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Emergency Housing Conditions and Accessibility Improvements Loan Program Application Packet Dear Program Participant: Thank you for your interest in Anoka County Community Development’s Emergency Housing Conditions and Accessibility Improvements loan program. The program provides deferred loan financing to income-eligible homeowners needing to address emergency conditions in the home or essential accessibility improvements for a disabled household resident. To determine if a repair or condition qualifies for the emergency loan, contact Kristina Hayes at [PHONE REDACTED] or by email at [EMAIL REDACTED]. Maximum loan amount is $15,000 and for properties taxed as real estate, the loan is forgiven after the Borrower remains a primary resident in the home for 15 years. (Loan term may vary for Manufactured Homes.) If the Borrower sells, transfers title or ceases to occupy the property as his/her Principal Residence during the loan term, the loan will become due and payable. Potential participants must complete the attached application. In order for your application to be reviewed, all attached forms must be completed and required documentation must be submitted. Any missing or incomplete information will delay the process. Please do not submit original documents with your application as they will not be returned to you. Please read all sections carefully. Submit completed applications to: Kristina Hayes Anoka County Community Development 2100 3rd Ave, Suite 700 Anoka, MN 55303 [PHONE REDACTED] [EMAIL REDACTED] www.AnokaCounty.us/CD Anoka County Housing and Redevelopment Authority ---PAGE BREAK--- 06/07/12 Anoka County E&A Application Page 2 Emergency and Accessibility Loan Program At a Glance Mortgage Status, Real Estate Taxes Applicant must be current on mortgage loan payments and up to date on real estate taxes. Borrower Age and Co-Signers Borrower must be eighteen (18) year of age or older or have been declared emancipated by a court having jurisdiction. Co-signers ARE NOT allowed on Emergency and Accessibility loans. Ownership Interest Borrowers must have clear title to the subject property and will be evidenced by a title search conducted by Anoka County. For additional information about ownership interest, contact Kristina Hayes at [PHONE REDACTED] or [EMAIL REDACTED] Maximum Borrower Income Applicant must meet income requirements, as set by Minnesota Housing. Household annual income maximum based on household size, and income level, Effective 2012 Household Size 1 2 3 4 5 6 7 8 Gross annual income $17,700 $20,200 $22,700 $25,200 $27,100 $29,100 $31,300 $33,300 If Borrower’s gross annual income is zero or a negative amount, the Borrower is ineligible for financing. Assistance Loan Rates and Terms Maximum loan amount is $15,000 and for properties taxed as real estate, the loan is forgiven after the Borrower remains a primary resident in the home for 15 years. (Loan term may vary for Manufactured Homes.) If the Borrower sells, transfers title or ceases to occupy the property as his/her Principal Residence during the loan term, the loan will become due and payable. Rehabilitation Requirements Construction work requiring a permit must be completed by a licensed contractor, with applicable permits and inspections completed. Use of local contractors is encouraged. Work can be performed by home owner with certain restrictions and requirements. A home inspection must be completed prior to final loan approval to determine condition of home and needed repairs. Construction/repairs on the home must be completed within 9 months of loan closing. Other Borrowers may NOT receive any cash back. A credit report or credit check WILL NOT be conducted and IS NOT REQUIRED. Borrower Occupancy Requirement Borrower must have owned the property and resided in the property as his/her Principal Residence for at least 6 months. The Borrower must continue to own and regularly reside in the property as his/her Principal Residence during the term of the loan. ---PAGE BREAK--- 06/07/12 Anoka County E&A Application Page 3 Required Documentation Emergency Housing Conditions and Accessibility Improvements loan funds will be provided to income qualified households with a qualified, completed application. In order to be considered for assistance, a complete application must be received. An application will not be processed until all of the documents are completed and received as listed below: Included in this application package: Emergency & Accessibility Loan Program Borrower Application (MN Housing form) – must have signed signature page **Click on the link above to complete the PDF application. Complete the application, print, sign and submit the original application. Conflict of Interest Statement Data Privacy form - signed Authorization to Release form - signed Other required documentation: Copy of applicant(s) photo identification Copy of applicant(s) Social Security Card and/or Permanent Resident Card Copy of current mortgage statement Copy of income documentation from all income sources for all household members age 18 and older ---PAGE BREAK--- 06/07/12 Anoka County E&A Application Page 4 Income Documentation If you select any of the following forms of income, documentation must be attached to this application for verification. Do NOT submit originals. Has any member of the household 18 years and older received, or is expected to receive in the next 12 months, the following: (Two months of documentation must be submitted if any are selected) Wages, salaries, overtime pay, commissions, fees, tips, bonuses, or other compensation Income or gain from CD’s, money market accounts, brokerage accounts, stocks, bonds, or Treasury Bills Periodic payments from Social Security, disability/death benefits, pensions, retirement funds, annuities, insurance policies, or similar types of periodic benefits payments Payments in lieu of earnings, such as unemployment and disability compensation, workers compensation or severance pay Welfare assistance or TANF benefits Child support, spousal support/alimony, or regular contribution or gifts from persons not residing in the household including scholarships, parental gifts for tuition, etc. Revocable trust Lump sum payment or receipt of inheritances, capital gains, lottery winnings, victims’ restitution or insurance settlements Real estate other than the primary residence or other capital investments Does any member of the household have any of the following: (Three months of documentation must be submitted if any are selected) Checking account Savings account Retirement, pension, IRA, Koegh fund accounts Life insurance policy available before death (whole or universal life insurance) Holding of personal property as an investment Mortgage or deed of trust Interest or payments from Indian Land Trust(s) Conflict of Interest Provision The conflict of interest provision applies to any individual, business, or private entity receiving federal assistance, who has any family, business, contract or subcontract ties to: an employee, agent, consultant, officer, or elected official or appointed official of Anoka County HRA, designated public agencies, or subrecipients that are receiving funds for their tenure or for one year after. If there are questions in regards to your participation with this program all information needs to be disclosed and Anoka County will work HUD to determine your eligibility. If it is later found that a conflict of interest occurred and was not reported, the loan balance will immediately become due and payable. No conflict of interest. Yes, there is a conflict of interest. Please contact me to discuss my eligibility. Improvements Please check items to be considered for improvement: Replace/repair roof Replace furnace Insulation Windows/doors Soffits and fascia Replace water heater Handrails Electrical Siding Plumbing Smoke detectors Other, please list below Other: ---PAGE BREAK--- 06/07/12 Anoka County E&A Application Page 5 Data Privacy NOTICE OF RIGHTS CONCERNING THE INFORMATION YOU SUPPLY TO ANOKA COUNTY COMMUNITY DEVELOPMENT In accordance with the Minnesota Government Data Practices Act (“MGDPA”), Anoka County (“County”) is required to inform you of your rights as they pertain to private information collected from you. Private data is that information held by the county that is available to you, but not to the public. The private data collected from you, or from other agencies or individuals authorized by you, is used to determine your eligibility for the Emergency Housing Conditions and Accessibility Improvements loan program. You are not required to provide information relating to your marital status, race, ethnicity, or citizenship, but it is requested for federal reporting, statistical information and monitoring purposes. All other information is required to determine your eligibility for assistance from the county. If you choose not to supply the required information, Anoka County will not be able to determine your eligibility for this program. The dissemination and use of private data the county collects is limited to that necessary for the administration and management of the Emergency Housing Conditions and Accessibility Improvements program. Persons or agencies with whom this information may be shared are: 1. Anoka County personnel involved in administering the Emergency Housing Conditions and Accessibility Improvements program; 2. Authorized personnel from the Minnesota Housing Finance Agency; 3. Federal, state, local and contracted auditors; 4. Law enforcement personnel in the case of suspected criminal activity; and, 5. Those individuals or agencies to which you give your express written permission for release of information. Unless otherwise authorized by state or federal law, other government agencies utilizing the reported private data must also treat the information as private. You may wish to exercise your rights as contained in the MGDPA. Those rights include: 1. The right to see and obtain copies of the data maintained on you. 2. The right to be told the contents and meaning of the data. 3. The right to contest the accuracy and completeness of the data. I have read and understand the above information regarding my rights relative to the collection of personal data for government programs. Applicant Date Co-Applicant Date ---PAGE BREAK--- 06/07/12 Anoka County E&A Application Page 6 Authorization to Release Information I have applied for a loan or grant through Anoka County Community Development. As part of the application process, employees of Anoka County may verify information contained in my/our loan or grant application and in other documents required in connection with the loan, including, but not limited to employment history, income; bank, money market and other financial account balances; copies of income tax returns and property information. A copy of this authorization may be accepted as an original. Print Name Social Security Number Date Signature Print Name Social Security Number Date Signature