COMMUNITY DEVELOPMENT BLOCK GRANT10/2013

PROGRAM INCOME PLAN

Applicant/ Grantee Name: / Grant Number:
Project Title: / Date:

A.Program Income on Hand

1.Does the applicant (or any subrecipient) have CDBG program income on hand?YesNo

2.If yes, what grant(s) generated the program income? / Grant #
3.Total amount of program income on hand: $

4.Are the program income funds in a Grants Administration-approved Revolving Fund?YesNo

If yes, give the purpose of the fund and the amount in the fund: $
Purpose:

B.Program Income Determination

1.Does the applicant expect this project in combination with income from other CDBG projects to generate income in excess

of $35,000 in a single year?YesNo

If no program income is expected, but the grantee receives program income before the grant is programmatically closed, the grantee agrees that it will be used to defray CDBG project costs in accordance with Grants Administration requirements, or returned to the State. The grantee also agrees to notify Grants Administration immediately upon receipt of any unanticipated income.

After programmatic closeout, if unexpected program income in excess of $35,000 in a single year is received, the recipient agrees to notify and return the funds to Grants Administration immediately.

2.If yes to Question B-1, does the applicant wish to retain the program income?YesNo

If yes, complete Part C, Program Income Plan.

If no, the grantee agrees to remit the program income to the State in accordance with Grants Administration policies and procedures.

C.Program Income Plan

If program income is proposed to be retained, attach additional sheets providing a detailed description of the following information: (Each page must be initialized and dated by the authorized official)

  1. Describe the need for continuing the same activity which generated the program income and how the proposed use of program income will serve to address the need in a timely manner.
  2. Describe how the grantee will ensure that activities undertaken with program income will be in accordance with this plan, will meet a national objective, and will comply with applicable requirements of Title I and other Federal regulations such as citizen participation, environmental review, acquisition, relocation, and labor requirements, etc. Identify the entity that will administer the program income.
  3. Describe the administrative procedures for collecting, distributing, accounting and reporting the program income.
  4. Provide an anticipated time frame for program income receipts and expenditures.
  5. Provide assurance that the grantee will return all unexpended funds and collectable accounts to the State in the event the State finds evidence of fraud, waste, mismanagement, and/or substantial non-compliance with the Program Income Plan.

A Program Income Annual Report must be submitted by January 5 for the preceding calendar year if any program income is anticipated or received from this or any previously funded CDBG grant. This Plan will remain in effect past grant closure, and covers any program income received as a result of the CDBG funded activity.

Typed Name and Title of Authorized Official / Signature