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O <br />9. Pets. A statement describing the PHAs policies and <br />requirements pertaining to the ownership of pets in public <br />housing. <br />10. Civl Rights Certification. A PHA will be considered in <br />compliance with the Civil Rights and AFFH Certification <br />iF it can document that it examines its programs and <br />proposed programs to identify any impediments to fair <br />housing choice within those programs; addresses those <br />impediments in a reasonable fashion in view of the <br />resources available; works with the local jurisdiction to <br />implement any of the jurisdiMion's initiatives to <br />affirmatively further fair housing; and assures that the <br />annual plan is consistent with any applicable Consolidated <br />Plan for its jurisdiction. <br />11. Fiscal Year Audit. The results of the most recent fiscal <br />year audit for the PHA. <br />12. Asset Management. A statement of how the agency will <br />carry out its asset management functions with respect to <br />the public housing inventory of the agency, including how <br />the agency will plan for the long-term operating, capital <br />investment, rehabilitation, modemi~ation, disposition, and <br />other needs for such inventory. <br />13. Violence Against Women Act (VAWA). A description <br />of: 1) Any activities, services, or programs provided or <br />offered by an agency, either directly or in partnership with <br />other service providers, to child or adult victims of <br />domestic violence, dating violence, sexual assault, or <br />stalking; 2) Any activities, services, or programs provided <br />or offered by a PHA that helps child and ailutt victims of <br />domestic violence, dating violence; sexual assault, or <br />stalking, to obtain or maintain housing; and 3) Any <br />activities, services, or programs provided or offered by a <br />public housing agency to prevent domestic violence, <br />dating violence, sexual assault, and stalking, or to enhance <br />victim safety in assisted families. <br />that the public housing agency plans to voluntarily convert; <br />2) An analysis of the projects or buildings required to be <br />converted; and 3) A statement of the amount of assistance <br />received under this chapter to be used for rental assistance or <br />other housing assistance in connection with such conversion. <br />See guidance on HUD's website at: <br />http•/he~.cw hod uw%offices/nihlttntcrs/wc/cum•crsion.cl'm <br />(d) Homeownership. A description of any homeownership <br />(including project number and unit count) administered by <br />the agency or for which the PHA has applied or will apply <br />for approval. <br />(e) Project-based Vouchers. if the PHA wishes to use the <br />project-based voucher program, a statement of the projected <br />number of project-based units and general locations and how <br />project basing would be consistent with its PHA Plan. <br />8.0 Capital Improvements. This section provides information on a PI-IA's <br />Capital Fund Program. With respect to public housing projects owned, <br />assisted, or operated by the public housing agency, a plan describing the <br />capital improvements necessary to ensure long-term physical and social <br />viability of the projects must be completed along with the required <br />forms, Items identified in 8.1 through 8.3, must be signed where <br />directed and transmitted electronically along with the PHA's Annual <br />Plan submission. <br />8.1 Capital Fnnd Program Annual Statement/Periormance and <br />Evaluation Report. PHAs must complete the Capita! Fund <br />Program Annual Statement/Performance and Evaluation Report <br />(form HUD-50075.1), for each Capital Fund Program (CFP) to be <br />undertaken with the current year's CFP funds or with CFFP <br />proceeds. Additionally, the form shall be used for the following <br />purposes: <br />(a) To submit the initial budget for a new grant or CFFP; <br />(b) To report on the Performance and Evaluation Report progress <br />ooany open grants previously funded or CFFP; and <br />7.0 Hope VI, Mixed Finance Modernization or Development, <br />Demolition and/or Disposition, Conversion of Public Housing, <br />Homeownership Programs, and Project based Vouchers <br />(a) Hope Vl or Mixed Finance Modernization or Development. <br />1) A description of any housing (including project number (if <br />known) and unit wunt).For which the PHA will apply for HOPE <br />VI or Mixed Finance Mobemization or Development and 2) A <br />timetable for the submission of applications or proposals. The <br />application and approval process for Hope VI, Mixed Finance <br />Modemization or Development, is a separate process. See <br />guidance on HUD's website at: <br />h I~:lhvwtv.htxl.sov/offices/pil>/nmrmms/nh/hooeG/index.c fm <br />(b) Demolition and/or Disposition. With respect to public housing <br />projects owned by the PHA and subject to ACCs under the Act: <br />(1) A description of any housing (including project number and <br />unit numbers [or addresses)}, and the number of affected orals <br />along with their sizes and accessibility features) for which the <br />PHA will apply or is currently pending for demolition or <br />disposition; and (2) A timetable for the demolition or <br />disposition. The application and approval process for demolition <br />and/or disposition is a separate process. See guidance on HUD's <br />website at <br />htto://wutiv.hu Gov/offices/pih/ccnlcrs/sac/demo disno/inrlex.c <br />Note: This statement must be submitted to the extent that <br />approved and/or pending demolition and/or disposition has <br />changed. <br />(c) Conversion of Public Housing. With respect to public <br />housing owned by a PHA: I) A deseripuort of any building <br />or buildings (including project number and unit count) that <br />the PHA is required to convert to tenant-based assistance or <br />(c) To record a budget revision on a previously approved open <br />grant or CFFP, e.g., additions or deletions of work items, <br />modification of budgeted amounts that have been undertaken <br />since the submission of the last Annual Plan. The Capital <br />Fund Program Annual Statement/Performance and <br />Evaluation Report must be submitted annually. <br />Additionally, PHAs shall complete the Performance and <br />Evaluation Report section (see footnote 2) of the Capita/ Fund <br />Program Annuol Statement/Performance and Evaluation (fore <br />HUI}-50075.1), at the following times: <br />i . At the end of the program year; until the program is <br />completed or aU funds are expended; <br />2. When revisions to the Annual Statement are made, <br />which do not require prior HUD approval, leg., <br />expenditures for emergency work, revisions resulting <br />from the PHAs application of fungibitity); and <br />3. Upon completion or termination of the activities funded <br />in a specific capital fund program year. <br />8.2 Capital Fund Program Five-Year Action Plan <br />PHAs must submit the Capital Fund Program FFve-Year Action <br />Plan (form HUD-50075.2) for the entire PHA portfolio for the first <br />year of participation in the CFP and annual update thereafter to <br />eliminate the previous year and to add a new fifth year (rolling <br />basis) so that the form always covers the present five-year period <br />beginning with the current year. <br />83 Capital Fuad Financing Program (CFFP). Separate, written <br />HUD approval is required if the PHA proposes to pledge any <br />Page 2 of 3 Instructions form HUD-50075 (2008) <br />