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E};HIBIT A <br />HOUSING OPPORTUNITY FOR PEOPLE WITH AIDS <br />ACCOMPLISHMENT REPORT <br />HOPWA Recipient Name: <br />HOPWA Funded Activity: <br />Location of Activity: <br />1. Select the one category that best describes service provided with HOPWA Funds: <br />^ Facility Based Housing: (e.g., Construction, Rehab) .............. Submii Repod Form A & Supplemental <br />^ Facility Based Non-Housing .................................................. Submit Report Form B & Supplemental <br />^ Scattered Site Only: (e.g., Tenant Based Rental Assistance)..Submit Report Fomt C ~ Supplemental <br />^ Housing InformatiorilResource ID/Admin .............................. Submit Report Form D <br />^ Supportive Services Only ......................................................Submit Report Form E <br />2. Check Box Indicating Report Period: <br />^ 151 Quarter <br />^ 2"d Quarter <br />^ 3`d Quarter <br />^ 4th Quarter <br />(7/1 - 9/30) <br />(1011 - 12/31) <br />(1/1 - 3/31) <br />(Mi - 6/30) <br />3. Amount of HOPWA Expended During This Report Period: $ <br />4. Number of Unduplicated Persons Assisted During the Report Period: ". <br />'Must equal Total Number o/Persons Receiving Ass/stance' listed !n Report Forth <br />5. Number of Units Completed During the Report Period (if applicable): <br />For construction projects only <br />I certify that the information within this quarterly report is true and correct. <br />Name: <br />Signature: <br />Telephone No: <br />Fax No: <br />Date: <br />email: <br />1 of 7 <br />