Waukon Affordable Housing Rehabilitation Program Loan Application Form 2013

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Waukon Affordable Housing Rehabilitation Program Loan Application Form 2013 Sponsored by: Farmer s & Merchants Savings Bank Waukon Economic Development Corporation (WEDC) Upper Explorerland Regional Planning Commission (UERPC)

Purpose: The mission of this project is to retain the structural integrity of owner-occupied low-income housing in Waukon through rehabilitation and/or repair to ensure low-income Waukon residents have access to well-maintained, safe and affordable housing. Eligible Projects: The Federal Home Loan Bank funds will be used to assist twenty-five (25) households with homeowner rehabilitation under 50% of the HUD guideline. Application Procedure: Applications will be accepted by the UERPC & WEDC on a continuous basis. For applications submitted by hand or by mail to: Upper Explorerland RPC (UERPC) Attn: Lori Brockway or Sarah Snitker l 134 West Greene Street, PO Box 219 Postville, IA 52162 563-864-7551, Ext. 106 or 101 Or Waukon Economic Development Office (WEDC) 101 West Main Waukon, IA 52172 563-568-2624 UERPC or WEDC will not be liable for any cost incurred in connection with preparation and submittal of any application. Staff at WEDC (ph: 563-568-2624) or Upper Explorerland (563-864-7551) will be happy to answer any questions about the Waukon Affordable Housing Rehabilitation program, this form or the application process. PROGRAM CRITERIA: Owner occupied requirements: Applicant must occupy the property and maintain the improvements for the life of the loan. Property must be in compliance with health a nd safety codes. Applicant must have title at time of application. Taxes and insurance must be current. Land sales contracts are ineligible. The Waukon Affordable Housing Rehabilitation program will finance projects through a five year receding forgivable loan which will recede 1/60 over the course of the loan. A retention agreement (mortgage) will be secured against your property at project completion. A recording fee of $17 will be required at the start of the project made payable to the Allamakee County Recorder s office. Funding limits are set at a maximum of $7,000 per project. Loan will be paid in the event that occupancy or ownership conditions change during the loan term. Initial inspections and upon completion of the proposed project, will be required. Any applicant for funding will be required to provide verification of income and sign necessary releases. Applicants must demonstrate the capacity to complete the project and provide sufficient documentation supporting the feasibility of a proposed project. Applicant cannot receive funding more than one time. Applicants will be required to obtain two bids from the entity providing the improvement to the property. Bids/Estimates must be fully detailed providing scope of work. Estimates that are not fully detailed will not be accepted. Any rebates associated with the project must go to the contractor and be deducted from the estimate. The contractor will be paid directly at project completion. Contractors must be registered with the State of Iowa and LSR certified with IDPH. The Waukon Affordable Housing Rehabilitation program reserves the right to recall any loan if the above requirements are not met. Final 02/02/13

Eligible Projects: The following is a list of eligible and ineligible projects that may b e performed on residences in owner-occupied rehabilitation projects. This list is not inclusive of all possible eligible or ineligible rehabilitation. 1. Eligible Rehabilitation: Repair directed toward an accumulation of deferred maintenance, and/or needed replacement of principal fixtures and components of existing structures, including: Roof repair or replacement, including gutters and downspouts Repair or replacement of mechanical systems(furnace, air conditioning, water heater) Upgrade to minimum 100 ampere electrical service, electrical repairs, and needed replacement of fixtures. Upgrade plumbing service, plumbing repairs, and needed replacement of fixtures Structural repairs and reconstruction including foundation or chimney repair and repairs due to termite damage or to treat for termites and other infestations. Exterior siding repair or replacement and exterior paint. Repair or replacement of entrance doors and windows. Repair or replacement of porches and decks to fix code or safety violation Repair or replacement of basic carpeting or floor covering Interior wall and ceiling repair, drywall, interior doors and trim, and paint. Removal of unsightly blight, dilapidation or deterioration due to deferred maintenance, such as tear down of dilapidated garages, sheds, or removal of dead trees Garage repair Functional landscaping for redirection of water away from foundations, or retaining walls to prevent soil erosion Sidewalk and driveway repair or replacement Smoke detectors and dead bolt locks for safety and home security Improvements to increase the efficient use of energy in structures through such means as installation of storm windows and doors, siding, wall and attic insulation, weather stripping, and conversion, modification, or replacement of heating and cooling equipment. Connection of residential structures to water distribution lines, local sewer collection lines, or septic system. Improvement to increase the efficient use of water through such means as water savings faucets and shower heads and repair of water leaks. Inspection and testing for remediation or abatement of lead based paint, asbestos, or other environmental hazards. Improvements designed to remove material and architectural barriers that restrict the mobility and accessibility of elderly or severely disabled persons to buildings. This may include remodeling kitchens and bathrooms for wheelchair access, lowering kitchen cabinets, installing wider doors, exterior ramps, and provision for at grade access. Final 02/02/13

2013 Income Guidelines: 12.13.12 Gross annual income cannot exceed these amounts: Household Size 50% of median income 1 20,950 2 23,950 3 26,950 4 29,900 5 32,300 6 34,700 7 37,100 8 39,500 Funding is available for 25 Owner Occupied homeowners below 50% of the area median with several units reserved for households with special needs. Nondiscrimination Statement: Nondiscrimination Statement: In accordance with Federal law, this institution is prohibited from discriminating on the basis of race, color, national origin, religion, creed, age, sex, disability, familial status, political affiliation, citizenship, gender identity, or sexual orientation. This is an Equal Opportunity Program. Final 02/02/13

Waukon Affordable Housing Program Application- 2013 A. SUMMARY Applicant Name: Contact Person: Title: Applicant Address and PO Box: City/State/Zip: Phone: Cell: Email: Social Security #: Date of Birth: Loan Amount Requested: $ *** Applicant will be required to pay a $17.00 recording fee at the start of the project*** Year Built: B. DEMOGRAPHIC INFORMATION The following information solicited on this application is requested by the UERPC in order to assure the Federal Government, acting through the Rural Development that Federal laws prohibiting discrimination against applicants on the basis of race, color, national origin, religion, sex, familial status, age, and handicap are being complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, UERPC is required to note the race/national origin and sex of the individual applicants on the basis of visual obser vation or surname. Name: Sex: DOB: Race: Veteran? Relationship: Number in Household: Final 02/02/13

INCOME INFORMATION Gross Income on Income Tax Return: Please enclose a copy of your most recent Federal Income Tax return with W-2 s and received by all household members. Applicant s Employer: Address: Phone: Monthly Income Before Taxes: $ YTD Income at Time of Application: $ Co-Applicant s Employer: Address: Phone: Monthly Income Before Taxes: $ YTD Income at Time of Application: $ Other sources of income, please fill in the information below for all that apply Enclose proof of dollar amounts received for example; include a copy of the Social Security Benefits letter. Source: Monthly Amount Received: Received By: Social Security Social Security Disability Pension/Retirement Child Support Rental Income Interest/Annuity/IRA Income Other Other Created 11.27.12

C. ASSET INFORMATION FOR ALL ADULT HOUSEHOLD MEMBERS Include verification of all assets listed, attach separate sheet if additional space is required. Checking: Checking: Savings: Savings: Cash: Investments/IRA s: Life Insurance (cash value): Other Real Estate Investments: Location Name and Address Approximate Balance Name and address of mortgage lender or land sales contract seller: Attach a copy of your homeowner s insurance policy or Declarations Page with the application. You must have homeowners insurance. D. ENCLOSE A COPY OF THE FOLLOWING DOCUMENTS, AS APPLICABLE: a. Proof of income. Can include, but is not limited to: Most recent income tax return, W2, bank or SS statements, 1099, FIP printout, child support website printout b. Signed assurances page. E. PROJECT COSTS. Please check the box before the repair that best describes your projec t: Plumbing Repair Roof Windows/Doors Wiring/Electrical Furnace/Heat Source Replacement Water Heater Replacement Other (please explain): Please attach corresponding quotes and bids. Contractor must be LSR certified and a registered contractor in the State of Iowa. Full scope of work and two detailed bids are required. Created 11.27.12

F. Identify all agencies or institutions (e.g. Housing Trust Fund, CDBG, USDA, etc.) involved in the project, and what their involvement is: G. AUTHORIZATION To the best of my knowledge and belief, all data in this application are true and current. I understand and agree that the UERPC will verify the information contained herein. I hereby give my permission to the WEDC and Upper Explorerland Regional Planning Commission to research the applicant s history, make credit checks, contact the applicant s financial institution, and perform other related activities necessary for the reasonable evaluation of this application. Signature: Date Printed Name: Title: Special Needs: I certify that I am a household with special needs. Such as the elderly (62 and older), mentally or physically disabled persons, persons recovering form physi cal abuse or alcohol or drug abuse, or persons with AIDS. Signature of Head and Co-Head Date Identify the person in the household with special needs and verify what category o f special needs qualifies. Created 11.27.12

Assurances The applicant hereby assures and certifies that he or she will comply with the regulations, policies, guidelines, and requirements, as they relate to the application, acceptance and use of the Federal Home Loan Program funds for this project. Also, the applicant gives assurance and certifies with respect to the loan that: It possesses legal authority to apply for the loan, and to finance and construct the proposed project. It will give the Upper Explorerland Regional Planning Commission access to and the right to examine all records and documents related to the loan. The project will be properly and efficiently administered, operated and maintained. It will cause work on the project to be commenced within a reasonable time after receipt of notification that funds have been approved and that the project will be prosecuted to completion with reasonable diligence. It will not dispose of or encumber its title or other interests in t he site and facilities during the period of the loan. The applicant further agrees that in the event it fails to comply with its undertakings hereunder, UERPC may call, cancel, terminate, accelerate repayment or suspend in whole or part the financial assistance provided or to be provided by UERPC or WEDC. Furthermore, UERPC and WEDC may take any other action that may be deemed necessary or appropriated to effectuate the requirements of this document. The Applicant acknowledges that he or she has read, understood, and agrees to the provisions of the above document. Date: By: Signature-Head of Household Signature Co-Applicant Created 11.27.12