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<br />EXHIBIT A <br /> <br />REPORT FORM D <br />(Housing Info, Resource ID, Admin) <br /> <br />ACTIVITY NAME: <br />ACTIVITY LOCATION <br /> <br />Total Family Units Assisted With Housing Assistance: <br /> <br />Estimated Persons Receiving Housing Information: <br /> <br />HOPWA EXPENDITURE DETAIL <br />Enter the amount of HOPWA expended during the report period for one or more of the activities listed below: <br /> <br />Housing Information Services: $ <br /> <br />Resource ID: $ <br /> <br />Sub-Grantee Administrative Costs: $ <br /> <br />Grantee (City of SA) Administrative Costs: $ <br />Total HOPWA Expenditures: $ <br /> <br />Available HOPWA Funds: <br /> <br />Allocated HOPWA Funds: <br /> <br />$ <br /> <br />Allocated HOPWA Program Income: <br /> <br />+$ <br /> <br />Total HOPWA funds for Project <br /> <br />=$ <br />-$ <br />=$ <br /> <br />Total HOPWA Expended to date: <br /> <br />Balance HOPWA Funds to date: <br /> <br />Source of Non-HOPWA Funds: <br />(Including In-Kind Contributions) <br /> <br />Expended To Date: <br /> <br />Total Available: <br /> <br />$ <br />$ <br />$ <br /> <br />$ <br />$ <br />$ <br /> <br />$ <br /> <br />Total Non-HOPWA Funds: $ <br /> <br />HOPW A Report Form 0 <br /> <br />p. 50f7 <br /> <br />Revised 9/13/05 <br />