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<br />E}HIBIT A <br /> <br />REPORT FORM D <br />(Housing Info, Resource 10, Admin) <br /> <br />Activity Name: <br /> <br />Activity Location: <br /> <br />Total Family Units Assisted With Housing Assistance: <br />Estimated Persons Receiving Housing Information: <br /> <br />HOPWA EXPENDITURE DETAIL <br /> <br />Enter the amount of HOPWA expended during the report period for one or more of the activities listed below: <br />Housing Information Services: $ <br />Resource 10: $ <br />Sub-Grantee Administrative Costs: $ <br />Grantee (City of SA) Administrative Costs: $ <br />Total HOPWA Expenditures: $ <br /> <br />HOPWA EXPENDITURES (in dollars) <br />Allocated HOPWA Funds: <br />Allocated HOPWA Program Income: <br />Total HOPWA funds for Project: <br />Total HOPWA Expended to date: <br />Balance HOPWA Funds to date: <br /> <br />$ <br />+$ <br />=$ <br />-$ <br />=$ <br /> <br />Source of Non-HOPWA Funds <br /> <br />Total Available <br /> <br />Expended To Date <br /> <br />Total Non-HOPWA Funds: <br /> <br />$ <br />$ <br />$ <br />$ <br /> <br />$ <br />$ <br />$ <br />$ <br /> <br />5 of 7 <br /> <br />HOPWA Report Form D <br /> <br />11/12/04 <br />