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Instructions for Preparation of Form HUD -50075-5Y 5 -Year PHA Plan for All PHAs A. PHA Information 24 CFR $903.23(4)(e) A.t Include the full PHA Name, PHA Code, , PHA Fiscal Year Beginning rMM YYYY). PHA Plan Submission Type, and the Availability of Information, specific location(s) of all information relevant to the hearing and proposed PHA Plan PHA Consortia: Check box if submitting a Joint PHA Plan and complete the table B. 5 -Year Plan. B.1 Mission. State the PHA s mission for serving the needs of low- income, very low- income, and extremely low- income families in the PHA'slunsdl.lion for the next five years. (24 CFR 4'°.'=3.6(x)(1)) B.2 Coals and Objectives Identify the PHA's quantifiable goals and objectives that will enable the PHA to serve the needs of low- income, very low- income. and extremely low- income families for the next five years. (24 CFR 903.61b1(I 1) For Qualified PHAs only, if at any tune a PHA pr, eposes to take units offline for modernization, then that action requires a significant amendment to the PHA's 5 -Year Plan. H.3 Progress Report. Include a rt. -port on the progress the PHA has made in meeting the goals and objectives described in the previous 5 - Year Plan. (24 CFR &903.6(h)(21) B.4 Violence Against Women Act (VAWA) Coals. Provide a statement of the PHA's goals, activities objectives, policies, or programs that will enable the PHA to serve the needs of child and adult victims of domestic violence, dating violence, sexual assault, or stalking (24 CFR :(N)3.6(a)(3)) BS Significant Amendment or Modification. Provide a statement on the criteria used for determining a significant amendment or modification to the 5 -Year Plan. B.6 Resident Advisory Board (RAB) comments. (a) Did the public or RAB provide comments"' (b) If yes, submit comments as an attachment to the Plan and descnbe the analysis oldie comments and the PHA's decision made on these recommendations_ (24 CFR $903.17(a) 24 CFR 3903.19) This Information collection is authorized by Section 511 of the Quality housing and Work Responsibility Act, which added a new section SA to the It5. Housing Act of 1937, as amended, which introduced the 5•Year PIA Plan. The S -Year PITA Plan provides the PHA's mission. goals and objectives for serving the needs of low. income very low• income, and extremely low Income families and the progress made in meeting the goals and objectives described in the previous 5•Year Pian. Public reporting burden for this information collection is estimated to average 76 hours per response, Including the time for reviewing Instructions. searching existing data sources, gathering and maintaining the data needed. and completing and reviewing the roPection of Information. InfD may not collect this Information, and respondents are not required to complete this form, unless It displays a currently valid OMR Control Number Privacy Act Notice. The United States Department of housing and Urban Development is authorized to solicit the Information requested in this form by virtue of Title 12.115. Code. Section 1701 et seq-. and regulations promulgated thereunder at Title 12. Code of Federal Regulations. Responses to the collection of information are required to obtain a benefit or to retain a benefit. The information requested does not lend itself to confidentiality. 6559skaks Page 7 of 7 form HUD-50075- SY (12/2014)