Form HUD 96002 HUD 96002 Comprehensive Needs Assessment Project Profile

Comprehensive Needs Assessment
Project Profile

U.S. Department of Housing
and Urban Development
OMB Approval No.2502-0505 (exp.11/30/2003)
Act of 1992, as amended Multifamily Housing
Property Disposition Reform of 1994 and
Section 531 of the Departments of Veterans
Affairs and Housing and Urban Development,
and Independent Agencies Appropriations Act,
1998, P.L. 105.65, 1998. The Comprehensive
Needs Assessment is a description of current
and future financial resources and needs of
certain multifamily projects. The information
provided on this form will enable the Department
to determine the amounts of grant assistance.
Furnishing the information is voluntary; however,
failure to provide it may result in your not
receiving your grant assistance.
Disclosure of this information is voluntary.

Public Reporting Burden for this collection of
information is estimated to average 40 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. Send comments regarding this
burden estimate or any other aspect of this
collection of information, including suggestions
for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction
Project (2502-0505), Washington, DC 20503.
Do not send this completed form to either of
the above addresses.
Authority: The United States Department of
Housing and Urban Development (HUD) is
authorized to collect this information by Title IV
of the Housing and Community Development

Basic Identification
1

FHA/Project Number

2

Project Name & Address

3

Contact Name

4

Telephone Number

5

Comprehensive Needs
Assessment (CNA)
Completed Date
Assessor Name & Address

6

7
8
9

10

Contact name
Telephone Number
Owner/Management Agent
Name & Address

Contact Name

1
Form HUD-96002 (4/01)

Comprehensive Needs Assessment
Project Profile

11

Telephone Number

12

Section of the Act
(includes purchase money
mortgages)
Enter a number:
1=FHA-insured
2=HUD held
3=State agency
Enter a number
1=Elderly
2=Family
3=Other
Date of Final
Endorsement/Closing
Date of mortgage maturity

13

14

15
16
17
18
19

U.S. Department of Housing
and Urban Development
OMB Approval No.2502-0505 (exp.11/30/2003)

Mortgage Unpaid Principal
Balance
Reserve Fund for
Replacements Balance
Residual Receipts Balance

Subsidy Type by Dwelling Unit
20

23

Section 8 NC/Sub Rehab
Units including 202/8
Section 8 Loan Mgmt. Set
Aside Units
Section 8 Property
Disposition Units
Rent Supplement Units

24

Rap Units

25

Total Rent-Subsidized
Units

21
22

Basic Identification
26

Non Rent-Subsidized Units

27

Total Units

28

Vacant Units

29

Households Surveyed

30

Households Responded

2
Form HUD-96002 (4/01)

Comprehensive Needs Assessment
Project Profile

U.S. Department of Housing
and Urban Development
OMB Approval No.2502-0505 (exp.11/30/2003)

Assessment Needs
A
Item
Number

B
Item Name

C
Year I

D
Years
2 thru 8

E
Years
9 thru 15

F
Total
Years
1 thru 15

G
Years
16 thru
20+

H
Total
Years
1 thru
20+

Environmental
31
32
33
34
35
36

Asbestos
CFC’s
Lead-Based Pain
PCB’s
Underground Storage Tanks
Total Environmental

Exterior
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58

Walls, Foundations
Roofs, Flashing, Vents
Gutters, Downspouts
Walks, Steps, Rails
Fences, Walls, Gates
Porches, Balconies
Fire Escapes
Doors, Windows, Screens
Garages, Carports
Storage, Utility Buildings
Swimming Pools
Benches, Play areas
Project Signs
Parking Lots, Paving, Curbs
Lawns, Plantings
Drainage, Sprinkler System
Exterior Lighting
Exterior Painting
Underground Utilities
Security System
Other exterior (explain)
Total exterior

Interior
59
60
61
62
63
64
65
66
67
68

Insulation
Caulking, Weather Stripping
Flooring
Stairs, Halls
Doors, Cabinets, Closets
Curtains, Shades
Major Kitchen Appliances
Electric Fixtures & Systems
Plumbing Fixtures & Systems
Heating & Air Conditioning

3
Form HUD-96002 (4/01)

Comprehensive Needs Assessment
Project Profile

U.S. Department of Housing
and Urban Development
OMB Approval No.2502-0505 (exp.11/30/2003)

Assessment Needs
A
Item
Number

B
Item Name

C
Year I

D
Years 2
thru 8

E
Years
9 thru 15

F
Total
Years
1 thru 15

G
Years
16 thru
20+

H
Total
Years
1 thru
20+

Interior
69
70
71
72
73
74
75

Hot Water & Boiler Systems
Laundry Rooms
Interior Lighting
Interior Painting
Elevators
Fire Safety/Detection/Prevention
Other Interior (explain)

76

Total Interior

Commercial, Recreation, Learning Centers
77
78
79
80
81
82

Commercial Kitchens
Congregate Dining Rooms
Day Care Centers
Recreation Rooms
Community Spaces
Other Commercial (explain)

83

Total Commercial

Additional Needs
84
85
86
87
88
89
90
91
92

Section 3 Compliance in addition
to above
Section 504 in addition to above
Supportive Services
Drug Prevention
Crime Prevention
Personal Needs
Modernization Needs
Total Additional Needs
Total Assessment Needs

4
Form HUD-96002 (4/01)

Comprehensive Needs Assessment
Project Profile

U.S. Department of Housing
and Urban Development
OMB Approval No.2502-0505 (exp.11/30/2003)

Resources
A
Item
Number
93

B
Item Name

94

Flexible Subsidy Operating
Assistance
Flexible Subsidy CILP Loan

95

Section 241 Loan

96

Loan Mgmt.. Set Aside (5 yr.
Contract)
Section 223(a)(7)

97
98
99

I
As of CNA
Date

J
Future
Resources

Notes

Low Income Housing Tax
Credits
Debt Restructuring

100

Owner Contributions through
TPA (Transfer of Physical
Assets)

101

Owner Contributions (excluding
TPA)

102

Private Contributions

103

HOME Funds

104

CDBG Funds

105

State/Local Funds

106

Secondary Loans

107

Rent Increase (yr. 1 only)

108

Other Assistance (explain)

109

Total Resources

TPA Date:

Explanations:

Explanations:

5
Form HUD-96002 (4/01)

Comprehensive Needs Assessment
Project Profile

U.S. Department of Housing
and Urban Development
OMB Approval No.2502-0505 (exp.11/30/2003)

I hereby certify that all the information stated herein, as well as any information provided in the
accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and
statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012;
U.S.C. 3729, 3802)
Assessor’s Name (Please type or print)

Assessor’s Title (Please type or print)

Assessor’s Signature

Date Signed:

6
Form HUD-96002 (4/01)