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Home / Programs / Community / Community Development Block Grant (CDBG) / Exhibit E2: LMI – Area Basis (LMA), Random Sample Survey

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Exhibit E2: LMI – Area Basis (LMA), Random Sample Survey

To document that the CDBG activity meets the national objective of LMA, complete one of the following forms: Exhibit E, Exhibit E1, and Exhibit E2. Complete Exhibit E2 if the service area qualifies based on the completion of a random sample survey.

To document that the CDBG activity meets the national objective of LMA, complete one of the following forms: Exhibit E, Exhibit E1, and Exhibit E2.

Complete Exhibit E2 if the service area qualifies based on the completion of a random sample survey.

To access templates and guidance, refer to the Department's Website under the Application Guidelines section: (https://opportunity.nebraska.gov/cdbg/).

Does the CDBG Activity meet the national objective of LMA through the completion of a random sample survey?(Required)

Yes

No

Part l. Information Contained In Your Survey

1. Total number of families (including single person families) in the activity service area.(Required)

2. Margin of error (must be lesser of 10% or the HUD-provided MOE).(Required)

To calculate MOE, use the available calculator at https://www.surveymonkey.com/mp/margin-of-error-calculator/.

UPLOAD: Copy of the MOE calculator output (e.g., screen print).(Required)

Max. file size: 300 MB.

3. Sample Size

4. Total number of families in the service area that were contacted (include those not reachable, refused to answer, incomplete interview/questionnaire)(Required)

5. Total number of families with completed interviews.(Required)

6. Total number of persons in the families interviewed.(Required)

7. Total number of persons in the families interviewed who are LMI persons(Required)

8. Divide line 7 by line 6 and enter that decimal number to determine the LMI percentage. For example, if the percentage is 57.2%, enter .572 in the field below.(Required)

9. Total number of persons in the service area (use number of persons from census survey).(Required)

10. Total number of LMI persons benefiting (Multiply line 8 by line 9).

Tabulated Income Survey Results

Family Size: 1 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 2 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 3 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 4 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 5 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 6 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 7 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Family Size: 8 Person

Income Limit(Required)

Number of Families Above Income Limit(Required)

Number of Families Below Income Limit(Required)

Part ll. Survey Analysis and Documentation

Date Survey Conducted: From(Required)

MM slash DD slash YYYY

Date Survey Conducted: To(Required)

MM slash DD slash YYYY

Effective Date of Income Limits Used(Required)

MM slash DD slash YYYY

Confidence Interval(Required)

Confidence Level: 90%

Margin of Error (%)(Required)

Area Surveyed(Required)

Target Area

Entire Community

Community and Surrounding Area

Does the area surveyed include the entire service area of the CDBG activity proposed?

Yes

No

List source(s) of information used to develop complete list of families in the service area.(Required)

Character limit: 300

UPLOAD: Copy of the list used to compile families/households in the service area(Required)

Max. file size: 300 MB.

Explain how a systematic representative sample was selected.(Required)

In addition to sampling an adequate portion of the population, the surveyor must ensure that the responses correspond to a geographic cross section of the service area benefiting. Essentially, the northern, eastern, southern, western and central areas of the service area should be represented with completed surveys. If the uploaded map of the service area indicates any gaps by street or block, also include explanation below.

Detail how the sample accurately reflects the total population and geographic cross-section of the survey area and, if there was a bias or gap in responses, how was it dealt with.(Required)

Character limit: 3,300 (about 1 page)

List all organizations and individuals conducting and analyzing the survey.(Required)

Character limit: 1,100 (about 1/3 page)

Summarize the survey process detailing the method of delivery (mail, door to door, telephone or other) and collection including time(s) of day/week, number of and follow-up efforts, and provisions for replacement of un-reachable and non-respondents. Explain how possible bias was avoided.(Required)

Most Current U.S. Census Data LMI Percentage. For example, if the percentage is 48.25%, enter .4825 in the field below.(Required)

Is the difference between the U.S. Census data LMI and the income survey results LMI 10% or greater?(Required)

Yes

No

If the difference between the U.S. Census data LMI and the income survey results LMI are 10% or greater, provide an explanation for the difference.(Required)

Character limit: 1,100 (about 1/3 page)

Using the template found on the Department's Website (https://opportunity.nebraska.gov/cdbg/), complete the Certification of Completion of an Income Survey and upload it below.

UPLOAD: Signed Exhibit E2_Certification of Completion of an Income Survey(Required)

Max. file size: 300 MB.

Is the LMI between 51% and 54%?(Required)

Yes

No

If the LMI is between 51% and 54%, attach additional analysis of the distribution curve of family sizes “above”, family sizes “below”, and family size percentages.

UPLOAD: Additional analysis of the distribution curve of family sizes “above”, family sizes “below”, and family size percentages.(Required)

Max. file size: 300 MB.

UPLOAD: Copies of 5 COMPLETED survey responses.(Required)

Max. file size: 300 MB.

UPLOAD: Copy of the list used to disseminate the survey, indicating which families completed the survey.(Required)

Max. file size: 300 MB.

UPLOAD: Map indicating service area boundaries and location of families who completed the survey.(Required)

Max. file size: 300 MB.

UPLOAD: Copy of all publications/advertisements/letters directed towards citizens to publicize the income survey.(Required)

Max. file size: 300 MB.

Grant Management Resources

This page will provide technical assistance on using AmpliFund to apply for and manage grants awarded by DED.

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Jenny B. Mason

Director of Community Development & Disaster Recovery

jenny.mason@nebraska.gov | 402-471-6280

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