HOMEOWNER REHABILITATION LOAN

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1 City of Mobile COMMUNITY & HOUSING DEVELOPMENT DEPARTMENT DEADLINE: Friday, February 27, 2015 at 4:00 p.m. CITYWIDE IV HOMEOWNER REHABILITATION LOAN APPLICATION Please Return the Completed Application with All Requested Documents to: CITY OF MOBILE Community & Housing Development Department P. O. Box 1827 Mobile, AL OR THE GOVERNMENT PLAZA 205 Government Street South Tower, 5 th Floor, Suite 508 Mobile, AL If You Have Any Questions or Need Additional Information, Please Contact Our Office at: (251) or (251) Page 1

2 I M P O R T A N T Before Beginning This Application, Please Answer the Following Questions! 1. Does Your Property Deed Reflect that You Are The Owner of the Property? 2. Do You Have Homeowner s Insurance? 3. Is Your Household Income Below the HUD Standards Outlined Below? Family Size % AMI $30,200 $34,500 $38,800 $43,100 $46,550 $50,000 $53,450 $56,900 If you do not meet the above criteria, you are not eligible for this program. Any applicant that meets the criteria, please complete the attached application and forward with all requested documents for processing. ANY APPLICATION THAT DOES T CONTAIN THE ABOVE LISTED DOCUMENTS, WILL BE RETURNED AND T CONSIDERED FOR THE 2015 HOMEOWNER REHAB PROGRAM.

3 CITY OF MOBILE Homeowner Rehab Program A P P L I C A T I O N C H E C K L I S T PLEASE INSURE THAT ALL REQUESTED DOCUMENTS HAVE BEEN INCLUDED IN YOUR APPLICATION PACKAGE BEFORE SUBMITTING TO OUR OFFICE FOR CONSIDERATION. Copy of Property Deed as Recorded with Mobile County Probate Court Copy of most recent Utility Statements (Mobile Gas, Alabama Power Company & Mobile Area Water and Sewer) Proof of Homeowner s Insurance Declaration page that identifies coverage summary and amounts. All policies MUST have Wind Coverage, date of coverage and amount of premium. Most recent (4) pay stubs, retirement statement, pension statement or social security/disability income itemization statement 2014 IRS Tax Return or Most Recent Tax Return Filed (For each adult in household) Most recent Mortgage Statement that reflects the mortgage balance, your payment and escrow information. Checking and Savings Account Statements for the past six consecutive months. (For each adult in household) Court order for award of monthly child support payments. Please contact the Child Support Enforcement Agency to obtain a printout of your support payment history for the past six months. Signature ONLY on the attached Request for Verification of Employment form for each employer of all household members 18-years of age and older. Signature ONLY on the attached Request for Release of Information form for all household members. Signature ONLY on the attached Request for Mortgage Verification form for household members listed on mortgage, if applicable. If you have children 18-years of age and older who attend school, please submit a copy of their school registration. If income is received from rental property, Current IRS Tax Return with the appropriate Schedules (Schedules E). Copy of your last two quarterly statements for any stocks, bonds, money market, IRA, 401K, Keogh accounts or any similar types of interest bearing accounts. Elevation Certificate, if your property is located within a Flood Zone. If it is determined that you reside within a flood zone, a flood insurance policy will need to be presented.

4 CITY OF MOBILE COMMUNITY & HOUSING DEVELOPMENT DEPARTMENT HOMEOWNER REHAB LOAN PROGRAM APPLICATION Application Period Begins Friday, January 23, 2015 Application Close Date February 27, 2015 TE: Submission of this application does not obligate the applicant or the City of Mobile s CHD in any way. HOMEOWNER APPLICANT(S) Married borrowers must have their spouse sign the mortgage deed. Owner Last Name First Middle Initial Social Security # Date of Birth Co-Owner Last Name First Middle Initial Social Security # Date of Birth Property Address City Zip Mailing Address, if Different from Above City Zip CONTACT INFORMATION Best Daytime Contact Number Best Evening Contact Number Home Phone Number Cellular Phone Number Work Phone Number Address PREVIOUS SERVICES Have you ever received Housing Rehab Assistance from the City of Mobile or the Mobile Housing Board? YES If YES, in what year did you receive assistance? Have you any past obligations owed to City of Mobile in the past five (5) years? YES Are there currently any unsatisfied judgments against you? YES Has either Owner or Co-owner declared bankruptcy in the past two (2) years? YES How Did You Hear About Our Program? Please check ALL that apply. CHD Department Television Direct Mail City Website Newspaper Other Please Explain Other: Page 2

5 HOUSEHOLD INFORMATION Demographic data is obtained for statistical purposes and will not be considered by the City in determining eligibility. Do You Currently Own The Above-listed Property? YES Do You Live in the Above Listed Property as Your Primary Residence? YES Is this a Single Family Home? Or a Two Family Home? Total Number of Bedrooms in the Home? Have You or Any Household Members Classified as Disabled by a Physician? YES Are You or Any of Your Household Members over the Age of 62? YES Please Provide Number of People Residing in Household: ADULTS CHILDREN Please List ALL Individuals that Currently Reside at this Property, including Yourself: NAME AGE RELATIONSHIP MONTHLY INCOME OWNER HEAD OF HOUSEHOLD: Male Female ETHNICITY: Are you of Hispanic Origin? YES RACE: Select One or More of the Following Categories: African American Asian American Caucasian Native Hawaiian/Other Pacific Islander Native American Indian or Native Alaskan Multi-Racial MARITAL STATUS: Married Single Divorced Widowed Are You or Any Member of Your Family a City of Mobile Employee? YES If YES, Please Provide Name & Position: Page 3

6 INCOME AND EMPLOYMENT: If any person listed is self-employed, please submit a current Financial Statement, copy of signed current tax return and current Profit and Loss Statement. Did you file an IRS Tax Return for 2013? YES If you answered, Please Provide Reason: Do you own any other REAL ESTATE? YES If you answered YES, do you receive Rent as a Source of Income? YES All Income Sources for all persons in the household that are age 18 or over must be stated below: Applicant s Gross Monthly or Annual Income $ Name of Employer No. of Years Employed: Employer Address Employer Telephone Co-Owner s Gross Monthly or Annual Income $ Co-Owner s Name of Employer No. of Years Employed: Employer Address Employer Telephone TOTAL Monthly Household Income from Other Sources: a. MONTHLY SALARY g. ALIMONY b. SOCIAL SECURITY OR DISABILITY h. DIVIDENDS/INTEREST c. CHILD SUPPORT i. VA BENEFITS d. UNEMPLOYMENT j. PENSION e. RENTAL INCOME k. RETIREMENT f. TEMP ASSIST TO NEEDY FAMILIES l. OTHER TOTAL MONTHLY HOUSEHOLD INCOME FOR ALL SOURCES $ Page 4

7 FAMILY ASSETS: Please Attach Additional Account Information on a Separate Sheet if Needed CHECKING ACCOUNT INFORMATION NAME & ADDRESS OF BANK OR CREDIT UNION CHECKING ACCOUNT NUMBER TELEPHONE. FOR BANK/CREDIT UNION SAVINGS ACCOUNT INFORMATION NAME & ADDRESS OF BANK OR CREDIT UNION SAVINGS ACCOUNT NUMBER TELEPHONE. FOR BANK/CREDIT UNION MORTGAGE INFORMATION: Do you have a Mortgage Loan? YES Second Mortgage Loan? YES Do you have Homeowner s Insurance on the home that includes Wind Coverage? YES Original Purchase Price of Home $ Year Purchased NAME & ADDRESS OF MORTGAGE COMPANY FIRST MORTGAGE ACCOUNT NUMBER CURRENT BALANCE SECOND MORTGAGE NAME & ADDRESS OF MORTGAGE COMPANY ACCOUNT NUMBER CURRENT BALANCE NAME & ADDRESS OF INSURANCE AGENT HOMEOWNERS INSURANCE POLICY NUMBER YEARLY PREMIUM Page 5

8 PROPOSED REPAIR PROJECT The Home Rehab Program is designed to address health, safety, structural and deferred maintenance deficiencies. The following is a partial list of issues that may present an immediate health, safety or structural issue. This list is not intended to be exhaustive. Final determination of improvements will be made by the CHD staff in consultation with the homeowners. Exterior Repairs: Roof, gutters, windows, doors, siding, eaves, foundation, porch, drive way/walkway, water and sewer lines, accessibility needs and modifications, etc. Interior Repairs: Plumbing, furnace, electrical, kitchen, bathroom, painting, deteriorated structural members, floor, wall, lead stabilization (presumed present), etc. CHD feels it is important to note that we reserve the right to decline an applicant based on the internal conditions of the home. This applies in circumstances where we feel excessive pet waste, excessive clutter which prevents ease of movement and other conditions that may pose a health or safety threat to our staff. The owner and co-owner certify that all information contained in this application and all information furnished in support of this application, are given for the purpose of obtaining financial assistance under the City of Mobile s Homeowner Rehab Loan Program and are true and complete to the best of the applicants' knowledge and belief. The applicants further acknowledge that if any of the information provided is found to be false, the City of Mobile may refuse to process this application. In addition, the applicants may be subject to penalties of $5,000-$10,000 as outlined in the False Claims Act. Verification may be obtained from any source herein. A credit report may be obtained on the owner and co-owner by City of Mobile. Owner Co-Owner Date Date For Community Housing and Development Use Only Date Received: Date Reviewed: Date Mortgage Verified: Date Employment Verified: Page 6

9 City of Mobile Community Planning & Development Department Government Plaza 205 Government Street, South Tower, 5 th Floor, Suite 508 Mobile, AL (251) RELEASE OF INFORMATION FORM Purpose To insure that assistance is used properly as directed, Federal laws require that the information that you provide be verified. In order to receive assistance from the U.S. Department of Housing and Urban Development (HUD), applicants and all household members who are 18 years of age or older are required to sign this form that authorizes the above-named organization to obtain information from third parties relative to your eligibility and participation in its programs. Consequences for Not Signing the Consent Form If you fail to sign this form, or the individual verification forms, this may delay processing or your assistance being denied. Types of Information to be Released I authorize the City of Mobile and the U.S. Department of Housing and Urban Development to obtain information about me and my household that is pertinent to eligibility for participation in the Home Rehab Loan Program. Information may be requested regarding the following items: Income (all sources) and/or Assets (all sources). I acknowledge that: 1) A photocopy of this form is as valid as the original. 2) I have the right to review the file and the information received using this form. 3) I have the right to copy information from this file and to request correction of information that I believe is inaccurate. 4) All adult household members will sign this form and cooperate with the above-named organization in this process. INSTRUCTIONS: Each adult member of the household (18 years of age or older) must sign the release of information form prior to the receipt of assistance. Please Print and Sign your Name and Date: Head of Household Other Adult Member of Household Other Adult Member of Household Other Adult Member of Household Page 7

10 CITY OF MOBILE REHAB LOAN PROGRAM Community Housing and Development Department 205 Government Street, South Tower, 5 th Floor, Mobile, AL (251) Office Number (251) Fax Number Request for Verification of Mortgage A. Name and Address of Applicant B. Name and Address of Mortgagee I hereby authorize the release of the above requested information to the City of Mobile CHD Department. Print Name and Sign Date TE TO MORTGAGEE The applicant identified in Block A has applied for a City of Mobile Rehab Loan for property rehabilitation. The applicant has authorized the City to obtain verification from any source named in the application. Your verification of mortgage is for the confidential use of the City. Please furnish the information requested below and return this form to the address referenced above. Mortgagee's Verification Type of Mortgage MONTHLY PAYMENT BREAKDOWN: Principal and Interest $ Account Number Original Date of Mortgage Original Amount of Mortgage Taxes Insurance $ $ Present Mortgage Balance TOTAL PAYMENT $ Loan Payment Experience Excellent Good Fair Poor Signature of Authorized Officer Title Date Officer s Address: Telephone: Please Return this Form to: City of Mobile Community Housing & Development P. O. Box 1827 Mobile, AL Page 8

11 CITY OF MOBILE REHAB LOAN PROGRAM Community Planning and Development Department 205 Government Street, South Tower, 5 th Floor, Mobile, AL (251) Office Number (251) Fax Number Request for Verification of Employment SOCIAL SECURITY NUMBER _ - - APPLICATION NUMBER: DATE OF REQUEST: A. Name and Address of Applicant B. Name and Address of Applicant's Employer TE TO EMPLOYERS The applicant identified in Block A has applied for the City of Mobile Homeowner Rehab Loan Program for property rehabilitation under the City Rehabilitation Program. The applicant has authorized the City in writing to obtain verification from any source named in the application. Your verification of employment is for the confidential use of the City of Mobile. Please furnish the information requested below and return this form to the address referenced above. EMPLOYER S VERIFICATION C. Position Held D. Dates of Employment E. Probability of Continued Employment Rate of Pay Hourly: $ Overtime $ Commission $ Bonus $ Other Taxable Benefit $ or Compensation BiWeekly: $ Annually: $ If applicant has military service, provide monthly income basis as follows: Base Pay $ Quarters & Sustenance $ Flight or Hazard Duty Allowance $ F. Other Remarks Signature of Employer Title Date Please Return this Form to: City of Mobile Community Planning & Development 205 Government St South Tower, Suite 508 Mobile, AL I hereby authorize the release of the above requested information to the City of Mobile CPD Department. Print Name and Sign Date Page 9

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