Instructions: Submit This Status Report to Nancy Madsen, Grants Manager at the End of Each

CDBG & Human Services Program Quarterly Status Report Fiscal Year 2014-15 City of Lompoc Community Development Division

Instructions: Submit this status report to Chanel Navarro no later than the 10th of the month following the end of each quarter. Submit via email to [email protected] or [email protected].

1st Quarter 2nd Quarter 3rd Quarter 4th Quarter July 1 – September 30 October 1 – December 31 January 1 – March 31 April 1 – June 30 Contact Agency Person Phone Program Number

Contract # Email Address

Reporting Period Narrative Briefly describe major quarterly activities/accomplishments toward specific annual goals and depict the status of program objectives. If the program is not performing as planned, provide an explanation. Annual Goals:

Direct Benefit Data Report unduplicated quarter and year-to-date data for each category. Quarter Year-to-Date Annual Goal Total Served Total Served Persons Households1 Female-Headed Households2 Race & Ethnicity Quarter Year-to-Date # of Race in left # Race who are column who Total Total of Hispanic/ are of Hispanic/ Latino Heritage Latino heritage White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander American Indian/Alaskan Native & White Asian & White Black/African American & White American Indian/Alaskan Native & Black/African American Other multi-racial

1 Household means all the persons who occupy a housing unit. The occupants may be a single family, one person living alone, two or more families living together, or any other group of related or unrelated persons who share living arrangements. 24 CFR 570.3 2 Household headed by a single female CDBG & Human Services Program Quarterly Status Report Fiscal Year 2014-15 City of Lompoc Community Development Division

Total Income Levels Quarter Year-to-Date Total Total Extremely Low (0% to 30%) Low (31% to 50%) Moderate (51% to 80%) Non-Low/Moderate Total

Program Funding Report funding received during the program year by source. This section can be completed at the end of the program year.

HUD Funds Amount CDBG – County $ CDBG – Other $ Section 108 Loan Guarantee $ ESG $ HOME $ HOPWA $ Total $

Other Funds Amount Other Federal Funds $ State Funds $ Local Funds $ Private Funds $ Other Funds (Specify fund source below) $ $ $ $ $ Total $

Manager/Executive Director/Fiscal Officer Title

Signature Date