Form HUD-96008, HUD-960 HUD-96008, HUD-960 OLHCHH Benchmarks

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Overview

36-month grant period
42-month grant period
48-month grant period
PRA and Warning Statements

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Sheet 1: 36-month grant period

													OMB Approval Number 2539-0015 (exp. MM/DD/2027)
Grantee Organization:								Period of Performance: 36 months				Enter just proposed amts. in 100% column
PERIOD ACTIVITY	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10	Q11	Q12	Q13
Applicant Capacity (0-90 days)
Staff Hired
Approved Environmental Review and Release of Funds
Written Policies and Procedures
Number of Paint Inspections / Risk Assessments / Hazard Evaluations Proposed:		< Enter Number of Units to be Assessed.
Paint Inspections / Risk Assessments / Hazard Evaluations:
Minimum Performance Standard	0%	2%	5%	15%	25%	35%	50%	65%	80%	95%	98%	100%
Proposed # Evaluated
Number of Completed & Cleared Housing Units Proposed:		< Enter Number of Units to be Completed and Cleared.
Units Completed and Cleared:
Minimum Performance Standard	0%	1%	2%	5%	10%	25%	40%	55%	70%	85%	95%	99%	100%
Proposed # Completed
LOCCS DRAWDOWNS Grant Award Amount =			< Enter Requested OHHLHC Dollar amount.
LOCCS Drawdowns:
Minimum Performance Standard	2.5%	5%	10%	15%	25%	35%	45%	55%	65%	80%	90%	99%	100%
Proposed Dollars Drawn
Proposed Match Amount ($)
Proposed Leverage Amount ($)
Proposed Healthy Homes Initiative HUD Funding Amount (if applicable) Dollars Drawn
Community Outreach / Education/ Training
Community Outreach Milestone
Education Milestone
Skills Training Milestone
Close-Out
Note the tab with the Paperwork Reduction Act Statement and the Warning Statement and Certification.													Form HUD-96008 (05/2024)

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Sheet 2: 42-month grant period

															OMB Approval Number 2539-0015 (exp. MM/DD/2027)
Grantee Organization:										Period of Performance: 42 months				Enter just proposed amts. in 100% column
PERIOD ACTIVITY	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10	Q11	Q12	Q13	Q14	Q15
Applicant Capacity (0-90 days)
Staff Hired
Approved Environmental Review and Release of Funds
Written Policies and Procedures
Number of Paint Inspections / Risk Assessments / Hazard Evaluations Proposed:		< Enter Number of Units to be Assessed
Paint Inspections / Risk Assessments / Hazard Evaluations:
Minimum Performance Standard	0%	2%	5%	20%	35%	45%	55%	65%	70%	80%	90%	95%	99%	100%
Proposed # Assessed
Number of Completed & Cleared Housing Units Proposed:		< Enter Number of Units to be Completed and Cleared.
Units Completed and Cleared:
Minimum Performance Standard	0%	1%	5%	20%	35%	45%	55%	65%	70%	80%	85%	90%	95%	99%	100%
Proposed # Completed
LOCCS DRAWDOWNS Grant Award Amount =			< Enter Requested OHHLHC Dollar amount.
LOCCS Drawdowns:
Minimum Performance Standard	2.5%	5%	10%	20%	30%	40%	50%	55%	60%	65%	75%	85%	90%	95%	100%
Proposed Dollars Drawn
Proposed Match Amount
Proposed Leverage
Proposed Healthy Homes Initiative HUD Funding Amount (if applicable) Dollars Drawn
Community Outreach / Education/ Training
Community Outreach Milestone
Education Milestone
Skills Training Milestone
Close-Out
Note the tab with the Paperwork Reduction Act Statement and the Warning Statement and Certification.															Form HUD-96009 (05/2024)

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Sheet 3: 48-month grant period

																	OMB Approval Number 2539-0015 (exp. MM/DD/2027)
Grantee Organization:												Period of Performance: 48 months				Enter just proposed amts. in 100% column
PERIOD ACTIVITY	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10	Q11	Q12	Q13	Q14	Q15	Q16	Q17
Applicant Capacity (0-90 days)
Staff Hired
Approved Environmental Review and Release of Funds
Written Policies and Procedures
Number of Paint Inspections/ Risk Assessment Proposed:		< Enter Number of Units to be Assessed
Number of Paint Inspections / Risk Assessments / Hazard Evaluations Proposed:
Paint Inspections / Risk Assessments / Hazard Evaluations:	1%	2%	5%	20%	35%	45%	55%	65%	70%	75%	80%	85%	90%	95%	99%	100%
Proposed # Assessed
Number of Completed & Cleared Housing Units Proposed:		< Enter Number of Units to be Completed and Cleared.
Units Completed and Cleared:
Minimum Performance Standard	1%	2%	5%	20%	35%	45%	50%	60%	65%	70%	75%	80%	85%	90%	95%	99%	100%
Proposed # Completed
LOCCS DRAWDOWNS Grant Award Amount =			< Enter Requested OHHLHC Dollar amount.
LOCCS Drawdowns:
Minimum Performance Standard	2%	5%	10%	20%	30%	40%	50%	55%	60%	65%	70%	75%	80%	85%	90%	95%	100%
Proposed Dollars Drawn
Proposed Match Amount
Proposed Leverage
Proposed Healthy Homes Initiative HUD Funding Amount (if applicable) Dollars Drawn
Community Outreach / Education/ Training
Community Outreach Milestone
Education Milestone
Skills Training Milestone
Close-Out
Note the tab with the Paperwork Reduction Act Statement and the Warning Statement and Certification.																	Form HUD-96009-A (05/2024)

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Sheet 4: PRA and Warning Statements

OMB Approval Number 2539-0015 (exp. MM/DD/2027)

Paperwork Reduction Act Statement

The public reporting burden for this collection of information is estimated to be 15 minutes 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. Send comments regarding the accuracy of this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Reports Management Officer, U.S. Department of Housing and Urban Development, Office of the Chief Data Officer, REE, 451 7th St SW, Room 8210, Washington, DC 20410-5000. Do not send this completed form to this address. When providing comments, please refer to OMB Approval No. 2539-0015. The Department of Housing and Urban Development (HUD) may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid OMB control number. HUD is authorized to collect this information under the authority cited in the Notice of Funding Opportunity for this grant program. The information collected will provide proposed grant implementation data for multiple programs. HUD will use this information in the selection of applicants and monitoring of awarded grantees. This information is required to obtain the benefit sought in the grant program. Although an assurance of confidentiality for this collection is not provided, HUD generally only discloses the information collected here in response to a Freedom of Information Act (FOIA) request with potential withholdings to the information applied in accordance with FOIA exemptions (5 U.S.C. § 552(b)) as applicable.

Warning Statement and Certification

The Authorized Representative who signed the Standard Form 424, Application for Federal Assistance, on behalf of the Applicant for the grant for which this form HUD-96008 is part of the application, certifies under penalty of perjury that the information provided in this form is true and correct. WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §§ 3729, 3802).