MHFA Program codes: ARIF = Affordable Rental Investment Fund Program ARM= Apartment Renovation Mortgage EDHC = Economic Development and Housing

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1 MHFA Program codes: ARIF = Affordable Rental Investment Fund Program ARM= Apartment Renovation Mortgage EDHC = Economic Development and Housing Challenge Program ELHIF = Ending Long Term Homelesness Initiative Fund FARIF = Flood Relief Rental Rehabilitation Program HOME = Home Rental Rehab Program HOPWA = Housing Opportunities for Person Living with AIDS HTF = Housing Trust Fund Program LILF = Low Income Large Family Rental Housing Program IIH = Innovative and Inclusionary Housing Program LMIR = Low and Moderate Income Rental Program MARIF = Minnesota Families Affordable Rental Investment Fund Program NCTC= New Construction Tax Credit Program TARIF= Tornado Relief Rental Rehabilitation Initiative Fund PARIF = Preservation Affordable Rental Investment Fund Program PARIF-SH= Preservation - Supportive Housing POHP= Publicly Owned Housing Program PONLT = Publicly Owned Neighborhood Land Trust Program POPR = Publicly Owned Permanent Rental Housing Program POPSHP = Publicly Owned Supportive Housing Program POTH = Publicly Owned Transitional Housing RRDL= Rental Rehabilitation Deferred Loan Program RRL= Rental Rehabilitation Loan Program SN = Special Needs Housing Program TL = Transitional Housing Program TH= Targeted HOME UIHP= Urban Indian Housing Program 501 c3= 501c3 Bond Program N/A Not funded by any MHFA program

2 CHARACTERISTICS OF TENANT HOUSEHOLDS Instructions You will need one Excel file for each one of the development(s) for which you are reporting. Save and name the file by the property's assigned D number, the property name, CTH and the year of the report (i.e., D0001ABCApts CTH11). If the report is being submitted for Rental Rehabilitation Loan Program (RRL), please name the report using the following protocol: D0001ABCAptsRRL11) If you need additional copies of the report, duplicate the Excel file by opening the workbook, selecting "Save As" from the file menu, giving the workbook a new name using the above protocol, and saving it. If you are providing data electronically, move through the sheets using the arrow keys or, for sheet #2 of the workbook use the Enter key and for sheet #3 use the Tab key. In sheet #2, simply enter a contact telephone number as 10 digits, e.g., without hyphens. If an arrow appears at the right side of a cell, hold down on that arrow with your cursor and select the appropriate response from the popup list. Sheet #3 is formatted so that you may enter appropriate responses identified in the headings (use capital letters) or select from the popups. In sheet #3 do not enter dollar signs or commas for amounts. First, complete the information in yellow highlighted cells of the Development Info tab. This must be done in order for the report to be uploaded into Minnesota Housing's database. If this information is not completed, you will be required to correct and resubmit. Next, enter information onto the tab entitled CTH Report for each unit in the property and the that occupies it on 12/31 of the report year (group homes & shelters, list occupants as of the date you complete the report). Each row on the unit worksheet should contain information on only one unit and its occupants. If a unit is vacant, please provide a unit number and unit characteristics; simply leave the characteristics blank. The definition of head of is the primary person in whose name the unit is ed. For your convenience, the Initial Occupancy Statement by Tenant and Tenant Profile forms can be printed from this Excel workbook and given to residents to fill out. The workbook is not designed for users to enter the information on the profile form electronically. Enter dates as month, day, and year, e.g., or 3/29/08, and they will convert to a standard format. Formatting will prevent entry of incorrect responses, such as a letter rather than a number, or an income of $1,000,000. If the application indicates an entry is not valid, retry and type over the information you tried to enter and tab to the next cell. Unit Characteristics

3 CHARACTERISTICS OF TENANT HOUSEHOLDS Instructions Unit number - Unit number or any other type of building/unit identification used in the development for which you are providing the information. For shelters and transitional housing properties with "beds" rather than units list each bed as a separate unit. If there is more than one building in a property, list the building number, a hyphen and the unit number (i.e., if the address is 1572 Main St, the format for unit 101 would be: ). Do not list the building number on one line and the associated units below it and do not leave blank rows between buildings. This will frustrate the data import routine. Number of bedrooms - Number of bedrooms in the unit; enter 0 for efficiencies (up to maximum of 6 bedrooms). For shelters and transitional housing properties list each bed on a separate line and report as 0 bedroom. Total - Rent amount of the unit, including monthly amount of tenant, subsidies (if any), and utility allowance for the unit. MHFA program - From the description of program codes on worksheet #8, use the drop-down menu to select the MHFA program for which the unit was funded or satisfies qualification requirements. Only one program code will be allowed per unit even though there may be multiple programs funding the same unit and/or for which the qualifies. Select the main funding source for the unit/property (i.e., if property was funded by a LMIR first mortgage, select LMIR for all units).

4 CHARACTERISTICS OF TENANT HOUSEHOLDS Instructions Tax credit unit - Enter or select from the popup list: Y if the unit is a housing tax credit unit or N if the unit is not a tax credit unit. Popup list also includes M for identifying manager/caretaker/office units. Unit designed to be accessible - If unit is designed to be accessible or barrier-free for a tenant who has a permanent mobility impairment, e.g., uses a wheel chair, enter the appropriate response or click the arrow and from the popup list select Y for yes or N for no. For units that are vacant on 12/31 and units not covered under any MHFA Program, the Unit Characteristics is all that needs to be entered. Enter Household Characteristics and Head of Household Characteristics for all occupied units funded by any MHFA Program. Note that residents are not required to provide answers to questions about protected class status, e.g., race, ethnicity, gender, disability, but please encourage full participation. HOUSEHOLD CHARACTERISTICS Mobility impaired occupant - Use the popup list or enter Y if the head of or any member of the living in the unit is mobility impaired, or N if none of the tenants in the units are mobility impaired. Adults - Enter the number of tenants age 18 or older who live in the unit. Children - Enter the number of children under the age of 18 who live in the unit. Enter 0 if no minor children live in the unit. Homeless Household - Use the popup list or enter Y if was homeless (without permanent shelter) prior to occupancy, or N if was not homeless prior to occupancy. If homeless, indicate if the was without permanent shelter for at least 12 months or at least 4 times in the last 3 years. Social Services - Use the popup list or enter Y if receives any type of social services, or N if does not receive any social services. Leave blank if unknown. Gross annual income - Enter the amount of gross income of all persons living in the unit at the s most recent recertification. Gross income includes all income from all sources listed below. Enter 0 if the has no income. Main source of income - Use the popup list to find the code for the main source of income for the (enter only one code): SW= Salary or wages SS= Social Security benefit SE= Self employment income R= Retirement, pension, annuities I= Interest, stock dividends, al income U= Unemployment, disability compensation W= Welfare/public A= Alimony, child support

5 N= no income CHARACTERISTICS OF TENANT HOUSEHOLDS Instructions Rental - If the property has project-based al (i.e., Rural Development, Section 8, etc.) and the unit receives such al, use the popup list or enter PBA. If the receives tenant- based al (i.e., Section 8 Housing Choice or other type of voucher, enter TBA).

6 CHARACTERISTICS OF TENANT HOUSEHOLDS Instructions Date moved into this unit - Date cur moved into this unit: month, day, and year (formatted or 3/1/08) that the cur began leasing the unit that it now occupies (worksheet converts all date entries to a standard format). HEAD OF HOUSEHOLD CHARACTERISTICS Head of date of birth - Enter the date of birth (month, day, year) for the head of, only. Marital Status - Use the popup list or enter M if the head of is married, N if the head of is not married (includes single, divorced, widowed), or S if the head of is separated (need not be legal separation). Race of the head of - From the list provided, enter the race code(s) for the head of only. Note that there is no popup list--be sure to enter only the code(s), but enter all that apply (i.e., if a head of identifies him or herself as both White and Black or African American, enter WB). If tenant chooses to not self-identify racial category, the person filling out the report should designate a category based on visual observation. If uncertain, leave blank. W= White B=Black or African American I=American Indian Or Alaska Native N=Native Hawaiian Or Other Pacific Islander A= Asian Hispanic or Latino - Use the popup list or enter Y if head of is of Hispanic or Latino ethnicity, or N if head of is not of Hispanic or Latino ethnicity. Gender of the head of - Use the popup list or enter F for female or M for male. CTH Reports must be submitted using the Secure Upload Tool. Instructions will be provided with the notice of annual certification. Minnesota Housing will not accept CTH Reports sent by .

7 CHARACTERISTICS OF TENANT HOUSEHOLDS Instructions

8 Development Information Management company name: Contact person for this report: Telephone number (10 digits, no hyphens): address: Property name: MHFA D#: Property address: If property has Housing Tax Credits, compliance is monitored by one of the following: (Entry must be either MHFA or Sub-allocator) At initial financing/credit allocation, this development was : (Entry must be either New construction or Existing housing) Total # of units in this development: # of tax credit units in this development: Targeted population of this development (select one): City: General occupancy Homeless Other County: Elderly Special needs State: MN Zip: Large family SRO Thank you for your cooperation in providing this information, which will be summarized for analysis and review. Please complete this report electronically. You can enter data into this Excel workbook or download forms from MHFA's website at: See Instructions worksheet for instructions on sending this report to MHFA.

9 Characteristics of Tenant Households Property Name 0 City, County & Zip Report Year MHFA # 0 *Occupied buildings, use initial closing date. **If tenant chooses to not self-identify racial category, person filling out report should designate category based on visual observation. If uncertain, leave blank. Only the blue-shaded areas are required when funding is only Rental Rehab Loan Unit characteristics (Complete one line for each unit and the curly residing in it) Household characteristics Head of characteristics Unit number Number of bedrooms Total tenant plus subsidies plus utility allowance MHFA program See MHFA Program Codes & definitions on next worksheet Tax credit unit? M= mgr/ caretaker /office unit Unit is designed to be accessible Mobility impaired occupant Is one or more members mobility impaired? Adults Children # of adults age 18 or older # of children under age 18 Household previously without permanent shelter Homeless Homeless for at least 12 months or more than 4 times in 3 years Social services Does receive any type of social services? (leave blank if unknown) Gross annual income Income at last recertification (unadjusted income of all residents from all sources) Main source of income (enter one code) SW=salary, wages SS= Soc Security SE= self employment R=retirement, pension, annuity I= interest, dividends, al income U=unemployment/ disability W= public asst. A=alimony, child support N= no income Rental Does receive?p BA=Projectbased TBA=Tenantbased (leave blank if no ) *Date moved into unit Head of date of birth Marital status mm/dd/yyyy mm/dd/yyyy M=Married t married (includes divorced, single, widowed) S=Separate d **Race W= White B=Black or African American I=American Indian or Alaska Native N=Native Hawaiian Or Other Pacific Islander A=Asian (List ALL that apply) Hispanic or Latino Gender F=Female M=Male Characteristics of Tenant Households 9 MHFA (ver 1/12

10 Characteristics of Tenant Households Property Name 0 City, County & Zip Report Year MHFA # 0 *Occupied buildings, use initial closing date. **If tenant chooses to not self-identify racial category, person filling out report should designate category based on visual observation. If uncertain, leave blank. Only the blue-shaded areas are required when funding is only Rental Rehab Loan Unit characteristics (Complete one line for each unit and the curly residing in it) Household characteristics Head of characteristics Unit number Number of bedrooms Total tenant plus subsidies plus utility allowance MHFA program See MHFA Program Codes & definitions on next worksheet Tax credit unit? M= mgr/ caretaker /office unit Unit is designed to be accessible Mobility impaired occupant Is one or more members mobility impaired? Adults Children # of adults age 18 or older # of children under age 18 Household previously without permanent shelter Homeless Homeless for at least 12 months or more than 4 times in 3 years Social services Does receive any type of social services? (leave blank if unknown) Gross annual income Income at last recertification (unadjusted income of all residents from all sources) Main source of income (enter one code) SW=salary, wages SS= Soc Security SE= self employment R=retirement, pension, annuity I= interest, dividends, al income U=unemployment/ disability W= public asst. A=alimony, child support N= no income Rental Does receive?p BA=Projectbased TBA=Tenantbased (leave blank if no ) *Date moved into unit Head of date of birth Marital status mm/dd/yyyy mm/dd/yyyy M=Married t married (includes divorced, single, widowed) S=Separate d **Race W= White B=Black or African American I=American Indian or Alaska Native N=Native Hawaiian Or Other Pacific Islander A=Asian (List ALL that apply) Hispanic or Latino Gender F=Female M=Male Characteristics of Tenant Households 10 MHFA (ver 1/12

11 Characteristics of Tenant Households Property Name 0 City, County & Zip Report Year MHFA # 0 *Occupied buildings, use initial closing date. **If tenant chooses to not self-identify racial category, person filling out report should designate category based on visual observation. If uncertain, leave blank. Only the blue-shaded areas are required when funding is only Rental Rehab Loan Unit characteristics (Complete one line for each unit and the curly residing in it) Household characteristics Head of characteristics Unit number Number of bedrooms Total tenant plus subsidies plus utility allowance MHFA program See MHFA Program Codes & definitions on next worksheet Tax credit unit? M= mgr/ caretaker /office unit Unit is designed to be accessible Mobility impaired occupant Is one or more members mobility impaired? Adults Children # of adults age 18 or older # of children under age 18 Household previously without permanent shelter Homeless Homeless for at least 12 months or more than 4 times in 3 years Social services Does receive any type of social services? (leave blank if unknown) Gross annual income Income at last recertification (unadjusted income of all residents from all sources) Main source of income (enter one code) SW=salary, wages SS= Soc Security SE= self employment R=retirement, pension, annuity I= interest, dividends, al income U=unemployment/ disability W= public asst. A=alimony, child support N= no income Rental Does receive?p BA=Projectbased TBA=Tenantbased (leave blank if no ) *Date moved into unit Head of date of birth Marital status mm/dd/yyyy mm/dd/yyyy M=Married t married (includes divorced, single, widowed) S=Separate d **Race W= White B=Black or African American I=American Indian or Alaska Native N=Native Hawaiian Or Other Pacific Islander A=Asian (List ALL that apply) Hispanic or Latino Gender F=Female M=Male Characteristics of Tenant Households 11 MHFA (ver 1/12

12 Minnesota Housing Finance Agency Deferred Loan Owner Certification Certification From: To: Dates: Property Name: MHFA No: 0 0 Property Address: City: Zip: Owner Name Owner Address Part I. CERTIFICATION OF RENT, INCOME AND PROPERTY INSURANCE Owner of the above property hereby certifies the following are true and correct: 1. Owner has solicited information regarding the income of those individuals who reside in the designated development and has confirmed the validity of such information Yes No The individuals who reside in the designated development meet the guidelines for income as originally specified in the Regulatory Agreement, Loan Repayment and Mortgage, and/or Declaration of Covenants Conditions and Restrictions. Yes No If applicable, the units meet guidelines for and unit mix as originally specified in the Regulatory Agreement or Loan Repayment and Mortgage. Yes No Owner has not sold, transferred or conveyed any portion of its interest in the development without previously obtaining written approval from the Minnesota Housing Finance Agency. Yes No Owner has obtained and maintains in force and effect the required insurance on the designated development and the policies are endorsed with a standard mortgagee clause with loss payable to MHFA, or shows MHFA as a named insured, and that, where appropriate, public liability, boiler, fire, extended coverage, burglary and theft insurance are in force. Yes No N/A* Name of Insurance Co. Policy No(s): *Not applicable only for HOME Rental Rehabilitation loans. If the property has other Minnesota Housing financing, you must answer yes or no. Minnesota Housing Finance Agency 12 Ver 10/09

13 6. 7. If applicable, owner is in compliance with limits relating to return on equity pursuant to the Regulatory Agreement. Yes No Property was inspected during the year for Rental License, Operating License, Board or Lodging License, or from the City, County or HUD. Yes No N/A* If yes, you must attach a copy of the inspection report. * Not applicable for properties with a Minnesota Housing first mortgage or tax credits, only. If the property does not have a Minnesota Housing first mortgage or tax credits, you must answer yes or no. Part II. INCOME, EXPENSES, ETC. 1. Income on the above property: $ 2. Expenses on the above property: $ 3. Is property experiencing any vacancy problems? Yes No If yes, please explain: MARIF Properties only: 4. MARIF Excess Income for above Fiscal Year was 5. MARIF Operating Reserve Balance at Fiscal Year end $ $ Part III. SIGNATURES Signature of Owner/Administrator Date 0 Minnesota Housing Finance Agency 13 Ver 10/09

14 Below, note any change in owner, management or service provider: Date of Change: OWNER Date of Change: MANAGEMENT COMPANY Owner Entity Name: Management Co. Name: Owner Address: Management Address: City, state, zip: City, state, zip: Owner contact: Management Contact: Phone Phone: Fax: Fax: Date of Change: SERVICE PROVIDER Service Provider Name: Provider's Address: City, State, zip: Service Provider Contact: Phone Fax 0 Minnesota Housing Finance Agency 14 Ver 10/09

15 Dear Renter: MHFA Program PART I. TO BE FILLED OUT BY TENANT Initial Occupancy Statement By Tenant We have applied for/received a mortgage loan through the Minnesota Housing Finance Agency for the property located at: Please fill out the following information to help determine our eligibility. Be assured that the information you provide will be held in strict confidence by us and by Minnesota Housing Finance Agency. Thank you. Unit # # of BR's Name Total Gross Annual Household Income of All Household Members: $ Number of persons in Household: I declare the above information is true and correct, to the best of my knowledge. Head of signature Date PART II. TO BE FILLED OUT BY OWNER Monthly gross $ Rent limit $ Income limit $ Owner signature Date Ver. 1/2012

16 TENANT DEMOGRAPHIC PROFILE Property Name: MHFA Number: 0 0 For Management Use Only Building Address: Unit # # of BR's Name: Name and Date of Birth (Mo./Day/Year) of Head of Household: DOB: Ethnicity of Head of Household Hispanic or Latino Y=Hispanic or Latino t Hispanic or Latino Number in Household Adults (including head of ) Children under age 18 residing in unit Race of Head of Household (check all that apply) 1 3 A=Asian B=Black/African American W=White 2 4 I=American Indian or Alaska Native N = Native Hawaiian or Pacific Islander Gender of Head of Household Homeless Household? Household previously without permanent shelter M=Male F=Female Homeless for at least 12 months or more than 4 times in 3 years Marital Status of Head of Household Mobility Impaired M = Married Y= Yes (Does at least one S = Separated N= No member require features N = Not married (includes divorced of an accessible unit?) single, widowed) Main Source of Household Income (select only one) SW=Salary/Wages SE=Self Employment R=Retirement/pension/annuity SS=Soc. Security I=Interest/dividends/al income U=Unemployment/disability A=Alimony/Child Support W=Public income Social Services Y= Yes Does receive any type of social services? The information contained on this form will be used by the owner to compile and submit the Characteristics of Tenant Households, a report of demographic data, to the Minnesota Housing Finance Agency. Failure to provide the requested information will not result in the rejection of your tenant application. Tenant Demographic Profile Ver. 1/08