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05/01/2013 Dear Program Participant: Thank you for your interest in the federal Neighborhood Stabilization Program (NSP) offered by Anoka County Community Development. The goal of the program is to stabilize our communities and the properties within. Attached is an application and requested documentation that is required for your participation with the NSP program. In order for our Non-profit partners to accept your request to purchase an NSP property, all attached forms must be completed and required documentation submitted. This program has specific federal requirements that need approval prior to the acceptance of your purchase agreement Any missing or incomplete information will delay the process. Please do not submit original documents with your application. Once documentation has been reviewed we will notify you and the non-profit of the status. Signatures on the application must be original, fax and scanned copies will not be accepted. Complete documentation and original applications should be mailed or delivered to: Anoka County Government Center Attn: Community Development Department 2100 3rd Ave., Suite 700 Anoka, MN 55303 Please read all sections carefully. If you have additional questions, contact: Kate Thunstrom Community Development Manager [EMAIL REDACTED] [PHONE REDACTED] Anoka County Housing and Redevelopment Authority ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 2 Program At a Glance Eligible First Mortgage Loan Products Prime, Fixed Rate (HUD, VA, Conventional) Maximum Borrower Income Household annual income maximum based on household size, Effective 12/2011 Size/AMI 1 2 3 4 5 6 7 8 50% $28,850 $32,950 $37,050 $41,150 $44,450 $47,750 $51,050 $54,350 Maximum Housing Ratio 26-35% Minimum Borrower Investment $1,000 earnest money submitted with Purchase Agreement Other Borrowers may NOT receive any cash back at closing. There is no first-time homebuyer requirement. Borrowers are required to complete a Homebuyer Education Course before the scheduled closing. For a listing of HUD approved agencies, visit HUD’s Web site: Borrower Occupancy Requirement Borrowers must owner occupy the property purchased as their principal place of residence and cannot have an ownership interest in any other property. Property Terms All properties will have an Affordability Period declaration filed against the property. This means that for 20 years the property will remain the principal residence of a “low to middle income family”. If the property is sold during those 20 years, it must be sold to a “low, to middle income family” as defined in 42 U.S.C. 5302(a) at the time of the purchase. Additional terms are discussed in the Declaration of Covenants, Conditions and Restrictions. / Applicant initial(s) ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 3 Homebuyer Information Full Name of Applicant/Head of Household Full name of Co-Applicant Relationship to Applicant: Social Security Number U.S. Citizen Legal Permanent Resident Social Security Number U.S. Citizen Legal Permanent Resident Marital Status Married Unmarried (widowed, single, or divorced) Marital Status Married Unmarried (widowed, single, or divorced) Current Address Current Address Phone Number (home): ( ) Alternate Phone: ( ) Email: Phone Number (home): ( ) Alternate Phone: ( ) Email: Name of Employer: Estimated Gross Income: Occupation: Number of Years with Name of Employer: Estimated Gross Income: Occupation: Number of Years with All applicants are required to attend Home Stretch classes. Have you attended a Homebuyer Education class within the last 12 months? Yes No If Yes, attach a copy of the Homebuyer Education Completion Certificate. If No, you will be required to attend this class before closing on the property. All applicants are required to attend Home Stretch classes. Have you attended a Homebuyer Education class within the last 12 months? Yes No If Yes, attach a copy of the Homebuyer Education Completion Certificate. If No, you will be required to attend this class before closing on the property. Household Information List the names of all individuals who will reside in the household in addition to the Applicant and Co-Applicant Name Birthdate Relationship to Applicant/Co-Applicant Student (Yes or No) Social Security Number Income (Yes or No) / / / / / / / / / / / ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 4 Applicant initial(s) General Documentation - Required Original signatures and full application to be submitted with all required attachments. Faxed or scanned applications will not be accepted. Copy of applicant(s) photo identification Copy of applicants(s) Social Security Card and/or Permanent Resident Card Copy of W2 forms for the last 3 years for every member of the household Copy of tax returns for the last 2 years for all household members Copy of mortgage pre-approval letter or approval letter Homebuyer Education Certificate from a HUD approved Housing Counseling Agency Income Documentation - Required 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: (Three 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) / Applicant initial(s) ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 5 Property Information Address of property to be purchased - (If not yet determined, this section may be left blank) Mortgage/Realtor Information Loan Information Type of Loan FHA Conventional Veterans Administration Other: Mortgage Lending Company Company Loan Officer Address Phone Number Fax E-mail Realtor Contact Information, if applicable Realtor Name Affiliated Company Phone Fax E-mail Conflict of Interest Provision The conflict of interest provision of the federal program 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, CDBG/NSP 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 exists Yes, there is a conflict or potential conflict of interest. That relationship is as follows: / Applicant initial(s) ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 6 Program Affidavit I/We certify that the information contained in all required and signed program-related documents submitted is true and correct. I/We further certify that: I am (We are) a U.S. citizen or I/we have legal permanent resident status. The house I/we purchase will be my/our principal place of residence. I/We will notify Anoka County Community Development in writing if the home ceases to be my/our principal residence. I/We further certify that I/We will comply with the 20-year Affordability Period attached to the property: As described in the formal Declaration of Covenants, Conditions and Restrictions, which will be signed at the closing of the property: 1. I/We agree to take such steps and execute such documents to insure that each UNIT shall be maintained in compliance with the Federal Act for a period of twenty (20) years from the date hereof. To that end, I/We hereby agree to the following: a. During the Affordability Period the property will be the principal residence of an owner whose family qualifies as a “low, moderate or middle income family” as defined in 42 U.S.C. 5302(a), at the time of purchase. b. During the Affordability Period the property shall be available for subsequent purchase only to subsequent purchasers whose family qualifies as a “low, moderate or middle income family” which will use the property as its principal residence. The property may be re-purchased by the Declarent during the Affordability Period but the unit must then be re-sold to an income qualified family within one year of the date of re-purchase. If the Declarent fails to re-sell during the one year period, it shall be considered an event of default and the Agency may pursue the remedies set forth in the Declaration. c. These affordability restrictions terminate upon the expiration of the Affordability Period. d. During the Affordability Period the property will be sold for a price which does not exceed the total estimated mortgage expense (including principal interest, taxes and insurance) for a qualified purchaser of 120% of the Area Median Income (AMI) for the area, as determined by HUD. The full Declaration is available for review prior to the closing and may be requested by contacting Anoka County Community Development at [PHONE REDACTED]. Applicant Signature Date Co-Applicant Signature Date ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 7 Government Monitoring The information being requested below is for determining compliance with federal equal credit opportunity, fair housing and home mortgage disclosure law. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may not discriminate on the basis of this information, or on whether you choose to furnish the information. If you choose not to furnish this information and you have made the application in person, we are required to note ethnicity, race and sex on the basis of visual observation or surname. Please check below if you choose not to furnish this information. Date of Application: Applicant Co-Applicant Applicant Name: Co-Applicant Name: I do not wish to furnish this information I do not wish to furnish this information Ethnicity: (select only one) Hispanic or Latino Not Hispanic or Latino Ethnicity: (select only one) Hispanic or Latino Not Hispanic or Latino Gender: Male Female Gender: Male Female Race: (select one or more) White Black/African American Asian American Indian/Alaska Native Native Hawaiian/Other Pacific Islander American Indian/Alaska Native & White Asian & White Black/African American & White American Indian/Alaska Native & Black/African American Other Multi Racial Race: (select one or more) White Black/African American Asian American Indian/Alaska Native Native Hawaiian/Other Pacific Islander American Indian/Alaska Native & White Asian & White Black/African American & White American Indian/Alaska Native & Black/African American Other Multi Racial Applicant Signature Co-Applicant Signature This Section for Anoka County’s Use Only Application received by: Mail Face-to-face Interview Telephone Staff Name: Date: ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 8 Data Privacy NSP Invest in Neighborhood Program 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 NSP Invest in Neighborhood program assistance from Anoka County. 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 NSP Invest in Neighborhood program. Persons or agencies with whom this information may be shared are: 1. Anoka County personnel involved in administering the NSP program; 2. Authorized personnel from the United States Department of Housing and Urban Development; 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--- Anoka County NSP Property Purchase Application Page 9 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; credit history; copies of income tax returns and property information. A copy of this authorization may be accepted as an original. Applicant (Print Name) Social Security Number Date Signature Co-Applicant (Print Name) Social Security Number Date Signature ---PAGE BREAK--- Anoka County NSP Property Purchase Application Page 10 Signature Page I/We hereby submit the information contained in the attached Application, Uniform Residential Loan Application, tax returns, and other furnished documents to be considered for the Anoka County NSP Invest in Neighborhood program. I/We read, completed all forms in connection with this application. I/We understand that any discrepancy or omissions in the information I/we have provided may disqualify me/us from participation in the program. If such discrepancies or omissions are discovered after any loan is approved or granted to me/us, I/we understand that any outstanding loan balance may immediately become due and payable. Applicant Signature Date Co-Applicant Signature Date WARNING: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government.