St. Francis Condominium applicatiom 05112015
Your application must include:
▪ Copies of the last five most recent current consecutive pay stubs for all household members age 18 or older
▪ Verification of self-employment income received during the preceding 12 months for all household members age 18 or older, if applicable
▪ Verification of unemployment income received during the preceding 12 months for all members age 18 or older, if applicable
▪ Copies of statements for all assets (checking, savings, stocks, bonds, money-market accounts and certificates of deposit) for three months prior to the application date for all household members age 18 or older
▪ Copies of IRA, 401K, social security, pensions and retirement account statement(s), and whole life insurance policies for the current year for all household members age 18 or older
▪ Copies of latest year filed federal tax return and two prior years, if filed, including W2and 1099 forms for all household members age 18 or older
▪ Supporting documentation for child support and/or alimony amounts, if applicable
▪ Supporting documentation for age 55 elderly first-time homebuyer exception, such as birth certificate and appraisal and/or mortgage statement of currently owned real estate, if applicable
▪ Supporting documentation for displaced homeowner first-time homebuyer exception, such as divorce decree, if applicable
▪ Supporting documentation for a residence not permanently affixed to a permanent foundation first-time homebuyer exception, if applicable
▪ Supporting documentation for residence not in compliance with building codes first-time homebuyer exception, if applicable
▪ Documentation of all other sources of income
▪ A notarized No Income Statement signed by any household member over the age of 18 who has no source of income
▪ A letter and supporting documentation explaining any unusual employment income or household circumstances
▪ Mortgage pre-approval letter from lending institution for a conventional mortgage with a current fair market fixed rate through the term of the mortgage. FHA mortgages are not accepted for purchasing this property. A co-signer is not acceptable for purchasing this property.
▪ The mortgage can have no more than 2 points and it must be sufficient to purchase the house. The purchaser must provide a down-payment of at least 3%, half of which must come from the borrower’s own funds.
▪ Signed application form
▪ Signed authorization for consent to release information form for all household members age 18 or older
• Signed gift letter from family member stating amount of gift, if applicable.
Submission of an application is for placement in a lottery. Participation in the lottery does not mean that your household is guaranteed an offer to purchase a unit at
The Residence @ One St. Clare.
Please complete all sections.
Write N/A is it does not apply to your household.
Applicant Name______________________________ Home Phone #________________
Address___________________________________ Work Phone # _________________
City______________________________________ State________ Zip_____________
E-mail_______________________________ Cell Phone #_______________________
Co-applicant Name_________________________ Home Phone #__________________
Address___________________________________ Work Phone #__________________
City______________________________________ State________ Zip_____________
E-mail________________________________ Cell Phone # ______________________
HOUSEHOLD MEMBERS
Please list ALL household members who will occupy the affordable unit:
Name Date of Birth Occupation Relationship to Purchaser
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________
5. ___________________________________________________________
6. ___________________________________________________________
FIRST-TIME HOMEBUYER
Are all members of your household “first-time homebuyers” as defined in the Information Packet? YES NO
If you answered no, please name the household member who is not a first-time homebuyer: ___________________________________________________
If you, or any member of your household, are not a first-time homebuyer, please refer to the exceptions to the first-time homebuyer requirement in the Information Packet and explain and document your response.
Any home owned must be sold prior to closing on the affordable home.
MINORITY INFORMATION
(Optional, for fair and affirmative marketing reporting purposes)
Please name any household member who is a member of any of the following minority groups.
Black or African American__________________________________________________
Hispanic/Latino___________________________________________________________
Asian, Native Hawaiian or Pacific Islander_____________________________________
Native American or Alaskan Native __________________________________________
CURRENT EMPLOYMENT STATUS
Applicant’s Name ________________________________________________________
Occupation _____________________________________________________________
Name and Phone Number of Current Employer _________________________________
Business Address of Current Employer _______________________________________
Name and Title of Supervisor ______________________________________________
If self-employed, name and address of business _______________________________
______________________________________________________________________
Annual Gross Salary __________________________
Co-applicant’s Name ____________________________________________________
Occupation _____________________________________________________________
Name and Phone Number of Current Employer _________________________________
Business Address of Current Employer _______________________________________
Name and Title of Supervisor _______________________________________________
If self-employed, name and address of business _________________________________
_______________________________________________________________________
Annual Gross Salary ___________________________
FULL-TIME STUDENT
Is any household member 18 years of age or older a dependent and a full-time student?
Name of full-time student: ____________________________________
School where enrolled: _______________________________
If yes, provide documentation from school supporting full-time enrollment.
Income of full-time dependent students who are age 18 or older is included in the household income up to $480.Total income should be listed below.
EMPLOYMENT HISTORY
If you or anyone in your household has had more than one job listed above in CURRENT EMPLOYMENT STATUS section (full-time or part-time) during the previous 12 months, please list ALL places employed during the previous 12 month below. Also note any breaks you have had in your employment and state if you received unemployment checks at that time.
Total Income
Name Date Started Date Stopped Employer Occupation During Tenure
_______________________________________________________________________
_______________________________________________________________________
INCOME INFORMATION
Please complete the following information for a full year to date for all household members.
APPLICANT ________________________________________________________
Gross Annual Salary (before deductions) ___________________________________
Annual self-employment income _____________________________________
Interest and Dividends_____________________________________________________
Veteran’s Benefits________________________________________________________
Alimony/Child Support____________________________________________________
Social and/or Disability Benefits_____________________________________________
Trusts__________________________________________________________________
Other Income____________________________________________________________
Total Annual Income______________________________________________________
CO-APPLICANT ___________________________________________________
Gross Annual Salary (before deductions) ____________________________________
Annual self-employment income ___________________________________________
Interest and Dividends_____________________________________________________
Veteran’s Benefits________________________________________________________
Alimony/Child Support____________________________________________________
Social Security and/or Disability Benefits_____________________________________
Trusts__________________________________________________________________
Other Income____________________________________________________________
Total Income Annual ______________________________________________________
VALUE OF ALL ASSETS
Cash in checking or savings accounts, stocks, bonds, certificates of deposit, Treasury bills, money market accounts, mutual funds, whole life insurance policies, revocable trusts, equity in real estate and other forms of capital investments, excluding equity accounts in homeownership programs or state assisted public housing escrow accounts are considered assets. Retirement accounts and pensions funds, IRA, 401K Keogh accounts are considered assets if the applicant has access to these funds.
Name on Account_________________________________________________________
Bank Name______________________________________________________________
Address_________________________________________________________________
Savings Account Number___________________________________________________
Checking Account Number__________________________________________________
Other Account Number_____________________________________________________
Retirement Account _______________________________________________________
Balance in Account as of today’s date_________________________________________
Name on Account_________________________________________________________
Bank Name______________________________________________________________
Address_________________________________________________________________
Savings Account Number___________________________________________________
Checking Account Number__________________________________________________
Other Account Number_____________________________________________________
Retirement Account _______________________________________________________
Balance in Account as of today’s date_________________________________________
Securities Account: Name and Value__________________________________________
Securities Account: Name and Value__________________________________________
Whole Life Insurance Policy: Name and Value _________________________________
Whole Life Insurance Police: Name and Value: ________________________________
Trust: Name and Value ____________________________________________________
Real Estate Owned/property address_________________________________________
Real Estate Owned/name(s) on deed_________________________________________
Date Purchased ______________________Date Sold ____________________________
Net Value of Real Estate (after outstanding mortgage amount) ____________________
Please provide HUD settlement statement if home is sold.
Please attach an additional sheet if needed.
HOME SIZE
Please check only the one condominium size in which you are interested:
_____ One bedroom condominium ($172,500)
_____Three bedroom condominium ($215,500)
FUNDS TO PURCHASE A CONDOMINIUM AT THE RESIDENCE @ ONE ST. CLARE
Purchase price: $___________
Amount of mortgage preapproval: $ __________
Estimate needed for closing costs: $___________
Estimate needed for down payment: $ __________
Please specify source of down payment and closing costs (savings, gift, sale of assets, grant, other):
_______________________________________________________________________
________________________________________________________________________
TO BE ENTERED IN THE LOTTERY THE APPLICATION MUST
BE POSTMARKED BY OCTOBER 2, 2015 AND MAILED TO:
Housing Resource Group, LLC; Four Raymond Street; Lexington, MA 02421
PLEASE READ, COMPLETE AND CHECK ALL THE FOLLOWING ITEMS
_________ I/We certify that our household size is ______ persons.
_________ I/We certify that our total household income is $________________and does not exceed the income limits provided in the Information Packet.
_________ I/We certify that our household assets total is $ ______________and does not exceed the asset limits provided in the Information Packet.
_________ I/We certify that the information contained in this application and filed in support hereof is true and correct to the best of my/our knowledge and belief. I/We understand that perjury will result in disqualification from further consideration.
_________ I/We understand that the use of this application is for eligibility to be
placed in the lottery. Participation in the lottery does not does mean I/we
are guaranteed an offer to purchase a condominium at The Residence @
One St. Clare.
.
_________ I/We understand that the Deed Rider will require the resale to an income
eligible buyer at a maximum affordable resale price which limits the
profit.
_________ I/We agree that all issues pertaining to this lottery process will be resolved by the Housing Resource Group, LLC in coordination with Department of Housing and Community Development and all decisions are final.
Your signature(s) below give consent to the Housing Resource Group, LLC and the Department of Housing and Community Development to obtain and verify information regarding my/our household’s eligibility for affordable housing. This consent includes information about my/our income, assets, present and former tenancies and credit history from any parties having information, including any agency or housing authority managing any housing subsidy for which I/we are eligible. I/We authorize and authorize all parties from whom this information is requested to release it to the Housing Resource Group, LLC and/or the Department of Housing and Community Development. No application will be considered complete unless signed and dated by the Applicant/Co-Applicant. The information given in this application will be used to determine that I/we are income and asset qualified to participate in the lottery.
______________________________________ _______________________
Applicant Signature Date
______________________________________ _______________________
Co-Applicant Signature Date
................
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