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when all revenue amounts and all expended. encumbered and unencumbered amounts have been added to Form i Form 2 Page 2 of Funding Sources for Units Produced SHIP Funds Expended $ 195, Public Moneys Expended Private Funds Expended $ 71, Owner Contribution $ Total Value of All Units $ 267, SHIP Prooram Compliance Summary - Home Owr 351 75 Income Set -Asides I 1 11 11 1 1 g^Jya q t 1 1 1 1 1 I NumberNumber ofof HouseholdsHouseholds / / UnitsUnits ProducedProduced PagePage 33 C l-U' Zl- LL' LVOLAdjotspodaulenuutldlHSlolenoiddtl : olSZ) sNodaH IenuuvdlHS: luaWu3epv SHIP 67- 37008 ()( 0. F A.A Effevive Date 1112008 IIJ Totals: 18 6 13 Totals: 5 21 8 3 37 Race ( Head of Household) Totals: 11 26 37 Spe 7al Needs (Any Member of Household) Page 4 E t- ZL' ZL- LL' LL- oLAjjoi sVodaalenuuVdlHSlolenoiddV : oLSZ) sVodaalenuuVdlHS: luawyoeRV v Nw Form SHIP )( fl, F 9 6R3Zve Ow , FAA. EHecTrve Oate: 1112009 dm Y Rehabilitafion- 0 Rental Totals: 0 Special Target Groups for Funds Expended ( i. e. teachers, nurses, law enforcement, fire fighters, etc.) Set Aside Form 4 Page 5 U- el' Zl- LL' ll-ol Athol stiodaylenuuydlHSlolenomddV : ol9Z) syjodaalenuuVdlHS3uaw43e» y Form SHIP AR2009 07- 37. 008( 3$ f), FA G. a® Effective Date: 1112009 Rehabilitation- Riley, Victoria 226 Swaying Pine Crestview 32536 1, 761. 19 Yw n Rental Rehabilitation- Mount, 228 Swaying Pine Crestview 32536 1, 761. 19 Rental Kimberly Rehabilitation- Walker, 230 Swaying Pine Crestview 32536 1, 761_ 19 Rental Rashad and Kavdian Rehabilitation- Spencer, Tina 154 Swaying Pine Crestview 32536 1, 761. 19 Rental Rehabilitation- Sanders, Mary 174 Swaying Pine Crestview 32536 1, 761. 19 Rental Rehabilitation- Clark, Bernard 188 Swaying Pine Crestview 32536 1, 761. 19 Rental Rehabilitation- Butterworth, 190 Swaying Pine Crestview 32536 1, 761. 19 Rental Joanna and William White Rehabilitation- Johnson, 194 Swaying Pine Crestview 32536 1, 761. 19 Rental Carman Rehabilitation- Lewis ll, 196 Swaying Pine Crestview 32536 1, 761. 19 Rental Kenneth Rehabilitation- Wortham, 198 Swaying Pine Crestview 32536 1, 761. 19 Rental Gloria Rehabilitation- Smiley, 208 Swaying Pine Crestview 32536 1, 761. 19 Rental Princess Rehabilitation- Williams, 216 Swaying Pine Crestview 32536 1, 761. 19 Rental Tameko and Adrian Rehabilitation- Carter, Vicona 220 Sawying Pine Crestview 32536 1, 761. 19 Rental and Byron Rehabilitation- McGlaughlin, 224 Swaying Pine Crestview 32536 1, 761. 19 Rental Gwedyln Rehabilitation- Paris, Natavia 236 Swaying Pine Crestview 32536 1, 761. 19 Rental and Nicloe Blount Rehabilitation- Alford, Sandra 238 Swaying Pine Crestview 32536 1, 761. 19 Rental Rehabilitation- Turbeville, 242 Swaying Pine Crestview 32536 1, 761. 19 Rental Scott and Virginia Rehabilitation- Peters, Donald 248 Swaying Pine Crestview 32536 1, 761. 19 Rental and Molly Rehabilitation- Wortham, 252 Swaying Pine Crestview 32536 1, 761. 19 Rental Annika Rehabilitation- White, Melinda 256 Swaying Pine Crestview 32536 1, 761. 19 Rental Rehabilitation- Berry, Ausefa 258 Swaying Pine Crestview 32536 1, 751. 19 Rental Rehabilitation- Janson Telisa 262 Swaying Pine Crestview 32536 1, 761. 30 Rental Purchase Bailey, 115 Willard Rd. Fart Walton 32548 8, 500. 00 Assistance Jefferey Beach Page 6 EL- ZL ' ZL- LL ` LL- OL Ad jol spodaH lenuuV dIHS to IenoiddV : OLSZ) svoday lenuuV dlHS : 1uaw4OEUV m Farm $ MIF 9 OI 67 37 )( f), F a EYective Data' .11i20C9 d I u OkalccsaOkalccsa County/County/ FortFort WaltonWalton BchBch 20112011 Intent-Intent- n-n- 11^^ PagePage 77 Zl ZL- IL LL- OL Ad JoJ spodaa lenuutl dlHSJo lenojddtl: OLSZ) spodam lenuuv dlHS: 1uOw40eJJV 0 m Farm SHIP AR2009 p, 67 37,008(3)( Date0,), F.A.C. ERedive Date: 112009 YY Title: SHIP Annual Report Report Status: Unsubmitted a Okaloosa County /Fort Walton Bch FY 2012/ 2013 Form 1 Page t L- ZL' ZL- LL' LL- OLA dio; spodaalenuutldlHSlolenoiddy : OLSZ) s>JOdaalenuuydlHS7u3wy3e; LV m Form SHIP Xf, FA e]- 5] ve Date FA0 Effective Date: 112009 6 xUA a. SHIP Distribution Summary Homeownership 3 Rehabilitation 49, 985001 2 Homeownership Totals: 49, 985. 00 2 Rentals Construction- Rental a< a, suu. uu 6 25, 300. 00 6$ 49, 985. 00 Total Revenue (Actual and/ or Anticipated) for Lo, al SHIP Trust Fund State Annual Distribution 72,286. 00 ProgramProgram IncomeIncome ( ( Interest)Interest) 398. 00 ProgramProgram IncomeIncome ( ( Payments)Payments) 10, 921. 00 Recaptured

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