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E}:HIBIT A <br />REPORT FORM D <br />(Housing Info, Resource ID, Admin) <br />Activity Name: <br />Activity Location: <br />Total Family Units Assisted With Housing Assistance: . <br />Estimated Persons Receiving Housing Information: <br />HOPWA EXPENDITURE DETAIL <br />Enter the amount of HOPWA expended during the report period for one or more of the activiCtes listed below: <br />Housing Information Services: $ <br />Resource ID: $ <br />Sub-Grantee Administrative Costs: $ <br />Grantee (City of SA) Administrative Costs: $ <br />Total HOPWA Expenditures: $ <br />HOPWA EXPENDITURES (in dogars) <br />Allocated HOPWA Funds: <br />Allocated HOPWA Program Income: <br />Total HOPWA funds for Project; <br />Total HOPWA Expended to date: <br />Balance HOPWA Funds to date: <br />.. $ <br />+; <br />=S <br />-$ <br />_$ <br />Source of Non-HOPWA Funds <br />Total Non-HOPWA Funds: <br />Total Available <br /> <br />Expended To Date <br />S <br />S <br /> <br />5 of 7 <br />w~~wA Repot tom o ~v,zoa <br />