Annual draw requests and supporting documentation must be submitted to MHFA’s online Multifamily Secure Upload Tool. Using the online tool, send items to mhfa.app@state.mn.us. Review the Upload Tool Instructions for more information.
Annual Draw Requests must be submitted within 60 days of the end of the Development’s operating year to request Grant Proceeds for the current fiscal year. Summision of the Draw Request and Annual Report must also include the following items: 
1.	On MHFA’s Operating Subsidy Budget Form* for each type of use for the grant (Revenue Shortfall, Front Desk or Tenant Service Coordinator):
a.	Complete the reconciled budget(s) based on the actual financial statement for the recently completed year (or draw period), and 
b.	Complete the proposed budget(s) for the request year (or draw period) for each type of use for the grant (Revenue Shortfall, Front Desk or Tenant Service Coordinator), and 
2.	An attested year-end financial statement, which must include the Development’s operating statement and balance statement (for the recently completed year or draw period).  The Chief Financial Officer of Executive Director may sign attesting to the accuracy of the information.

*All budgets must be completed on the appropriate Operating Subsidy Budget Form(s) available on the Operating Subsidy Administration webpage. 

Questions regarding the draw request can be directed to: mhfa.grants@state.mn.us 

Development Name	     	D#:      	MOS#:      	
Development Address	        	
Contact Name	     	
Phone	     	
Email	     	

FISCAL YEAR FOR WHICH GRANT FUNDS ARE REQUESTED:
Enter time period (MM/DD/YY - MM/DD/YY)	     	

Approval is requested from Minnesota Housing to draw the following amount(s):
                                   USE TYPE	Tenant Service Coordinator	                                         Front Desk	 Revenue Shortfall	                            TOTAL REQUEST	
Requested Amount:
	$     	$     	$     	$     	

Include a description of the specific use for the Grant Proceeds for each funding category being requested. List expenses corresponding to the line items listed in the Operating Budget Form that are easily identified and documented.  The total amount shown should equal or exceed the amount requested. MHFA may request additional documentation (i.e. invoices, timesheets, etc.) for expenses paid in the previous year as reported in the reconciled budget.
USE TYPE	Line Item from Operating Budget 	Amount Grant Proceeds will pay for 	
Tenant Service Coordinator:	     	$     	
	     	$     	
	     	$     	
Front Desk:	     	$     	
	     	$     	
	     	$     	
Revenue Shortfall:	     	$     	
	     	$     	
	     	$     	
	     	$     	
	     	$     	
	     	$     	

Program Report Information	

1.	Occupancy Information for the Fiscal Year	 	
Total number of units at the property 	     	
Number of units occupied on first day of fiscal year	     	
Number of move outs during the year 	     	
Number of move-ins during the year	     	
Number of units occupied on the last day of the fiscal year	     	
Vacancy rate for the year	     	

2.	Demographics of Heads of Household served in last year (report period)
Total number of Households served	     	
Number of Head of Household with a disabling condition	     	

Race and Ethnicity of Head of Household	Hispanic/
Latino	Non-Hispanic/ 
Non-Latino	Don't Know/
Refused	
White	     	     	     	
Black or African-American	     	     	     	
Asian	     	     	     	
American Indian or Alaska Native	     	     	     	
Native Hawaiian or Other Pacific Islander	     	     	     	
Multiple Races	     	     	     	
Don't Know/Refused	     	     	     	

3.	Tenant Screening Data
Number of applicants denied based on tenant screening criteria	     	

Enter the demographic information for the head of household for households denied housing based on tenant screening criteria. Enter the number of head of households by the applicable race and ethnicity category and the total number with a disabling condition. Enter the number/followed by race (e.g., 2/American Indian) and for ethnicity (e.g., 3/Non-Hispanic). 
Demographics of Head of Household 
Reason for Denial 	Number by Race of Head of HH (use the categories from Q# 2)
#/Race	Number by Ethnicity of Head of HH
#/Ethnicity	Number with Disabling Condition 
Total #	
Rental History (evictions, references)	     /     
     /     
     /     	     /     
     /     
     /     	     	
Credit History (including money owed)	     /     
     /     
     /     	     /     
     /     
     /     	     	
Criminal History- Type:
	     /     
     /     
     /     	     /     
     /     
     /     	     	
Other- List:
	     /     
     /     
     /     	     /     
     /     
     /     	     	

4.	Lease Data
Number of evictions or non-renewal of leases 	     	

Enter the demographic information for the head of household for households who were evicted or received a non-renewal of lease. Enter the number of head of households by the applicable race and ethnicity category and the total number with a disabling condition. Enter the number/followed by race (e.g., 2/American Indian) and for ethnicity (e.g., 3/Non-Hispanic). 

Demographics of Head of Household 
	Number by Race of Head of HH (use the categories from Q# 2)
#/Race	Number by Ethnicity of Head of HH
#/Ethnicity	Number with Disabling Condition 
Total #	
Eviction	     /     
     /     
     /     	     /     
     /     
     /     	     	
Non-renewal of lease or mutual termination	     /     
     /     
     /     	     /     
     /     
     /     	     	

NOTE: This form can be signed digitally, electronically or via wet signature by either the Grantee’s Executive Director or Chief Financial Officer.

GRANTEE'S APPROVAL:		
                                                             Signature:	
     	
                                          Print name and Title: 	
     	
                                                                     Date: