West Virginia Association of Housing Agencies

General Information
Name of Housing Authority: Executive Director: Telephone Number: Fax Number: E-Mail Address: Member of Congress: Number of Employees: Of this total, how many work in the following programs? Public Housing Section 8 HCVP Other Programs
Statistics/Conventional Program Authority/Resident Information
Number of federal public housing units:
Most recent PHAS Score:
Number of Senior Citizens Units within your PH total:
Population/Number of Residents: (Including seniors and children. Some authorities prefer to use a factor of 3 against their total unit count as a simplistic way of estimating the population of residents.)
Of this number, how many residents are: Elderly: Disabled: Veterans: Minor Children: Adults:
Number of female heads of household with children:
Number of residents receiving TANF Assistance:
Statistics/Section 8 Housing Choice Voucher Program
Number of Section 8 units:
Most recent SEMAP score:
What is your current Section 8 HCVP utilization rate:
Population/Number of Residents-Section 8: (Including seniors and children. Some agencies prefer to use a factor of 3 against their total unit count as a simplistic way of estimating the population of residents.)
Of this number, how many residents are: Elderly: Disabled: Veterans: Minor Children: Adults:
Number of female heads of household with children:
Number of residents receiving TANF Assistance:
Financial Data (Dollar amounts received in most recent year, rounded to the nearest dollar.)
Housing Authority's Fiscal Year:
Operating Subsidy: $ FY Jan 1 April July Oct
Capital Fund Grant Amount: Most recent year?
Section 8 HCV Program:
Current FY HCVP Annual Budget Authority: $
Most Current FY Section 8 Earned Administrative Fee Total:	$
Current FY Section 8 Earned Administrative Fee Reserve Total:	$
Was your PHA's Earned Administrative Fee Reserve over the 105% amount allowed on 1/21/2003?	Yes No
If you answered yes, how much funding will you lose as a result of the FY 2003 Budget rule concerning the 105% Administrative Fee Reserve?	$
Amount of PHDEP funds formerly received (if any)?	$
Other grants and dollar amounts:
Name of Grant: Dollar Amount (rounded nearest $)
Name of Grant: Dollar Amount (rounded nearest $)
Name of Grant: Dollar Amount (rounded nearest $)
Name of Grant: Dollar Amount (rounded nearest $)
Name of Grant: Dollar Amount (rounded nearest $)