Frederick County Department of Housing and Community Development Neighborhood Conservation Initiative (NCI) Program LENDER CHECKLIST for NCI/AG APPLICATION PACKAGE Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS Homebuyer information NCI Application August 2013, ORIGINAL Ratified sales contract Ratified sales contract Lead Disclosure if Lead Disclosure Form property pre 1978 Property in eligible zip Eligible zip codes: 21701, 21702, 21703, code 1% purchase price discount if foreclosed property Income verification for all adult members of household 18 years and older (not including documented fulltime students) Approved credit package, with conforming fixed rate, 30 year mortgage Home inspection by MD. certified inspector 21704, 21716, 21758, 21788 and 21793 Appraisal and evidence of foreclosure. Program does not require property to be a foreclosure. Appraisal required with every application. Minimum of 3 months of pay statements/voe Documentation of any and all other income sources for all adult income earners Asset account information- most recent statements; see application page 4 2 most recent federal tax returns, 1040 only Approval letter from lender confirming type of mortgage, amount and terms 1 st Mortgage Uniform Residential Loan Application- FNMA Form 1003 Invoice for home inspection report; do not include the report Home warranty Invoice/registration for home warranty 8 hours of Homebuyer Education Pre-settlement worksheet Certificate for 8 hours of Homebuyer Education- provided by Frederick Community Action Agency Draft HUD-1 Settlement Sheet (final HUD-1 required pre-settlement) Lender (person) phone/email Mortgage Processor phone/email Buyer s Agent phone/email Title Company/Contact Estimated Closing Date Hazard Insurance Co. Phone Please inform Heather Sutton hsutton@frederickcountymd.gov of changes to ANY information provided on this checklist, particularly the Closing Date or the Title Company.
Frederick County Department of Housing and Community Development (DHCD) 5340 Spectrum Drive, Suite A Frederick, MD 21703 301-600-6647 www.frederickcountymd.gov/housing NEIGHBORHOOD CONSERVATION INITIATIVE (NCI) APPLICATION FOR DOWN PAYMENT AND CLOSING COST ASSISTANCE Section A. Checklist 1. Applicant(s): The Applicant/Co-Applicant is anyone listed on the sales contract; anyone listed as borrower on the primary mortgage application; or anyone to be named in the deed. 2. Property Address Street City & ZIP 3. Will this be your primary residence? Yes No If NO, do not continue. 4. Have you completed the 8-hour homebuyer education and counseling program? Yes No If yes, include copy of the Housing Counseling Certificate with the application. If No, what is your anticipated date of completion? 5. Is documentation of the home inspection and the home warranty (two items) included? Yes No If No, it must be provided prior to settlement. 6. Have you included the two most recent years Federal Form 1040 tax returns only (no state returns, please) with W-2 forms attached for each year. Yes No If any income earner did not file taxes for any year, (when over 18), include the certification form from the IRS that they have no record of a tax return. If NO, do not continue. 7. Have you included verification of all current gross income for all household members age 18 and older? (See Section D.) Yes No If NO, do not continue. 8. Have you included the ratified sales contract? Yes No If NO, do not continue. Amount requested (20,000 maximum)
Section B. The Applicant/Co-Applicant is anyone listed on the sales contract; anyone listed as borrower on the primary mortgage application; or anyone to be named in the deed. Applicant Applicant Name Home Address (FIRST) (LAST include Jr., Sr., II, III, etc) M.I. (STREET) Contacts (CITY, STATE, ZIP) (PHONE DAY) (PHONE NIGHT) (EMAIL) Soc Sec No. - - Date of Birth (MM-DD-YYYY) - - Co-Applicant Name Home Address (FIRST) (LAST) (M.I.) (STREET) Contacts (CITY, STATE, ZIP) (PHONE DAY) (PHONE NIGHT) (EMAIL) Soc Sec No. - - Date of Birth (MM-DD-YYYY) - - Section C. Household Members Beginning with the applicant(s) list ALL people who will live in the home, even if not related. Student 18-and-older: For a post high school student attending school fulltime, provide an official school transcript. If not a student or part-time student, provide income information, as applicable. Newborn: For a newborn child not listed on the most recent Federal tax return, provide a copy of the child s birth certificate or hospital verification. Name (first, last, middle initial) Age If over 18, in school fulltime? Circle Yes or No 1. Applicant 2. Co-Applicant (if applicable) 3. Yes/No 4. Yes/No 5. Yes/No 6. Yes/No For additional household members, attach a separate page with the above information. NCI/AG Application, September 2013 Page 2 of 7
Section D. Household Income Report all sources of income for everyone occupying the home. EMPLOYMENT Provide three months of pay statements. All job related income will be verified by contacting the employer. Do you or any household member(s) receive cash, tips or bonuses? Are you or any household member(s) self-employed? Do you or any household member(s) receive military reserve pay? PENSION / SSI / OTHER BENEFITS / ASSET INCOME Provide either the award letter or two months of benefit statements or income receipts from any assets. Do you or any household member(s) receive pension, retirement benefits, workman s compensation, annuity or any other benefits or pensions? Do you or any household member(s) receive unemployment benefits or disability benefits? Do you or any household member(s) receive Social Security/ SSI benefits? Do you or any household member(s) receive income from an asset? Do you or any household member(s) receive income for ANY other source not listed above? If yes, list below. List all household members starting Monthly Gross Name and contact information of with the Head of Household Pay/Income Employer/ Agency/Office/Asset Circle Yes or No Circle Yes or No For additional information, attach a separate page with the above information. Child Support / Alimony Provide information for any household member receiving payment. Include the award letter for any payment received. List Household Member Receiving Payment Type of Payment Child Support or Alimony Monthly Amount NCI/AG Application, September 2013 Page 3 of 7
Section E. Assets Assets are cash or non-cash items that can be converted to cash. Provide information for all household members. ACCOUNT INFORMATION Provide two months of most recent statements Do you or any household member(s) have a savings or checking account? Do you or any household member(s) have stocks, mutual funds, bonds or certificates of deposit (CD)? Do you or any household member(s) have a money market fund or trust fund? Do you or any household member(s) have a retirement, 401K, 457 Plan, federal thrift savings plan (TSP), IRA or Keogh account? Do you or any household member(s) have a life insurance policy with cash value? Do you or any household member(s) have ANY other asset not listed above? If yes, list below. Account holder (Name) Company/Bank Name Type of Account Account Number Circle Yes or No Current Value PROPERTY Provide proof of ownership: property tax statement, legal document, vehicle registration, or for disposition of property, executed contract. Do you or any household member(s) own or have an interest in commercial or residential real estate or mobile home? Do you or any household member(s) own or have an interest in a time-share? Have you or any household member(s) sold any real estate in the last two years? Do you or any household member(s) have a recreational vehicle (RV, ATV, boat, other) registered to him/her? Owner Type of Asset Circle Yes or No Value (Cash or market value) NCI/AG Application, September 2013 Page 4 of 7
FREDERICK COUNTY DEPARTMENT OF HOUSING & COMMUNITY DEVELOPMENT CERTIFICATION AND AUTHORIZATION TO VERIFY/RELEASE INFORMATION I certify that the information provided on this application and supporting documents are true and complete to the best of my knowledge. I am aware that any misrepresentation will result in the forfeiture of my right to participate in the Frederick County Neighborhood Conservation Initiative (NCI) program, and I may be subject to additional penalties and legal action. I authorize the Frederick County Department of Housing and Community Development to verify information on this application and obtain supporting documents to verify eligibility for the Frederick County NCI program. Entities authorized to release information include, but are not limited to, employers; mortgage companies; banks; and offices administering social security, retirement funds, unemployment and child support. I retain the right to review information in my file. A photocopy of this form may be considered valid and the original will be kept on file for the purpose of obtaining information pertaining to this loan. Signature of Applicant Date Print Name Signature of Co-Applicant Date Print Name Signatures of other household members reporting income. Copy and add additional page, if needed. Signature Print Name Date Signature Print Name Date Signature Print Name Date Frederick County Department of Housing and Community Development 5340 Spectrum Drive, Suite A Frederick, Maryland 21703 301-600-6647 FAX 301-600-3585 TTY Use Maryland Relay www.frederickcountymd/housing NCI/AG Application, September 2013 Page 5 of 7
Maryland Neighborhood Conservation Initiative (NCI) Equal Opportunity Data Collection Self Certification Form Because you are applying for assistance to a program that will use Federal NCI funds, the Agency providing the assistance is required to obtain the following information from the Head of the Household for statistical purposes only to determine whether the benefits of this program are being made to available to all persons on a non-discriminatory basis. To be completed by the Head of the Household only: What is your gender? Male Female Are you a person with a disability? Yes No Are you a person age 62 or older? Yes No Are you a female head of household? Yes No Are you a Military Veteran? Yes No What is your Race? Do you identify yourself as: (select one or more) American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Black or African American: A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. White American Indian or Alaska Native & White Asian & White Black or African American & White American Indian or Alaska Native & Black or African American More than one race selected (not listed above) What is your Ethnicity? Do you identify yourself as (select only one): Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term Spanish origin can be used in addition to Hispanic or Latino. Not Hispanic or Latino: A person not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. CERTIFICATION OF APPLICANT The Applicant certifies that all information stated regarding their status as the Head of the Household is true and complete to the best of the Applicant s belief. SIGNED DATE NCI/AG Application, September 2013 Page 6 of 7
Frederick County Neighborhood Conservation Initiative Program AFFIDAVIT The Frederick County loan will be a zero percent (0%) interest, deferred payment loan, secured by a Second Deed of Trust on the property. The loan is due and payable in full upon the occurrence of any of the following events, more fully detailed in the Second Deed of Trust/Promissory Note: 1) the sale or transfer of any interest in the property; 2) if property is no longer occupied as the principal residence, which includes the death of the Borrower.. Borrower(s) hereby acknowledge that the loan is subject to the requirements of the specified loan program, as described in the program fact sheet available online at www.frederickcountymd.gov/housing. Borrower(s) hereby agree to keep the property in good repair and in compliance with all applicable local Codes and Ordinances. Borrower(s) hereby agree to verify primary residency annually in the anniversary month of the Second Deed of Trust/Promissory Note. Borrower(s) certify having a combined household income at or below the specified program income limits based on the HUD published Area Median Income for Frederick County on the date of this application through the date of closing on the property to be purchased using the loan funds. Borrower(s) agree to complete an eight hour Homebuyer Education Program through an approved agency and provide a Certificate of completion prior to settlement, if applicable. Borrower(s) agree to provide a ratified sales contract and all other applicable information required by this application. Borrower(s) hereby certify and represent to the Frederick County Department of Housing and Community Development (FCDHCD) that the information provided in this Loan Application and the application of the Borrower(s) to the first mortgage lender for a first mortgage loan, a copy of which is hereby submitted to the FCDHCD, is true, correct and complete and the loan terms have not changed. Applicant(s) declare under penalty of perjury that the information provided on this Loan Application and Borrower s Affidavit is true and correct. Date: Date: Date: Applicant/Borrower: Applicant/Borrower: Applicant/Borrower: Please submit completed application and supporting documentation to: Heather Sutton Frederick County Department of Housing & Community Development 5340 Spectrum Drive, Suite A Frederick, MD 21701 301-600-6647 hsutton@frederickcountymd.gov NCI/AG Application, September 2013 Page 7 of 7