must protect integrity, security and confidentiality!
	Tribe of Consortia
2	Sitka Tribe Of Alaska
	District, Agency, Member Tribe of Consortia					Fiscal Year		Date of Application
3								Enter the date when the applicant signed the application.
	Last Name of Applicant	First Name		Suffix		Enrollment #		Category:
4		Enter Applicant's Last Name. Please ensure that Tribe name is selected in Cell B7 from dropdown box.		Please make selection from dropdown box.		Provide Enrollment #		Please make selection from Dropdown Box.
										Pts
5	Household Income:			Enter family size, then enter total income at right!		Enter the total income for all family members, the points for this factor will autocalulate to the right!		#N/A	#N/A	0
6	Aged Person:			Enter birthdate, e.g. 6/3/1954	0	0	0	0		0
7	Disabled Individual:			Select "Yes or No" need only one document stating condition.		0		0	0	0
8	Dependent Children:	Under age 18		Enter the number of Dependents under 18 years of age		0		0	0	0
9	Homeless/ Dilapidated			Select"Overcrowded or Dilapidated"		#VALUE!	0	Homeless		0
10						#VALUE!	0	Dilapidated		0
11	Overcrowded			Select"Yes or No"		0		0	0	0
12	Veteran			Select "Yes or No"		0			0	0
13	Have you applied for the Veterans Home Loan Program.			Select "Yes or No"		No
14								Subtotal	0	0
15	DownPayment Assistance, must be provide a Certificate of Eligibility from Lender.							Select "Yes" if the applicant is seeking down payment assistance, otherwise select "No", Category selection must be "D".	0	0
16	You are on the waiting list and have obtained a denial letter from the Local Housing Authority.							Select "Yes" if the applicant has a copy of a housing assistance application from the local Housing Authority. You may select "Pending", but the applicant must provide a copy before HIP assistance can be provided. Otherwise select "No".	0	0
17	You have received prior Federal Housing Assistance from HIP, NAHASDA, 1937 ACT, USDA							Select "Yes" if the applicant has received prior Federal Housing Assistance within the past Twenty Years, otherwise select "No".	0	0
18									0	0
19	HIP Eligibility requirements 25 CFR Part 256 effective after 12/10/15					Eligibility Status			0	0
20	If known, please provide an estimated start date to renovate or build new!
21	If known, please provide an estimated cost to renovate or build new!
22	Date of Evaluation:					See instructions on printing
23	Name of Evaluator:
24	Contact Number:

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Sheet 4: PriorityListForm

	Regional Office:					Number of Tribes Submitting Workplans:								Number of Eligible Applicants:						0
	Fiscal Year:					Number of Tribes In Region:								Number of Applications Considered:						0
Privacy Act Warning! Information on this sheet may pertain to the Privacy Act, must protect integrity, security and confidentiality!
	LAST NAME	FIRST NAME	SR. JR. III IV Suffix	Enter format dd:mm:yy Tribe/ District	Category B, C-1, C-2. Cat	Family size	See Table Page 711 25 CFR Part 256.14 Factor Number One, Annual Household Income. Income 1040 Form	Income Pts	See Table Page 711 25 CFR Part 256.14 Factor Number Two, Aged Person. Aged	See Table Page 711 25 CFR Part 256.14 Factor Number Three, Disabled Individuals. Disabled	See Table Page 711 25 CFR Part 256.14 Factor Number Four, Dependent Children. Dependent Children	See Table Page 711 25 CFR Part 256.14 Factor Number Five, Overcrowded. Homeless	See Table Page 711 25 CFR Part 256.14 Factor Number Five, Dilapidated. Dilapidated	See Table Page 711 25 CFR Part 256.14 Factor Number Five, Homeless. Overcrowded	No points assessed for this factor, for tracking data purposes only! Native Veteran	Veteran Loan	Down Payment	Denial Letter	Prior Assistance	This field is linked to the Applicant Data form . Eligibility Status	Total Points	Notes
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---

Sheet 5: TribePartI

PART I - TRIBAL WORK PLAN											Date:
1	Work Plan for Fiscal Year:									Name:
2	Name of Tribe / Consortium:									Title:
3	Number of Eligible Applicants:									Phone:
4	Number of Applications Received:									Fax:
	See instructions for printing form
5. Name of Eligible Applicant (ranked in order of need)				6. Applicant's Servicing Tribe	7. Program Category (Enter One As Applicable)					8a. Estimated Start Date	8b. Estimated Project Costs 25 CFR 256.17(b))**	Eligibility Status	8c. Priority Ranking Points (ranked in order from highest to lowest)
	Last	First	Suffix		(A)	(B)	(C-1)	(C-2)	(D)
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3470
3471
3472
3473
3474
3475
3476
3477
3478
3479
3480
3481
3482
3483
3484
3485
3486
3487
3488
3489
3490
3491
3492
3493
3494
3495
3496
3497
3498
3499
3500
3501
3502
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3507
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3641
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3650
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3808
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3990
3991
3992
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3995
3996
3997
3998
3999
4000
4001
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4008
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4010
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4097
4098
4099
4100

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Sheet 6: Tribe Part II

PART II - REPORT OF ACCOMPLISHMENTS
1	a. Number of Applicants Provided Service:									Name of Tribe / Consortium
	b. Number of Projects Completed within Fiscal Year:
2	a. Amount of Total Administration Funds to Report:									REGION
	b. Amount of Total Constuction Funds to Report:									AGENCY
	c. Amount of Total HIP Funds to Report:									FISCAL YEAR
	Type or Printed Name			Title
	Telephone			Fax
3	Name of Applicant Provided Program Services		4. Applicant's Servicing Tribe	5. Program Category (Enter one, as applicable)					6. Construction Schedules		7. Construction Funds
	Last	First		(A)	(B)	(C-1)	(C-2)	(D)	a.Date of Construction Start	b.Date of Construction Completion	a. Admin cost	b. Project cost	c.Sum of 7(a) & 7(b)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52

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Sheet 7: 150 Per Cent

FACTOR NO. 1 - HIP ELIGIBILITY/SELECTION CRITERIA @ 150%
INCOME GUIDELINE POINT SCHEDULE FOR ALL STATES EXCEPT ALASKA & HAWAII
FAMILY SIZE	0% to 25% of PG 25 POINTS			26% to 50% of PG 20 POINTS			51% to 75% of PG 15 POINTS			76% to 100 of PG 10 POINTS			101% to 125% of PG 5 POINTS			125% to 150% of PG 0 POINTS			OVER 150% of FPIG INELIGIBLE
1	0	TO	3,035	3,036	TO	6,070	6,071	TO	9,105	9,106	TO	12,140	12,141	TO	15,175	15,176	TO	18,210	18,211	& HIGHER
2	0	TO	4,115	4,116	TO	8,230	8,231	TO	12,345	12,346	TO	16,460	16,461	TO	20,575	20,576	TO	24,690	24,691	& HIGHER
3	0	TO	5,195	5,196	TO	10,390	10,391	TO	15,585	15,586	TO	20,780	20,781	TO	25,975	25,976	TO	31,170	31,171	& HIGHER
4	0	TO	6,275	6,276	TO	12,550	12,551	TO	18,825	18,826	TO	25,100	25,101	TO	31,375	31,376	TO	37,650	37,651	& HIGHER
5	0	TO	7,355	7,356	TO	14,710	14,711	TO	22,065	22,066	TO	29,420	29,421	TO	36,775	36,776	TO	44,130	44,131	& HIGHER
6	0	TO	8,435	8,436	TO	16,870	16,871	TO	25,305	25,306	TO	33,740	33,741	TO	42,175	42,176	TO	50,610	50,611	& HIGHER
7	0	TO	9,515	9,516	TO	19,030	19,031	TO	28,545	28,546	TO	38,060	38,061	TO	47,575	47,576	TO	57,090	57,091	& HIGHER
8	0	TO	10,595	10,596	TO	21,190	21,191	TO	31,785	31,786	TO	42,380	42,381	TO	52,975	52,976	TO	63,570	63,571	& HIGHER
9	0	TO	11,675	11,676	TO	23,350	23,351	TO	35,025	35,026	TO	46,700	46,701	TO	58,375	58,376	TO	70,050	70,051	& HIGHER
10	0	TO	12,755	12,756	TO	25,510	25,511	TO	38,265	38,266	TO	51,020	51,021	TO	63,775	63,776	TO	76,530	76,531	& HIGHER
11	0	TO	13,835	13,836	TO	27,670	27,671	TO	41,505	41,506	TO	55,340	55,341	TO	69,175	69,176	TO	83,010	83,011	& HIGHER
12	0	TO	14,915	14,916	TO	29,830	29,831	TO	44,745	44,746	TO	59,660	59,661	TO	74,575	74,576	TO	89,490	89,491	& HIGHER
EACH PERSON OVER 12 ADD			1,080			2,160			3,240			4,320			5,400			6,480	6,481	& HIGHER
	25%=		3,035	50%=		6,070	'75%=		9,105	100%=		12,140	125%=		15,175	150% =		18,210		-
	@ Add'l:		810	@ Add'l:		2,160	@ Add'l:		3,240	@ Add'l:		4,320	@ Add'l:		5,400	@ Add'l:		6,480		-
PG =	HHS Poverty Guidelines
FACTOR NO. 1 - HIP ELIGIBILITY/SELECTION CRITERIA @ 150%
INCOME GUIDELINE POINT SCHEDULE FOR ALASKA
FAMILY SIZE	0% to 25% of PG 25 POINTS			26% to 50% of PG 20 POINTS			51% to 75% of PG 15 POINTS			76% to 100 of PG 10 POINTS			101% to 125% of PG 5 POINTS			126% to 150% of PG 0 POINTS			OVER 150% of FPIG INELIGIBLE
1	0	TO	3,795	3,796	TO	7,590	7,591	TO	11,385	11,386	TO	15,180	15,181	TO	18,975	18,976	TO	22,770	22,771	& HIGHER
2	0	TO	5,145	5,146	TO	10,290	10,291	TO	15,435	15,436	TO	20,580	20,581	TO	25,725	25,726	TO	30,870	30,871	& HIGHER
3	0	TO	6,495	6,496	TO	12,990	12,991	TO	19,485	19,486	TO	25,980	25,981	TO	32,475	32,476	TO	38,970	38,971	& HIGHER
4	0	TO	7,845	7,846	TO	15,690	15,691	TO	23,535	23,536	TO	31,380	31,381	TO	39,225	39,226	TO	47,070	47,071	& HIGHER
5	0	TO	9,195	9,196	TO	18,390	18,391	TO	27,585	27,586	TO	36,780	36,781	TO	45,975	45,976	TO	55,170	55,171	& HIGHER
6	0	TO	10,545	10,546	TO	21,090	21,091	TO	31,635	31,636	TO	42,180	42,181	TO	52,725	52,726	TO	63,270	63,271	& HIGHER
7	0	TO	11,895	11,896	TO	23,790	23,791	TO	35,685	35,686	TO	47,580	47,581	TO	59,475	59,476	TO	71,370	71,371	& HIGHER
8	0	TO	13,245	13,246	TO	26,490	26,491	TO	39,735	39,736	TO	52,980	52,981	TO	66,225	66,226	TO	79,470	79,471	& HIGHER
9	0	TO	14,595	14,596	TO	29,190	29,191	TO	43,785	43,786	TO	58,380	58,381	TO	72,975	72,976	TO	87,570	87,571	& HIGHER
10	0	TO	15,945	15,946	TO	31,890	31,891	TO	47,835	47,836	TO	63,780	63,781	TO	79,725	79,726	TO	95,670	95,671	& HIGHER
11	0	TO	17,295	17,296	TO	34,590	34,591	TO	51,885	51,886	TO	69,180	69,181	TO	86,475	86,476	TO	103,770	103,771	& HIGHER
12	0	TO	18,645	18,646	TO	37,290	37,291	TO	55,935	55,936	TO	74,580	74,581	TO	93,225	93,226	TO	111,870	111,871	& HIGHER
EACH PERSON OVER 12 ADD			1,350			2,700			4,050			5,400			6,750			8,100	8,101	& HIGHER
	25%=		3,795	50%=		7,590	'75%=		11,385	100%=		15,180	125%=		18,975	150% =		22,770		-
	@ Add'l:		1,350	@ Add'l:		2,700	@ Add'l:		4,050	@ Add'l:		5,400	@ Add'l:		6,750	@ Add'l:		8,100		-
PG =	HHS Poverty Guidelines

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Sheet 8: HIP Home