Sample Copy for a Vacant Unit Appendix 3B SAMPLE CHECKLiST Special Claim for Regular Vacancies Project Name: Unity Housing LP Contract Number: WV15T811001 Unit Number / Eastview Unity Apts. 206 Attach the following items to the claim submission: Completed form HUD-52670-A Part 2. X 2. 3, ~ Completed form l-[UD-52671-C. A copy of the signed form HUD-50059 completed at move-in for the former tenant which shows the amount of the security deposit required. X 4, X 5. ~ A copy of the security deposit disposition notice provided to the tenant which indicates the move-out date, amount of security deposit collected, amount of security deposit returned and any charges withheld from the deposit for unpaid rent, tenant damages or other charges due under the lease. 6. X Documentation that verifies the date the unit was ready for occupancy. 7. 8. — ________ ~ Documentation that the appropriate security deposit was collected from the tenant: for example, a copy of the original lease, a copy of the tenant’s ledger card, or a copy of the receipt(s) for security deposit. Copy of the waiting list from which the tenant was selected (i.e. unit transfer waiting list, one-bedroom waiting list. etc.) If the unit was not filled from the waiting list(s), documentation of marketing efforts must be included such as copies of advertising or invoices for advertising expenses that substantiate the date marketing occurred in accordance with the AFHMP. Appendix 3-3 Main Office Completes Special Claims Schedule U.S. Department of Housing and Urban Development Office of Housing Federal Housing Commissioner Instructions Follow guidelines in HUD Handbook 4350.3, Rev. I Chapter 9 I Project Name I Head of Household Name, Social Security Number, Date of Birth 0MB Approval No. 2502-0182 FHA Project No. Eastview Unity Apartments 200 Jefferson Street Fairmont, WV 26554 Section 8/PAC/PRAC J Contract No. I WV15T811001 045EH029 Unit Number Type and Amount of Claim Unpaid Rent From HUD 52671-A (3) Tenant Damages From HUD 52671-A (4) Rent-up Vacancies From HUD 52671-B (5) ($): Regular Vacancies From HUD 52671-C (6) (1) (2) Lioscomb, Dorothy 23~589985 012319~6 00206 1,299 Liv inaston, Hobert T 23464’7562 0211 1941 00 403 1,438 0 Totals I certify: (a) the above amounts have been computed in accordance with all instructions and requirements prescribed by HUD and the applicable Section 8/PAC/PRAC Contract; (b) all prerequisites to and conditions for the assistance claimed have been met; and (c) All required documents will be retained in the projects file for 3 years. Owner’s printed name, signature, date, & phone no.: Tracey Bevins 304-296-8223 x22 0 0 2,737 Debit Service From HUD 52671-D (7) 0 HUD/Contract Administrator Review: ~ Claim approved. Claim adjusted. Claim denied. Reason Official’s name, signature, & date: 05/09/2013 j ~(( , . ~ ( HUD will prosecute false claims & statements. Conviction result in criminal and/or civil penalties (18 U.S.C. Sections 1001, 1010, 1012: 31 U.S.C. Sections 3729, 3802), Previous versions obsolete Submit an Original and three copies form HUD-52670-A Part 2 (03/2003) ref. Handbook 4350.3 Rev. 1 (Computer Generation by FHA Software -2013.03.31) 05/09/2013 02:41PM Main Office Completes Special Claims U.S. Department of Housing and Urban Development ‘for Regular Vacancies Instructions Project Name Follow guidelines in HUD Handbook~ i4r~~ ~ Part A 0MB Approval No. 2502-0 182 Office of Housing Federa’ Housing Commissioner FHA project no. Eastview Unity Apartments 200 Jefferson Street Fairmont, WV 26554 1. Tenants move-out 2. No. days taken to 3. Date unit ready for date clean/repair unit occupancy 03/03/2013 15 7. Contract rent/operating rent at move-out 8, Enter daily contract rent/operating rent (Divide contract rent/operating rent in effect on move-out date by actual no. days in move-out month) ~ 9, Multiply line 6 and 8 (Contract rent/operating rent for days vacant) 884: Rural Housing Services 886: LMSA Subpart A 891. Elderly Housing 10, Multiply line 9 by 0.80 for Section 8/PAC units or 0.50 for Section 202/ 811 PRAC units (This is the most HUD will pay) 11. Enter amounts paid by other sources (Security deposit, Title I, etc.) WV1 5T8 1 1001 Vacated Tenant name Unit no. Dorothy Lipscomb 4. Date unit ready for 5. Date unit was occup. + 59 days re-rented 00 206 6. No. of days vacant (Not to exceed 60. Include but not day day inin line line 35.) 03/19/2013 (applies to the following) 880: Section 8 New Construction Section 8/PAC/PRAC Cont# 045EH029 05/17/2013 839.00 60 31 27.06 1,623.60 0.00 (—) 1,623.60 12. Subtract line 11 from line 9 13. Compare line 10 with line 12 & enter the lesser amount Enter in column 6 on HUD 52670-A Part 2. 14. Tenant’s move-out 15. No. days taken to date clean/repair unit 03/03/2013 15 19. Enter daily assistance payment 16. Date unit ready for occupancy 1,299 17 Last day of mo. (or day before move-in if in same month) 18. Number of days vacant in first month (Line 17 minus line 16, plus one day. Not to exceed 30.) 03/19/2013 Note: This should be the day afer unit completed date on the work order. 22 16 (Divide assistance payment in effect on move-out date by actual no. days in 0 31 20. Multiply lines 18 by line 19 This is the most HUD will pay for the first month. If vacancy continues for a second month, continue with line 21, However, if a new tenant moved in the same month as the previous tenant moved out, skip to line 26. 0 00 0 0 21. Day of second month the unit was rented Part 8 (applies to) 22. Subtract one(1) day from line 21 (Or enter actual no. days vacant if the unit was not re-rented.l 27 06 23, Enter daily contract rent/operating rent (Divide contract rent/operating rent in effect on move-out by actual no. days in move-out month) 24. Multiply line 22 by line 23 ~ Subpart C ‘ 0 00 25. Multiply line 24 by 0.80 This is the most HUD will pay for the second month. 0.00 0.00 26. Add lines 20 & 25 27. Enter amounts paid by other sources (Security deposit, Title I, etc.) — 28. Subtract line 27 from 26 Enter in column 6 on HUD 52670-A Part2. I certify: (a) Units are in decent, safe, and sanitary condition, and are available for occupancy during the vacancy period in which the payments are claimed. (b) The Owner / Agent did not cause the vacancy by violating the lease, the contract, or any applicable law. (c) I notified 1-IUD or the contract administrator immediately upon learning of the vacancy, or prospective vacancy, and the reasons for it. (d) I complied with all HUD requirements on termination of tenancy (Chapter 8, Section 3 of Handbook 4350.3 Rev. 1) if the vacancy was caused by an eviction. (e) All documentation will be retained in the project’s file for 3 years. Owner’s printed name, signature, & date Tracey Bevins Claim approved. ~ Claim adjusted. Reason’ Claim denied. Reason: Official’s name, signature, & date 304-296-8223 x22 (,./ ~ “ HUD/Contract Administrator Review , . ~ ~ ~‘ 05/09/2013 Claim ID: HUD will prosecute faIse~laims & statements. Conviction result in criminal and/or civil penalties (18 U.S.C. Sections 1001, 1010, 1012; 31 U.S.C. Sections 3729, 3802). Previous versions obsolete Submit an Original and two copies (Computer Generation by FHA Software- 2013.03.31 ) 05/09/2013 02:33PM Site Manager Completes form HUD-52671.C (09/2002) ref. Handbook 4350.3 Rev. 1 uwners ~ertItlcation of Compliance U.S. Department of Housing with HUD~s Tenant Eligibility and Urban Development Office of Housing Federal Housing Commissioner and Rent Procedures NOT for submission to the Federal Government 0MB Approval Number 2502-0204 Section A. Acknowledgements Read this before you complete and sign this form HUD-50059 Public Reporting Burden. The reporting burden for this collection of information is estimated to average 55 minutes 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 (25020204), Washington, DC 20503. The information is being collected by HUD to determine an applicant’s eligibility, the recommended unit size, and the amount the tenant(s) must pay toward rent and utilities. HUD uses this information to assist in managing certain HUD properties, to protect the Government’s financial interest, and to verify the accuracy of the information furnished. HUD or a Public Housing Authority (PHA) may conduct a computer match to verify the information you provide. This information may be released in accordance with HUD’s Computer Matching Agreement (CMA) between the Social Security Administration and the Department of Health and Human Services. You must provide all of the information requested, including the Social Security Numbers (SSN5), unless exempted by 24 CFR 5.216, you, and all other household members, have and use. Giving the SSNs of all household members, unless exempted by 24 CFR 5.216, is mandatory; not providing the SSNs will affect your eligibility approval. Failure to provide any information may result in a delay or rejection of your eligibility approval. Privacy Act Statement. The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S. Housing Act of 1937, as amended (42 U.S.C. 1437 et. seq.); the Housing and Urban-Rural Recovery Act of 1983 (P.L. 98-181); the Housing and Community Development Technical Amendments of 1984 (P.L. 98-479); and by the Housing and Community Development Act of 1987 (42 U.S.C. 3543). Tenant(s)’ Certification - I/We certify that the information in Sections C, D, and E of this form are true and complete to the best of my/our knowledge and belief. I/We understand that I/we can be fined up to $10,000, or imprisoned up to five years, or lose the subsidy HUD pays and have my/our rent increased, if I/we furnish false or incomplete information. Owner’s Certification - I certify that this Tenant’s eligibility, rent and assistance payments have been computed in accordance with HUD’s regulations and administrative procedures and that all required verifications were obtained. Warning to Owners and Tenants. By signing this form, you are indicating that you have read the above Privacy Act Statement and are agreeing with the applicable Certification. False Claim Statement. Warning: U.S. Code, Title 31, Section 3729, False Claims, provides a civil penalty of not less than $5,000 and not more than $10,000, plus 3 times the amount of damages for any person who knowingly presents, or causes to be presented, a false or fraudulent claim; or who knowingly makes, or caused to be used, a false record or statement; or conspires to defraud the Government by getting a false or fraudulent claim allowed or paid. Certification Summary from Page 2 unit Number Name of Project Eastview Unity Apartments 00 208 Total Tenant Payment Head of Household $ 209 Dorothy Lipscomb Head of Household )/~7 ~ ~) Date . . Tenant Signatures. Other Adult Effective Date Certification Type 02104/2013 Assistance Payment Mi - Move in Tenant Rent $ 687 $ 152 Date fc~J/l Spouse! Co-Head Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date Other Adult Date OwnerlAgent Signature~ Owner/A ~nt ~ ‘7~1c~&~ ))1 ~ JJ . I Date ~ Anticipated Voucher Date .. Check this box if Tenant is unable to sign for a legitimate reason Previous versions of this form are obsolete, This form also replaces HUD-50059-D, -E, -F, & -G. (Computer Generation by FHA Software - Rel 2012.12.31 ) 02/04/2013 9:59 am April 2013 Page 1 of 2 Site Manager Copies and Submits form HUD-50059 (03/2011) HB 4350.3 Rev 1 U.S. Department of Housing and Urban Development Office of Housing Federal Housing Commissioner Owner’s Certification of Compliance with HUD~’s Tenant Eligibility and Rent Procedures For Personal Records ONLY - Not for Submission to the Federal Government Record for Landlords Section B. Summary Information 1. Project Name Eastview Unity Apartments 2. 3. 4. 5. 6. 7, 8. 9. 10. 11. 12. Subsidy Type Secondary Subsidy Type Property ID Project Number Contract Number Telecom Address Plan of Action Code HUD-Owned Project? FIPS county Code Previous Housing Code Displacement Status 1 - 13. Effective Date 14. Anticipated Voucher Date 15. Next Recertification Date Sec.8 ~Future 045EH029 WV1 5T81 1001 TRACMOO525 16. 17. 18. 19. 20. 21. 22. N/A ~Future 3 4 ~ Project Move-In Date Unit Move-In Date Certification Type Action Processed Correction Type Cert. Correction Date Prey. Subsidy Type 35., 36., 37. 38. Last Name, First Name Ml 39. Rel, Sex Lipscon,b, Dorothy . . .. . 50. Family is Mobility Impaired? 51. Family is Hearing Impaired? 52. Family is Visually Impaired? 02/04/2013 02/04/2013 Ml - Move In H NO NO NO 53. 54 ~ 56. F 40. 41. Eth. 42. Birth Date 43. Special Status Race W 2 01/23/1936 EH Number Family Members Number of of Non-Famil Members Number of Dependents Number of Eligible Members 01 0 60. Previous Head Last Name 61. Previous Head First Name 62. Previous Head Middte Initial Unit Number No. of Bedrooms Building ID Unit Transfer Code Previous Unit No. Security Deposit Basic Rent Market Rent Contract Rent Utility Allowance Gross Rent 00 206 1 BR WV-08-00102 209 0 839 57 896 66. Mbr No. 67. 68 Income Type / Code Amount Social Security? SS Supp. Sec. Inc.? SI 70. 71. 72. 73. 74. 44. Student Status 45. ID Code (SSN) 46. Elig. Code 233-58-9985 EC 47. Alien Reg. Number 48. 49. Age at Work Cert. Codes 77 57. Expected Family Addition - Adoption 58. Expected Family Addition - Pregnancy 59. Expected Family Addition - Foster Children 0 0 0 ( Blank> ( Blank) ( Blank) 63. Previous Effective Date 64. Previous Head ID 65. Previous Head Birth Date Section D. Income Information 1 1 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. Section C~ Household_Information.. 34. Mbr No. I 02104/2013 04/2013 02101/2014 8004 756 Total Employment Income Total Pension Income Total Public Assistance Income Total Other Income Non-Asset Income Section — 69. SSN Benefits Claim No. 75. Mbr No. 233-58-9985 233-58-9985 1 I 78. 77. 78. Description Status Cash Value 79. Actual Yearly Income 51 427 0 0 Checking Savings 0 8,760 0 0 8,760 Asset Information 81. 82. 83. 84. 85. C C Cash Value of Assets Actual Income from Assets HUD Passbook Rate Imputed Income from Assets Asset Income 80. Date Divested 478 0 2.000% 0 o Section F. Allowances & Rent Calculations 86. 87. 88. 89. 90. 91. 92, 93. 94. 95. 96. Total Annual Income Low Income Limit Very Low Income Limit Extremely Low Income Limit Current Income Status Eligibility Universe Code Section 8 Assist. 1984 Indicator Income Exception Code Police? Security Tenant? Survivor of Qualifier? Household Assistance Status 8,760 29,200 18250 11,000 3- Extremely Low 2 - Post 1981 NO E 97. 98. 99. 100. 101. 102. 103. 104. 105. 108. 107. o o a Deduction for Dependents Child Care Expense (work) Child Care Expense (school) 3% of Income Disability Expense Disability Deduction Medical Expense Medical Deduction Elderly Family Deduction Total Deductions Adjusted Annual Income Previous versions of this form are obsolete. This form also replaces HUD-50059-D, -E, -F, & -0. (Computer Generation by FHA Software - Rel.2012. 12.31 263 o o o o .100 400 8,360 Page 2 of 2 ) 02/04/2013 9:59 am Total Tenant Payment (UP) Determinations 209.00 - 30% of Adj Monthly Income 73.00 - 10% of Gross Monthly Income 0.00 - Monthly Welfare Rent Amount 25.00 - HUD Minimum Rent Amount 108. Total Tenant Payment UP 209 109. Tenant Rent 152 110. Utility Reimbursement 0 111. Assistance Payment 687 112. Welfare Rent 113. Hardship 114 Waiver form HUD-50059(03/2011) HB 4350.3 Rev 1 Security Deposit Ledger .~lSt\ ie~ Un tv Apartments 200 id erson Street (As of) Report Date : 05/09/2013 05/09/2013 2:29 pm Page I ol’ lainnont, WV 26554 l~ntry No. Itaicli No. t’nil No. 0() 206 - 7154 7154 759 0 0 20130205 759 20130205 I)ate Charge Code Charge Amount Type Description Adjustment Amount l’ayment Amount Running Balance 15,00 209,00 0.00 0.00 224.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 15.00 209.00 223.00 15.00 224.00 209.00 0.00 224.00 0.00 224.00 IJI)#1671 Lipscomh, Dorothy ( Move-Out Date: 03/03/2013 ) ( Refund Date: 03/14/2013 02/04/20 13 02/04/20 13 02/05/2013 02105/2013 SECDE1~ SECDEP SI/CDEP SI2CDEP C C P p Key Deposit Security Deposit at Move-In #00 206 Key Deposit #00 206 Security Deposit I)esignates that the Security l)eposit Payment has been refunded Tota’s * * You can find this report in FHA under: Accounting - Tenant Reports - Security Deposit Report - Select Tenant Only - Print Ledger ( Detailed Report) Site Manager Runs Report Security Deposit Refund Report E.setv:~’.v Umt Apartments 200 Jefferson Street Fairmsnt. WV 2655-i 03.’ 11 20 3 -1.14 pm Tenant ID Unit No. Tenant Name Move-In Date Beginning Date Ending Date 167 00 206 Dorothy L~pscomb 02/03~ 2013 02,’0-1i2013 03/03i20I3 Move-Out Date 03/0312013 No. of Days 27 Interest Rate % 0,000 For,\arding Address SECURITY DEPOSITS PAID CODE. Total Interest S S 209.00 0.00 Total Security Deposit $ 209.00 TENANT CHARGES SECDEP L\PPUED $2.00 Total Tenant Charges S( Net Refund S 2.00 ) 207.00 S S $ S 130.00 (209.00) ( l5.00~ 15.00 S 128.00 S 2.00 j DESCRIPTION Security Deposit CODE CABLE DESCRIPTION Cable Funds Transfer to Cash Account will be done by Bank Transfer. <~- Net Amount of Refund to Tenant February 2013 Rent Credit Security Depsoit Retained <--- March 2013 Rent Charge <--- Key Deposit Refund <--- <--- TOTAL REFUND Site Manager Runs Report Work Order c~I~,c~ci ~OpcnI 1’toject Site Manager Completes East~ jew Unity .Apai tinents 200 Jetterson Street Fairmont. WV 26554 Work Order ID 947 Reported h) Location Description Unit nit ‘4o.: 00 206 Date & Time Received Call l3ack on WO ID Name or Location .\ddress I Address 2 Phone Number: 03/03/20 13 03:55 PM Has Pets Permission to Enter Work Order Description VACANT 200 JEFFERSON STREET, #00 206 FAIRMONT. WV 26554 Vendor ID Work Assigned to: Tim VanPelt Date & Time Assigned 03/03/20 13 03:55 AM Schedule Date : 03/0312013 Priority: Normal Work Order Type 03 13/2013 3:57 pm f~4a.k~e- (_4.,~’~ .i~~e~aI ~ ~— No Call First 1~e4.~d1 — Ready apt for occupancy. ~ ,Jj Date & Time Completed: ~ Corrective Action Description: ~ ~. ~ // ~ ~ t~i~1 ~2 4W\—~. ~ A-~tc_/~ ~(LI_(.g~ ~ ~dQA1~) ~ ~ ~Jj~ ~ ~ ~f/,( ~-0~1~ I his ≤edi r~ Parts I. scd ~o 1c~ ~ No. I ~ed 4~p~cJ ~b Fi-I~4 Part Cost Total S____________ S____________ I.abor Fime / / ~j c~q _______ 2. 3. ________ I. ~± dV/~ (~)(J(~~ L ,~ x S_________________ S ‘$_____________ 5 .~‘- a in ten:mnce Sit perv i ~o r Please make sure the work order is signed and closed. Labor Wage C ~ \ S 1/ Property \lanagcr ~ ~. Site Manager Submits Copies of All Advertising MONTHLY MARKETING/ADVERTISING CONTACTS Please use Left Click Only to Access Drop DATE (MM/DD/YYYY) SITES MANAGED BY HRDE Down Fields NAME OF BUSINESS ADDRESS CITY, STATE, ZIP CODE EMAIL NAME OF CONTACT PHONE HOW MATERIALS PROPERTY -Indicate Date/Publication of Ad Leasing signs on the building ~ 1 U.~ 3/1/2013 COMMENTS NOTE -Indicate number in attendance at Presentation item. DisabtIit~ Action Center . 102 Benonj Avenue Fairmont, WV 26554 Julie Sole, Executive Director 304-366-3213 P~rsun to l’erson flrochiirv EU.% Disability Action center Schools transition fair, set up a displa) table with pre-appllcations, brochure, business cards. attached_invitation. (‘lick here to enter a date. (‘lick here to enter a date. (‘lick here to enter a date. (lick hei’e 10 enter a date. Click here to enter a (late, (‘lick here to enter a date. Click here to enter a date, (‘lick here to enter a :hoose an item. Choose an item. Choose an item. Choose an item. Choose an item. iii item. (‘h~iose an item. (.hoosc an item. Choose an item, Choose an item, C’htiose all date, Click here to date. (‘lick here to enter a date, (‘lick here to enter a date. C’lick here to enter a date, enter a HRDE Rev. 2-6 item. Choose item. Documenti au Choose an item, CThoose an item. (‘hoose an item. Choose an item. (‘hoose an item. (~ an tern. Choose an item. (‘hoose an item. Choose an item. Choose an item. Choose an item. (‘Iloose an item. (Thoose an (‘house an Choose ten). tern. Choose an item. (:ho~se an item. (‘Itoose an itetil. Choose an itch). ai~ (“lmose an ten). Choose an item. C:hciose an itCh)). itCh). Choose an item, Choose an item. See •~‘~ ~•. “ ~ ~ ~ THE I)IS~1llLIflT~ACTION~E1~I!El1 ANI) MARION COUNTY ~ SCHOOLS TRANSITION FAIR 2013 ~ ~“~‘ •~ • ~ ...., ~. ~ ~, . . ~ ~ ~‘ . ~ •~ •. — ~ ~MARCH13, 2fl13 9:O() A L’Q~i4:OO A.M. HEDISABIlI TYAC11~O~ CENTER • .. - •. ~: 102 RUNON1A~V~. ~ FAIR IONi~;,~fl~241554 .1 • •r The Disability Action Cen ~ ~ ço~S will be hosting the Transition Fair i ~ Marion~ niors and Seniors in the Special EducationDepa ment. We ~ ‘o be inviting adults and families embers wh~ are. terestëd in ices available in hii’ereduca ~ employm~n~t, a~td i~~p&rts after high school. I • at the Disability Action Center, 102 Benoni Ave., ? ~ 2i ~I on March 13, 2013 from 9:00 am to 11:00 am. tf chairs ~vai1able for your agency/school. Please let us if you wjl ‘fr I~ e part in this very valuable and needed ,4-I event. ~. ~ ‘~ -~ ‘N ‘~ ‘ ~, I — ~ - .~ ~. , I ~ ,I ~‘ ,,~,• ••:~ jActionpe,I and 1(31 3’i,,:chooIs~’ ‘ii Fair 2013 .7 ..p P•~ Y~PByFe. 15,2013 ‘I -“I ~:~‘ :J ~ ... : I - I - •5• 0 I -U A I I~ Telephon,O H4w many tables you wi eed? Wil you need and electr~ :1 outlet? j ~-‘ ,! ~ 1L~~ all You can RSVP by return~g the registration form to: Mail: Email: jso1e~disabilityactio Jul o ec ctor Fax: (304) 368-1300 The D s~ DIIi ction enter Phone: (304) 366-3213 102 Bendni Ave. Fairmon , WV 26554 1 II I ~I~IhJ I Apartments, LP Eastview - ; ::“ ~ !P~ ~F ___1J____ — ~ — I -, - — I I I Y fforda.le Ho sing for the ide lyan./or e sabl-d • • • • • • Studio and 1& 2 Bedroom Apartments Social Activities Rent Based on 30% Adjusted Income Electric Allowance Multi-Purpose Room for Activities Public Transportation Available For More Infor at’on Cal: Susan Hallums, Manager 200 Jefferson Street Fairmont, WV 26554 Phone: (304) 366-6934 TDD: 1-800-982-8771 Website: www.hrdewv.org M/F/V/D EQUAL HOUGIMO OPPOItUNITY aft 4009, afl-cio MONTHLY MARKETING/ADVERTISING CONTACTS Please use Left Click Only to Access Drop Down Fields DATE (MM/DDIYYYY) 4/1/2013 4/18/2(113 Click here to enter a date. Click here to enter a date. Click here to enter a date. Click here to enter a date. Click here to enter a date. Click here to enter a date. Click here to enter a (I1II1~. Click here to enter a date. Click here to enter a date. Click here to enter a date. Click here to enter a date. Click here to enter a date. H RDE Rev. 2-6 SITES MANAGED BY HRDE NAME OF BUSINESS ADDRESS CITY, STATE, ZIP CODE EMAIL ApartmentFinder.com Rivesville Post Office NAME OF CONTACT PHONE HOW MATERIALS PROPERTY COMMENTS NOTE~ -Indicate number in attendance at Presentation —Indicate Date/Publication nt Ad Barbara Van Baush 800-466-8732 Ran Ad Choose ~ item. EUA Ad online for the month of April Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Flyers I~UA Posted pull tab flyer Choose an item. Choose an item. Choose an item. Choose an item, Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an ttem. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. Choose an item. F:\MSWord\Sharon\Housing\Tina\Advertising-Marketing\Marketing Advertising Monthly Report.docx Un~ty Hous~ng Apa~rnents~ Eastv~ew LPI AFFORDABLE HOUSING FOR THOSE 62 YEARS OF AGE OR OLDER HANDICAP/DISABLED ~‘ ~ r4 ~tud~o and I & 2 ~i3edroom Apartments ~oda~ ActMti~es Rent ~8ased on 30% Adjusted kicome E~1ectrk AEll~owance t~Purpose Room for Act~v~t~es Publlc Transportation Ava~11ab~1e FOR MORE INFORMATION CONTACT: Susan Hallums, Manager 200 Jefferson Street Fairmont, WV 26554 Phone: (304) 366-6934 TDD: 1-800-982-8771 Website: www.hrdewv.org aft 4009, afl-cio Unity Housing Apartments, LP/Eastview does business in accordance with the Federal Fair Housing Law and does not discriminate against any person because of race, color, religion, sex, hand cap, familial status, or national origin. -~ m 0(1) coZ C,) H H H H H H H H c≤~Z C~) Zj -U H (I) C~) — -o H Cl) C~) coZ — -o H C/) C~) — -U H C/) C~) C~) -D H C/) -U H Cs) -~ 00) c~,m c~m C) CØZ -U H Cl) > -U H ~:l) m 00) 4~H (DZ —I ci) Page 1 of 1 Apqrtment Finder~ ApartmentFinder~com Invoice Date: 03/31/13 Invoice No: Due Date: Customer No: Sales Rep: AJ 2357 Job Reference: Charleston, V’N 04/30/13 Billing For: ‘Apr 2013” 902901884 BARBARA VAN BAUSH-D Terms: NET 30 DAYS 2 Sun Court Suite 300 Norcross, GA 30092 Phone (678) 346-9300 Fax (404) 759-2296 www.NC Loom Ship to: Bill to: EASTVIEW UNITY APARTMENTS 200 JEFFERSON STREET FAIRMONT WV 26554 UNITED STATES HUMAN RESOURCE DEVELOPMENT AND DON SAVAGE 1644 MILEGROUND MORGANTOWN WV 26505 IILINEj ITEM FPAK-D DESCRIPTION FINDER PAK (DIGITAL) UOM EACH QTY 1 UNIT PRICE DISCOUNT 399.00 350.00- TOTAL 49.00 Invoice Amount TAX Past Due Balance Net Due (USD) 49.00 0.00 0.00 $49.00 PLEASE REVIEW YOUR BALANCE Current Balance 1-30 Days 31-60 Days 61-90 Days Over 90 Days Total Due 49.00 $49.00 For a complete statement of your account or if you have questions regarding your balance, please contact [email protected] Apartment Finder ApartmentFjnder.com PLEASE DETACH THIS PORTION AND RETURN WITH YOUR PAYMENT Invoice Date: Invoice No: S REMITTANCE DOCUMENT: Please make check payable to: Network Communications, Inc. AIR ACCOUNT AF TELESALES P 0 BOX 935080 ATLANTA GA 31193-5080 2357 Due Date: 04/30/13 Customer No: 902901884 $ Invoice Amount (USD) 49.00 METHOD OF PAYMENT: (Credit card charges will reflect Network Communications, Inc.): LI Check [1 Credit Card LI Visa Card Number: Street: City, State, Zip: Ad 0 000235730 00 04 90 07 03/31/13 AJ [1 Mastercard LI Discover [I Amex Expiration Date:________
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