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Sheet 1: Instructions

	
	
	
		11/9/2011
		

		

		

		

		

		

		

		

	
	
		CHARACTERISTICS OF TENANT HOUSEHOLDS
		

		

		

	
	
		Instructions 
		

		

		

	
	
		You will need one Excel file for each one of the development(s) for which you are reporting.  Save and name the file by the property's assigned D number, the property name, CTH and the year of the report (i.e., D0001ABCApts CTH11).  If the report is being submitted for Rental Rehabilitation Loan Program (RRL), please name the report using the following protocol:  D0001ABCAptsRRL11)
		

		

		

	
	
		If you need additional copies of the report, duplicate the Excel file by opening the workbook, selecting "Save As" from the file menu, giving the workbook a new name using the above protocol, and saving it. If you are providing data electronically, move through the sheets using the arrow keys or, for sheet #2 of the workbook use the Enter key and for sheet #3 use the Tab key. In sheet #2, simply enter a contact telephone number as 10 digits, e.g., without hyphens. If an arrow appears at the right side of a cell, hold down on that arrow with your cursor and select the appropriate response from the popup list. Sheet #3 is formatted so that you may enter appropriate responses identified in the headings (use capital letters) or select from the popups. In sheet #3 do not enter dollar signs or commas for amounts. 
		

		

		

	
	
		First, complete the information in yellow highlighted cells of the Development Info tab.  This must be done in order for the report to be uploaded into Minnesota Housing's database.  If this information is not completed, you will be required to correct and resubmit.
		

		

		

	
	
		Next, enter information onto the tab entitled CTH Report for each unit in the property and the household that occupies it on 12/31 of the report year (group homes & shelters, list occupants as of the date you complete the report). Each row on the unit worksheet should contain information on only one unit and its occupants. If a unit is vacant, please provide a unit number and unit characteristics; simply leave the household characteristics blank.  The definition of “head of household” is the primary person in whose name the unit is rented.   For your convenience, the Initial Occupancy Statement by Tenant and Tenant Profile forms can be printed from this Excel workbook and given to residents to fill out.  The workbook is not designed for users to enter the information on the profile form electronically. 
		

		

		

	
	
		

		

		

		

	
	
		Enter dates as month, day, and year, e.g., 3-29-08 or 3/29/08,  and they will convert to a standard format.  Formatting will prevent entry of incorrect responses, such as a letter rather than a number, or an income of $1,000,000. If the application indicates an entry is not valid, retry and type over the information you tried to enter and tab to the next cell.
		

		

		

	
	
		

		

		

		

		

		

		

		

		

	
	
		Unit Characteristics
		

		

		

	
	
		Unit number - Unit number or any other type of building/unit identification used in the development for which you are providing the information.  For shelters and transitional housing properties with "beds" rather than units list each bed as a separate unit.  If there is more than one building in a property, list the building number, a hyphen and the unit number (i.e., if the address is 1572 Main St, the format for unit 101 would be:  1572-101).  Do not list the building number on one line and the associated units below it and do not leave blank rows between buildings.  This will frustrate the data import routine.
		

		

		

	
	
		

		

		

		

	
	
		Number of bedrooms - Number of bedrooms in the unit; enter 0 for efficiencies (up to maximum of 6 bedrooms).   For shelters and transitional housing properties list each bed on a separate line and report as 0 bedroom.
		

		

		

	
	
		

		

		

		

	
	
		Total rent - Rent amount of the unit, including monthly amount of tenant rent, subsidies (if any), and utility allowance for the unit. 
		

		

		

	
	
		

		

		

		

	
	
		MHFA program - From the description of program codes on worksheet #8, use the drop-down menu to select the MHFA program for which the unit was funded or satisfies qualification requirements.  Only one program code will be allowed per unit even though there may be multiple programs funding the same unit and/or for which the household qualifies.   Select the main funding source for the unit/property (i.e., if property was funded by a LMIR first mortgage, select LMIR for all units).  
		

		

		

	
	
		

		

		

		

	
	
		Tax credit unit -  Enter or select from the popup list: Y if the unit is a housing tax credit unit or N if the unit is not a tax credit unit.  Popup list also includes M for identifying manager/caretaker/office units. 
		

		

		

	
	
		

		

		

		

	
	
		Unit designed to be accessible - If unit is designed to be accessible or barrier-free for a tenant who has a permanent mobility impairment, e.g., uses a wheel chair, enter the appropriate response or click the arrow and from the popup list select Y for yes or N for no.
		

		

		

	
	
		For units that are vacant on 12/31 and units not covered under any MHFA Program, the Unit Characteristics is all that needs to be entered.  Enter Household Characteristics and Head of Household Characteristics for all occupied units funded by any MHFA Program.  Note that residents are not required to provide answers to questions about protected class status, e.g., race, ethnicity, gender, disability, but please encourage full participation. 
		

		

		

	
	
		

		

		

		

		

		

		

		

		

	
	
		HOUSEHOLD CHARACTERISTICS
		

		

		

	
	
		

		

		

		

	
	
		Mobility impaired occupant - Use the popup list or enter Y if the head of household or any member of the household living in the unit is mobility impaired, or N if none of the tenants in the units are mobility impaired.   
		

		

		

	
	
		

		

		

		

	
	
		Adults - Enter the number of tenants age 18 or older who live in the unit.
		

		

		

	
	
		

		

		

		

	
	
		Children - Enter the number of children under the age of 18 who live in the unit. Enter 0 if no minor children live in the unit.
		

		

		

	
	
		

		

		

		

	
	
		Homeless Household - Use the popup list or enter Y if household was homeless (without permanent shelter) prior to occupancy, or N if household was not homeless prior to occupancy.   If homeless, indicate if the household was without permanent shelter for at least 12 months or at least 4 times in the last 3 years.  
		

		

		

	
	
		

		

		

		

	
	
		Social Services - Use the popup list or enter Y if household receives any type of social services, or N if household does not receive any social services. Leave blank if unknown. 
		

		

		

	
	
		

		

		

		

	
	
		Gross annual household income  - Enter the amount of gross income of all persons living in the unit at the household’s most recent recertification. Gross income includes all income from all sources listed below. Enter 0 if the household has no income.
		

		

		

	
	
		

		

		

		

	
	
		Main source of household income - Use the popup list to find the code for the main source of income for the household (enter only one code):
		

		

		

	
	
		SW= Salary or wages
		I= Interest, stock dividends, rental income
		

		

		

	
	
		SS= Social Security benefit
		U= Unemployment, disability compensation
		

		

		

	
	
		SE= Self employment income
		W= Welfare/public assistance
		

		

		

	
	
		R= Retirement, pension, annuities
		A= Alimony, child support
		

		

		

	
	
		N= no income
		

		

		

		

	
	
		

		

		

		

	
	
		Rental assistance - If the property has project-based rental assistance (i.e., Rural Development, Section 8, etc.) and the unit receives such rental assistance, use the popup list or enter PBA.  If the household receives tenant- based rental assistance (i.e., Section 8 Housing Choice or other type of voucher, enter TBA).
		

		

		

	
	
		Date household moved into this unit - Date current household moved into this unit: month, day,  and year (formatted 3-1-08 or 3/1/08) that the current household began leasing the unit that it now occupies (worksheet converts all date entries to a standard format). 
		

		

		

	
	
		

		

		

		

		

		

		

		

		

	
	
		HEAD OF HOUSEHOLD CHARACTERISTICS
		

		

		

	
	
		

		

		

		

	
	
		Head of household date of birth - Enter the date of birth (month, day, year) for the head of household, only.
		

		

		

	
	
		

		

		

		

	
	
		Marital Status - Use the popup list or enter M if the head of household is married, N if the head of household is not married (includes single, divorced, widowed), or S if the head of household is separated (need not be legal separation).
		

		

		

	
	
		

		

		

		

	
	
		Race of the head of household - From the list provided, enter the race code(s) for the head of household only.  Note that there is no popup list--be sure to enter only the code(s), but enter all that apply (i.e., if a head of household identifies him or herself as both White and Black or African American, enter WB).  If tenant chooses to not self-identify racial category, the person filling out the report should designate a category based on visual observation.  If uncertain, leave blank.
		

		

		

	
	
		   W= White
		B=Black or African American 
		

		

		

		

		

		

		

	
	
		 I=American Indian Or Alaska Native 
		N=Native Hawaiian Or Other Pacific Islander   
		

		

		

	
	
		A= Asian
		

		

		

		

	
	
		

		

		

		

	
	
		Hispanic or Latino - Use the popup list or enter Y if head of household is of Hispanic or Latino ethnicity, or N if head of household is not of Hispanic or Latino ethnicity.
		

		

		

	
	
		

		

		

		

	
	
		Gender of the head of household - Use the popup list or enter  F for female or M for male.
		

		

		

	
	
		

		

		

		

	
	
		CTH Reports must be submitted using the Secure Upload Tool.  Instructions will be provided with the notice of annual certification.  Minnesota Housing will not accept CTH Reports sent by email.
		

		

		

	



Sheet 2: Development Info

	
	
	
	
	
	
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Development Information
		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Management company name:
		

		

		If property has Housing Tax Credits, compliance is monitored by one of the following:
		

		

		

		

		

	
	
		Contact person for this report:
		

		

		(Entry must be either MHFA or Sub-allocator)
		

		

		

		

		

		

	
	
		Telephone number (10 digits, no hyphens):
		

		

		At initial financing/credit allocation, this development was :
		

		

		

		

		

	
	
		E-mail address:
		

		

		(Entry must be either New construction or Existing housing)
		

		

		

		

		

		

	
	
		Property name:
		

		

		Total # of units in this development:
		

		

		

		

		

		

	
	
		MHFA D#:
		

		

		 # of tax credit units in this development:
		

		

		

		

		

		

	
	
		Property address:
		

		

		Targeted population of this development (select one):
		

		

		

		

		

		

		

		

		

		

	
	
		City:
		

		

		General occupancy 
		

		Homeless
		

		Other  
		

		

		

		

		

	
	
		County:
		

		

		Elderly
		

		Special needs
		

		

		

		

		

		

		

	
	
		State:
		MN
		

		Large family
		

		SRO
		

		

		

		

		

		

		

	
	
		Zip:
		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Thank you for your cooperation in providing this information, which will be summarized for analysis and review. Please complete this report electronically. You can enter data into this Excel workbook or download forms from MHFA's website at: http://www.mnhousing.gov.  See Instructions worksheet for instructions on sending this report to MHFA.
		

		

		

	
	
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

	



Sheet 3: CTH  Report

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
		

		

		

		

		

		

		

		

		

		Characteristics of Tenant Households
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Property Name
		

		0
		

		

		

		

		

		

		

		

		

		

		
 
		
		Only the blue-shaded areas are required when funding is only Rental Rehab Loan
		

		

		

		

	
	
		City, County & Zip
		

		0
		

		

		0
		0
		

		

		

		

		

		Report Year
		

		

		

		

	
	
		MHFA #
		

		0
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		*Occupied buildings, use initial closing date.
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		**If tenant chooses to not self-identify racial category, person filling out report should designate category based on visual observation.  If uncertain, leave blank.
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		(Complete one line for each unit and the household currently residing in it)
		

		

		

		

	
	
		Unit characteristics
		Household characteristics
		Head of household characteristics
		

		

		

		

	
	
		

		

		

	
	
		Unit number
		Number of bed-rooms
		Total rent
		MHFA program
		Tax credit unit?
		Unit is designed to be access-ible
		Mobility impaired occupant
		Adults
		Children
		Homeless house-hold
		Social services
		Gross annual household income
		Main source of household income (enter one code)  
		Rental assistance
		*Date household moved into unit
		Head of household date of birth
		Marital status
		**Race
		Hispanic or Latino
		Gender 
		User Notes 
		

		

		

	
	
		

		

		tenant rent plus subsidies plus utility allowance
		See MHFA Program Codes  & definitions on next worksheet
		Y=Yes N=No   M= mgr/ caretaker/office unit
		Y=Yes  N=No
		Is one or more household members mobility impaired? Y=Yes  N=No
		# of adults age 18  or older
		# of children under age 18
		Household previously without permanent shelter Y=Yes  N=No 
		Home-less for at least 12 months or more than 4 times in 3 years  Y=Yes N=No
		Does household receive any type of social services? Y=Yes  N=No (leave blank if unknown)
		Income at last recertification (unadjusted income of all residents from all sources)
		SW=salary, wages       SS= Soc Security      SE= self employment  R=retirement, pension, annuity           I= interest, dividends, rental income  U=unemployment/ disability W= public asst.  A=alimony, child support N= no income                   
		Does household receive rent assistance?PBA=Project-based rent assistance  TBA=Tenant-based rent assistance  (leave blank if no rent assistance)
		mm/dd/yyyy
		mm/dd/yyyy
		M=Married N=Not married (includes divorced, single, widowed) S=Separated 
		W= White B=Black or African American I=American Indian or Alaska Native N=Native Hawaiian Or Other Pacific Islander  A=Asian    (List ALL that apply)
		Y=Yes  N=No
		F=Female    M=Male
		Use this section to report any extenuating or unusual circumstances or anything else regarding any unit for which Minnesota Housing should be aware.

The words contained in this file might help you see if this file matches what you are looking for:

...Sheet instructions characteristics of tenant households you will need one excel file for each the development s which are reporting save and name by property assigned d number cth year report ie dabcapts if is being submitted rental rehabilitation loan program rrl please using following protocol dabcaptsrrl additional copies duplicate opening workbook selecting quot as from menu giving a new above saving it providing data electronically move through sheets arrow keys or use enter key tab in simply contact telephone digits eg without hyphens an appears at right side cell hold down on that with your cursor select appropriate response popup list formatted so may responses identified headings capital letters popups do not dollar signs commas amounts first complete information yellow highlighted cells info this must be done order to uploaded into minnesota housing database completed required correct resubmit next onto entitled unit household occupies group homes amp shelters occupants date ...

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11/9/2011
CHARACTERISTICS OF TENANT HOUSEHOLDS
Instructions
You will need one Excel file for each one of the development(s) for which you are reporting. Save and name the file by the property's assigned D number, the property name, CTH and the year of the report (i.e., D0001ABCApts CTH11). If the report is being submitted for Rental Rehabilitation Loan Program (RRL), please name the report using the following protocol: D0001ABCAptsRRL11)
If you need additional copies of the report, duplicate the Excel file by opening the workbook, selecting "Save As" from the file menu, giving the workbook a new name using the above protocol, and saving it. If you are providing data electronically, move through the sheets using the arrow keys or, for sheet #2 of the workbook use the Enter key and for sheet #3 use the Tab key. In sheet #2, simply enter a contact telephone number as 10 digits, e.g., without hyphens. If an arrow appears at the right side of a cell, hold down on that arrow with your cursor and select the appropriate response from the popup list. Sheet #3 is formatted so that you may enter appropriate responses identified in the headings (use capital letters) or select from the popups. In sheet #3 do not enter dollar signs or commas for amounts.
First, complete the information in yellow highlighted cells of the Development Info tab. This must be done in order for the report to be uploaded into Minnesota Housing's database. If this information is not completed, you will be required to correct and resubmit.
Next, enter information onto the tab entitled CTH Report for each unit in the property and the household that occupies it on 12/31 of the report year (group homes & shelters, list occupants as of the date you complete the report). Each row on the unit worksheet should contain information on only one unit and its occupants. If a unit is vacant, please provide a unit number and unit characteristics; simply leave the household characteristics blank. The definition of “head of household” is the primary person in whose name the unit is rented. For your convenience, the Initial Occupancy Statement by Tenant and Tenant Profile forms can be printed from this Excel workbook and given to residents to fill out. The workbook is not designed for users to enter the information on the profile form electronically.

Enter dates as month, day, and year, e.g., 3-29-08 or 3/29/08, and they will convert to a standard format. Formatting will prevent entry of incorrect responses, such as a letter rather than a number, or an income of $1,000,000. If the application indicates an entry is not valid, retry and type over the information you tried to enter and tab to the next cell.

Unit Characteristics
Unit number - Unit number or any other type of building/unit identification used in the development for which you are providing the information. For shelters and transitional housing properties with "beds" rather than units list each bed as a separate unit. If there is more than one building in a property, list the building number, a hyphen and the unit number (i.e., if the address is 1572 Main St, the format for unit 101 would be: 1572-101). Do not list the building number on one line and the associated units below it and do not leave blank rows between buildings. This will frustrate the data import routine.

Number of bedrooms - Number of bedrooms in the unit; enter 0 for efficiencies (up to maximum of 6 bedrooms). For shelters and transitional housing properties list each bed on a separate line and report as 0 bedroom.

Total rent - Rent amount of the unit, including monthly amount of tenant rent, subsidies (if any), and utility allowance for the unit.

MHFA program - From the description of program codes on worksheet #8, use the drop-down menu to select the MHFA program for which the unit was funded or satisfies qualification requirements. Only one program code will be allowed per unit even though there may be multiple programs funding the same unit and/or for which the household qualifies. Select the main funding source for the unit/property (i.e., if property was funded by a LMIR first mortgage, select LMIR for all units).

Tax credit unit - Enter or select from the popup list: Y if the unit is a housing tax credit unit or N if the unit is not a tax credit unit. Popup list also includes M for identifying manager/caretaker/office units.

Unit designed to be accessible - If unit is designed to be accessible or barrier-free for a tenant who has a permanent mobility impairment, e.g., uses a wheel chair, enter the appropriate response or click the arrow and from the popup list select Y for yes or N for no.
For units that are vacant on 12/31 and units not covered under any MHFA Program, the Unit Characteristics is all that needs to be entered. Enter Household Characteristics and Head of Household Characteristics for all occupied units funded by any MHFA Program. Note that residents are not required to provide answers to questions about protected class status, e.g., race, ethnicity, gender, disability, but please encourage full participation.

HOUSEHOLD CHARACTERISTICS

Mobility impaired occupant - Use the popup list or enter Y if the head of household or any member of the household living in the unit is mobility impaired, or N if none of the tenants in the units are mobility impaired.

Adults - Enter the number of tenants age 18 or older who live in the unit.

Children - Enter the number of children under the age of 18 who live in the unit. Enter 0 if no minor children live in the unit.

Homeless Household - Use the popup list or enter Y if household was homeless (without permanent shelter) prior to occupancy, or N if household was not homeless prior to occupancy. If homeless, indicate if the household was without permanent shelter for at least 12 months or at least 4 times in the last 3 years.

Social Services - Use the popup list or enter Y if household receives any type of social services, or N if household does not receive any social services. Leave blank if unknown.

Gross annual household income - Enter the amount of gross income of all persons living in the unit at the household’s most recent recertification. Gross income includes all income from all sources listed below. Enter 0 if the household has no income.

Main source of household income - Use the popup list to find the code for the main source of income for the household (enter only one code):
SW= Salary or wages	I= Interest, stock dividends, rental income
SS= Social Security benefit	U= Unemployment, disability compensation
SE= Self employment income	W= Welfare/public assistance
R= Retirement, pension, annuities	A= Alimony, child support
N= no income

Rental assistance - If the property has project-based rental assistance (i.e., Rural Development, Section 8, etc.) and the unit receives such rental assistance, use the popup list or enter PBA. If the household receives tenant- based rental assistance (i.e., Section 8 Housing Choice or other type of voucher, enter TBA).
Date household moved into this unit - Date current household moved into this unit: month, day, and year (formatted 3-1-08 or 3/1/08) that the current household began leasing the unit that it now occupies (worksheet converts all date entries to a standard format).

HEAD OF HOUSEHOLD CHARACTERISTICS

Head of household date of birth - Enter the date of birth (month, day, year) for the head of household, only.

Marital Status - Use the popup list or enter M if the head of household is married, N if the head of household is not married (includes single, divorced, widowed), or S if the head of household is separated (need not be legal separation).

Race of the head of household - From the list provided, enter the race code(s) for the head of household only. Note that there is no popup list--be sure to enter only the code(s), but enter all that apply (i.e., if a head of household identifies him or herself as both White and Black or African American, enter WB). If tenant chooses to not self-identify racial category, the person filling out the report should designate a category based on visual observation. If uncertain, leave blank.
W= White	B=Black or African American
I=American Indian Or Alaska Native	N=Native Hawaiian Or Other Pacific Islander
A= Asian

Hispanic or Latino - Use the popup list or enter Y if head of household is of Hispanic or Latino ethnicity, or N if head of household is not of Hispanic or Latino ethnicity.

Gender of the head of household - Use the popup list or enter F for female or M for male.

CTH Reports must be submitted using the Secure Upload Tool. Instructions will be provided with the notice of annual certification. Minnesota Housing will not accept CTH Reports sent by email.

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