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					                                        HOME               IMPROVEMENT PROGRAM
                                         Program Participant Application—Grant / Loan
                                          Redevelopment Agency of the City of Corona

SECTION A. APPLICATION MATERIALS
Please read, complete, and sign the following. All persons named on Grant Deed must sign ALL documents.
         Application                     Household Information                                                                                                2-5
         Exhibits A-Q                    All Exhibits Complete, Signed & Dated                                                                                6-26

SECTION B. INCOME DOCUMENTATION
Please provide the requested items below, if applicable to your household.
All documents submitted must be copies and will not be returned. Do not send originals.

         Paycheck Stubs                      Three (3) most recent pay stubs
         Social Security                     Current year’s award letter
         Retirement                          Copy of check(s) or direct deposit bank statement
         Disability                          Current year’s award letter or copy of check(s)
         AFDC/Welfare                        Aid to Families with Dependent Children
         Rental Receipts                     Copies of payments received from tenants
         Proof of Income                     Provide proof for ALL persons living in household
         Interest                            Provide statements for interest on interest bearing accounts
         Federal Income                      Complete (all pages) for the current year and past two years 1040’s, with W-
          Tax Returns                         2’s, and Schedule C’s (if self-employed)
                                              OR
                                              Exhibit P: Statement of Filing Status if not required to file taxes

SECTION C. OTHER INFORMATION
The following documentation must be included with the application.
All documents submitted must be copies and will not be returned. Do not send originals.

         Ownership                           Grant Deed OR HCD Certificate of Title AND Registration
         Insurance                           Current Homeowners Insurance Policy
         Property Taxes                      Copy of tax bill and copy of cancelled check
         Mortgage                            Recent mortgage payment statement with current loan balance
         Bank                                Three (3) most recent consecutive bank statements (ALL PAGES) for ALL
                                              bank accounts
         Identification                      Current Driver License OR CA ID Card for all persons over 18
         Birth Certificate                   For any household member under 18
         Other

The undersigned certifies that the application is current and complete.
Applicant Signature:                                                Date:              Co-Applicant Signature:                                                 Date:



                                            Incomplete Applications Will Not Be Processed
                            By checking this box, I certify under penalty of perjury under the laws of the State of California that I am the person identified in this 
  application and that all information provided in this application is true, correct and complete to the best of my knowledge. I further acknowledge                      1
  that I have read and understand this application. I understand that false or incomplete answers may be grounds for ineligibility or termination. I 
  agree to and accept all the terms and conditions of this document. I understand that checking this box is an electronic signature and it has the same 
  legal effect and enforceability as a written signature on an application. 
                                             CITY OF CORONA REDEVELOPMENT DEPARTMENT
                     HOME IMPROVEMENT PROGRAM                                      GRANT/LOAN APPLICATION
                     400 SOUTH VICENTIA AVENUE #310, CORONA, CA, 92882            PHONE (951) 736-2260         FAX (951) 736-2488

Information provided herein shall be kept confidential and shall only be used for determining eligibility and collecting statistical data for the program.


                                                                    APPLICANT
NAME          ______________________________________________________________________________                                     AGE      ______________
             Last                                                     First                           Middle



CURRENT RESIDENCE ADDRESS                              STREET          _________________________________________________________________

                                                  CITY/STATE           ______________________________________                   ZIP      _______________

TYPE OF HOME                        CONDO / TOWN HOME                     MOBILE HOME               SINGLE FAMILY RESIDENCE                      OTHER

  HOME PHONE              (     )    ________________________                          WORK PHONE               (     )   __________________________

   CELL PHONE             (     )    ________________________           EMAIL        _________________________            @ ________________________

PREVIOUS ADDRESS                                  STREET          _____________________________________________________________________

(If less than 3 years at above address)       CITY/STATE           _________________________________________                    ZIP      _______________

SOCIAL SECURITY NUMBER                      ___________________________________                 DATE OF BIRTH             __________________________

DRIVER LICENSE NUMBER                       ___________________________________                                STATE      __________________________

MARITAL STATUS                             SINGLE                         MARRIED                         DIVORCED                         WIDOWED



                                                                 CO-APPLICANT
NAME          ______________________________________________________________________________                                     AGE      ______________
             Last                                                     First                           Middle



CURRENT RESIDENCE ADDRESS                              STREET          _________________________________________________________________

                                                  CITY/STATE           ______________________________________                   ZIP      _______________

  HOME PHONE              (     )    ________________________                          WORK PHONE               (     )   __________________________

   CELL PHONE             (     )    ________________________           EMAIL        _________________________            @ ________________________

PREVIOUS ADDRESS                                  STREET          _____________________________________________________________________

(If less than 3 years at above address)       CITY/STATE           _________________________________________                    ZIP      _______________

SOCIAL SECURITY NUMBER                      ___________________________________                 DATE OF BIRTH             __________________________

DRIVER LICENSE NUMBER                       ___________________________________                                STATE      __________________________

MARITAL STATUS                             SINGLE                         MARRIED                         DIVORCED                         WIDOWED



List the head of your household and all members, including those under 18 years of age, who live in your home at the
  time of application, including applicant and co-applicant. Give the relationship of each family member to the head.
Household Member                                 Full Name                           Relationship                   Age       Social Security No.
    Applicant                                                                            Self
       2
       3
       4
       5
       6
       7
       8
                                                                                                                                                        2
                                                EMPLOYMENT DATA—APPLICANT
 EMPLOYER                                                                 MONTHLY
   NAME      __________________________________________________________ GROSS INCOME      _____________________
ADDRESS ____________________________________     CITY/STATE ___________________________    ZIP ______________
   DATES EMPLOYED                    OCCUPATION
FROM ___/___ TO ___/___                                            EMPLOYER
    MO/YR     MO/YR         _________________________________         PHONE       (   )   _____________________

(If with present employer less than 2 years)
   PREVIOUS                                                              MONTHLY
 EMPLOYER NAME     ___________________________________________________ GROSS INCOME       _____________________
ADDRESS ____________________________________    CITY/STATE ___________________________     ZIP ______________
   DATES EMPLOYED                   OCCUPATION
FROM ___/___ TO ___/___                                            EMPLOYER
    MO/YR     MO/YR        _________________________________         PHONE       (   )    _____________________



                                               EMPLOYMENT DATA—CO-APPLICANT
 EMPLOYER                                                                 MONTHLY
   NAME      __________________________________________________________ GROSS INCOME      _____________________
ADDRESS ____________________________________     CITY/STATE ___________________________    ZIP ______________
   DATES EMPLOYED                    OCCUPATION
FROM ___/___ TO ___/___                                            EMPLOYER
    MO/YR     MO/YR         _________________________________         PHONE       (   )   _____________________

(If with present employer less than 2 years)
   PREVIOUS                                                              MONTHLY
 EMPLOYER NAME     ___________________________________________________ GROSS INCOME       _____________________
ADDRESS ____________________________________    CITY/STATE ___________________________     ZIP ______________
   DATES EMPLOYED                   OCCUPATION
FROM ___/___ TO ___/___                                            EMPLOYER
    MO/YR     MO/YR        _________________________________         PHONE       (   )    _____________________




CHECK THE APPROPRIATE BOX                                                                         YES     NO
Have you or any other person listed on this application received any previous rehabilitation
assistance through the City? If yes, please give year(s)____________________________
and amount(s) _____________________________.
Do you own other residential property?
Are all your debts listed?
Is any debt past due? Type of debt______________________________________________
Have you or your co-applicant filed for bankruptcy in the past (3) years?
Are your property taxes paid and current?
Did you include evidence that it is paid?
What was the date that your home was purchased?                                                   ___/__/___




                                                                                                           3
                                  Present MONTHLY Income
    INCOME SOURCE          APPLICANT            CO-          OTHER                      TOTAL
                                             APPLICANT     HOUSEHOLD
                                                          MEMBERS 18 OR
                                                             OLDER
Income from employer       $             $                $                    $ 0.00
Interest from savings      $             $                $                    $ 0.00
Interest from CD 's        $             $                $                    $ 0.00
Social Security            $             $                $                    $ 0.00
Rental Income              $             $                $                    $ 0.00
Child Support              $             $                $                    $ 0.00
Foster Care                $             $                $                    $ 0.00
Pension                    $             $                $                    $ 0.00
Alimony                    $             $                $                    $ 0.00
AFDC, Unemployment, etc.   $             $                $                    $ 0.00
Other:                     $             $                $                    $ 0.00
Other:                     $             $                $                    $ 0.00

                    Total Present GROSS Monthly Household Income           A   $ 0.00
                                     Multiply by 12 months in a year       B                     X 12

                      A times B is equal to TOTAL ANNUAL INCOME            C   $ 0.00




                                 Present MONTHLY EXE;!enses
 PAYMENT TYPE       NAME OF CREDITOR           ACCOUNT NUMBER              BALANCE       MONTHLY
                                                                                         PAYMENT
RenUMortgage                                                           $                $
Mortgage-Seco nd                                                       $                $
Auto                                                                   $                $
Other Loan                                                             $                $
Credit Card                                                            $                $
Other: HOA Fees                                                        $                $
Other: Utilities                                                       $                $
Other: Insurance                                                       $                $

                                                 Total present MONTHLY Expenses
                                                                                        $ 0.00




                                                                                                    4
                                                    Assets
          TYPE           BANK NAME OR                ACCOUNT NUMBER                       BALANCE
                        NAME OF ACCOUNT
Checking Account                                                                  $
Savings Account                                                                   $
Other Bank Account                                                                $
Other Bank Account                                                                $
                   OTHER INVESTMENTS—ITEMIZE                                                VALUE
Stocks                                                                            $
Bonds                                                                             $
Property (Address)                                                                $
Other                                                                             $
Other                                                                             $
                  RETIREMENT ACCOUNTS—ITEMIZE                                               VALUE
IRA                                                                               $
401K                                                                              $
Other                                                                             $

                                                                   Total Assets $ 0.00


IMPORTANT—READ BEFORE SIGNING
I/We acknowledge that a material misstatement or omission made by me/us in any statement or application
by me/us in connection with my/our application for the Agency’s Home Improvement Program will be
grounds (at the discretion of the Agency) for immediate revocation by the Agency of the loan made to
me/us in conjunction with the Home Improvement Program and will result in the immediate demand for
repayment of all amounts due under the Promissory Note and/or the Unsecured Promissory Note executed
by me/us in conjunction with the Agency’s Home Improvement Program.
In addition, I/we hereby acknowledge and understand that any false pretense, including any false
statement or representation; or the fraudulent use of any instrument, facility, article, or other valuable item
or service pursuant to my/our participation in any program administered by the Agency, may be subject to
both civil and criminal prosecution and immediate disqualification from the Agency’s Home Improvement
Program.

I/We certify that I/we have read and understood the provisions in this document and that I/we wish
to proceed with the application for the Agency’s Home Improvement Program.

Applicant Signature:                        Date:       Co-Applicant Signature:                       Date:




                       INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED




                                                                                                              5
                                             EXHIBIT A

                              CITY OF CORONA REDEVELOPMENT AGENCY
                 HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
     400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                            INFORMATION FOR GOVERNMENT REPORTING
                                     (STATISTICAL INFORMATION)
The following information will be kept confidential and used only to provide aggregate data for program
analysis. Completion of this form is OPTIONAL and WILL NOT be used to evaluate your application for
participation in the Home Improvement Program.

                BORROWER                                CO-BORROWER
PLEASE MARK ONE:                         PLEASE MARK ONE:
   WHITE (11)                               WHITE (11)
   BLACK / AFRICAN AMERICAN (12)            BLACK / AFRICAN AMERICAN (12)
   ASIAN (13))                              ASIAN (13))
   AMERICAN INDIAN / ALASKAN NATIVE (14)    AMERICAN INDIAN / ALASKAN NATIVE (14)
   NATIVE HAWAIIAN / OTHER PAC ISLANDER     NATIVE HAWAIIAN / OTHER PAC ISLANDER
   (15)                                     (15)
   AMERICAN INDIAN / ALASKAN NATIVE &       AMERICAN INDIAN / ALASKAN NATIVE &
   WHITE (16)                               WHITE (16)
   ASIAN & WHITE (17)                       ASIAN & WHITE (17)
   BLACK / AFRICAN AMERICAN & WHITE (18)    BLACK / AFRICAN AMERICAN & WHITE (18)
   AMERICAN INDIAN / ALASKAN NATIVE &       AMERICAN INDIAN / ALASKAN NATIVE &
     BLACK / AFRICAN AMERICAN (19)            BLACK / AFRICAN AMERICAN (19)
   OTHER (20)                               OTHER (20)
HEAD OF HOUSEHOLD:                       HEAD OF HOUSEHOLD:
HISPANIC      YES     NO                 HISPANIC      YES     NO
              MALE    FEMALE                           MALE    FEMALE




                                                                                                      6
                                                     EXHIBIT B

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                                    PROGRAM DISCLOSURE STATEMENT

Please review the following program qualifications:
       LOAN PROGRAM
       For median-income households, loans are available for up to $40,000, for single-family residences,
       town homes, and condominiums, or $15,000 for mobile and manufactured homes. Repairs are
       limited to code violations, health and safety repairs, and the repair/replacement of major systems
       including roofs, plumbing, electrical, and existing heating and air conditioning. If you qualify, the
       loan (1) carries no interest charge, (2) requires no monthly payments, (3) is 100% repayable upon
       sale, transfer, or in the event of refinance for cash-out, or when the borrower no longer lives in the
       home.

          GRANT PROGRAM
          For very low-income households, grants are available for up to $5,000. Repairs are limited to minor
          home maintenance of items such as faucets, broken windows, water heaters, minor electrical, etc.
          If you qualify, the grant does not require repayment and NO lien is placed against your property.

                                 2009 Maximum Gross Annual Income Limits
                    Number of People       LOAN- Income limit                GRANT- Income limit
                   Living in Household      (Median-Income)                   (Very-Low Income)
                             1                 $45,150                             $23,300
                             2                 $51,600                             $26,650
                             3                 $58,050                             $29,950
                             4                 $64,500                             $33,300
                             5                 $69,650                             $35,950
                             6                 $74,800                             $38,650
                             7                 $80,000                             $41,300
                             8                 $85,150                             $43,950

In addition to the income guidelines, there are additional requirements as outlined in the Program
Guidelines. These include, but are not limited to:
        a. Loan amount is limited by the available equity, which cannot exceed 100 percent loan to value.
        b. Properties must be insured for full replacement value, except for grants.
        c. All improvements are to be conducted by licensed contractors selected through a bidding
            process by the homeowner.

I/We have read and understand the program information.

Applicant Signature:                         Date:        Co-Applicant Signature:                   Date:




                                                                                                            7
                                                 EXHIBIT C

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                            ANTI-DISCRIMINATION HOUSING ACT STATEMENT

          Under the Housing Financial Anti-Discrimination Act of 1977, it is unlawful for the
          Redevelopment Agency of the City of Corona to discriminate in the availability of, or in
          the provision of financial assistance for the purpose of rehabilitation of housing
          accommodations based on an applicant’s race, religion, sex, marital status, or physical
          disabilities.

I/We have received and read a copy of the Anti-Discrimination Housing Act Statement.

Applicant Signature:               Date:             Co-Applicant Signature:                    Date:




                                                                                                        8
                                                EXHIBIT D

                              CITY OF CORONA REDEVELOPMENT AGENCY
                 HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
     400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                        AUTHORIZATION FOR CONFIDENTIAL INFORMATION
                               CREDIT REPORT / TITLE REPORT

PROGRAM APPLICANTS:
Please complete the following for all persons 18 years of age and older who are living and will be living in
the home rehabilitated through the Agency’s Home Improvement Program. All persons in the household
must obtain a Social Security number prior to being considered for assistance through the Program. Please
complete all names as shown on the Social Security card.

I/We hereby authorize the Agency and/or its consultant, Housing Programs, to obtain a credit report and/or
title report in conjunction with my/our application for assistance through the Agency’s Home Improvement
Program.



PRINT NAME:                                                    SOC. SEC. #:

SIGNATURE:                                                            DATE:


PRINT NAME:                                                    SOC. SEC. #:

SIGNATURE:                                                            DATE:


PRINT NAME:                                                    SOC. SEC. #:

SIGNATURE:                                                            DATE:


PRINT NAME:                                                    SOC. SEC. #:

SIGNATURE:                                                            DATE:




                                                                                                           9
                                                    EXHIBIT E

                                CITY OF CORONA REDEVELOPMENT AGENCY
                    HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
        400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                             WAIVER FOR OWNER-OCCUPIED PROPERTY

As a participant in the Redevelopment Agency of the City of Corona’s Home Improvement Program, I
understand that I can choose any state-licensed Contractor from the Agency provided contractor list at my
sole discretion. I also understand that the Contractor I select to perform repairs on my home is not in any
way affiliated with the Agency and/or the City of Corona and that any personal injury or damages caused
by the Contractor to my personal or real property, or any defects in repair work are the sole responsibility of
the Contractor. I also understand the contractors on the Agency provided list meet these minimum criteria:
Has a current City of Corona business license; is licensed by the State Contractors License Board to
perform home-repair work authorized under the Program; carries a minimum liability insurance of
$500,000; and carries workers’ compensation insurance.

I also understand that if I would like to receive a bid from and/or choose a Contractor that is not on the
Agency’s contractor list, the Contractor may apply to be added to the list if he/she meets the
aforementioned minimum requirements and I may choose to hire that Contractor to perform work on my
home. I further understand that there are certain risks to persons and property inherent in the home-repair
work authorized under the Program.

Given my/our understanding of the above, I/we agree not to file any claim, demand, or lawsuit against the
Agency and/or the City of Corona, its elected or appointed officials, employees, or agents arising from or
related in any way to the actions of any contractor performing work on my/our home in connection with the
Program.


Property Owner Signature:                   Date:       Property Owner Signature:                     Date:




                                                                                                              10
                                                  EXHIBIT F

                                 City of Corona Redevelopment Agency
                  HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
      400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                         CONSENT TO GATHER CONFIDENTIAL INFORMATION

TO:    STATE OF CALIFORNIA EMPLOYMENT DEVELOPMENT DEPARTMENT
       PO BOX 781, SAN BERNARDINO, CA 92402-0781

PROGRAM APPLICANTS:
Please complete the following for all persons 18 years of age and older who are living and will be living in
the home rehabilitated through the Redevelopment Agency of the City of Corona’s Home Improvement
Program. All persons in the household must obtain a Social Security number prior to being considered for
assistance through the Program. Please complete all names as shown on the Social Security card.

I/We hereby authorize the release of the requested information in conjunction with my/our application for
assistance through the Agency’s Home Improvement Program.



PRINT NAME:                                                       SOC. SEC. #:

SIGNATURE:                                                               DATE:


PRINT NAME:                                                       SOC. SEC. #:

SIGNATURE:                                                               DATE:


PRINT NAME:                                                       SOC. SEC. #:

SIGNATURE:                                                               DATE:


PRINT NAME:                                                       SOC. SEC. #:

SIGNATURE:                                                               DATE:

The person(s) listed above have applied to participate in the Agency’s Home Improvement Program. The
Agency is required to verify the amounts of financial assistance being provided to the person(s) named
above through the State of California Employment Development Department including, but not limited to:
(a) temporary disability; (b) permanent disability; and or; (c) unemployment benefits and any other form of
assistance which is not specifically identified in a, b, or c. This information is required in order to determine
eligibility for participation in the Home Improvement Program. This information is for the exclusive and
confidential use of the Agency and its cooperating escrow or lending agent.

DATE _________________________ ____________________________________________________________
                               REDEVELOPMENT AGENCY

PLEASE FORWARD THE                          CITY OF CORONA
REQUESTED INFORMATION TO THE                REDEVELOPMENT AGENCY
FOLLOWING:                                  ATTN: HOME IMPROVEMENT PROGRAM
                                            400 S. VICENTIA AVE. #310, CORONA, CA 92882                        11
                                                     EXHIBIT G

                               CITY OF CORONA REDEVELOPMENT AGENCY
                  HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
      400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                          CONSENT TO GATHER CONFIDENTIAL INFORMATION

TO:     UNITED STATES DEPARTMENT OF HEALTH AND SOCIAL SERVICES
        SOCIAL SECURITY ADMINISTRATION
        2191 SAMPSON AVE. #105, CORONA, CA 92879

PROGRAM APPLICANTS:
Please complete the following for all persons 18 years of age and older who are living and will be living in
the home rehabilitated through the Redevelopment Agency of the City of Corona’s Home Improvement
Program. All persons in the household must obtain a Social Security number prior to being considered for
assistance through the Program. Please complete all names as shown on the Social Security card.

I/We hereby authorize the release of the requested information in conjunction with my/our application for
assistance through the Agency’s Home Improvement Program.


PRINT NAME:                                                         SOC. SEC. #:

SIGNATURE:                                                                  DATE:


PRINT NAME:                                                         SOC. SEC. #:

SIGNATURE:                                                                  DATE:


PRINT NAME:                                                         SOC. SEC. #:

SIGNATURE:                                                                  DATE:


PRINT NAME:                                                         SOC. SEC. #:

SIGNATURE:                                                                  DATE:

The person(s) listed above have applied to participate in the Agency’s Home Improvement Program. The Agency is
required to verify the amounts of financial assistance being provided to the person(s) named above through the
United Sates Department of Health and Social Services, Social Security Administration including, but not limited to:
Supplemental Security Income; Survivors Benefits Income; Retirement Income; Disability Income and any other form
of assistance being provided to the person(s) named above. This information is required in order to determine
eligibility for participation in the Home Improvement Program. This information is for the exclusive and confidential
use of the Agency and its cooperating escrow or lending agent.

DATE _________________________ ____________________________________________________________
                               REDEVELOPMENT AGENCY

PLEASE FORWARD THE                           CITY OF CORONA
REQUESTED INFORMATION TO THE                 REDEVELOPMENT AGENCY
FOLLOWING:                                   ATTN: HOME IMPROVEMENT PROGRAM
                                             400 S. VICENTIA AVE. #310, CORONA, CA 92882
                                                                                                                   12
                                                                    EXHIBIT H

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                                          REQUEST FOR VERIFICATION OF DEPOSIT

INSTRUCTIONS
APPLICANT: COMPLETE ONLY ITEMS 1, 7, 8, AND 9 IN PART I.
DEPOSITORY: COMPLETE ITEMS 10-15 IN PART II AND RETURN DIRECTLY TO LENDER NAMED IN ITEM 2.
                     PART I – REQUEST FOR DEPOSIT VERIFICATION
1. TO (NAME & ADDRESS OF                   2. FROM (NAME & ADDRESS OF LENDER)
DEPOSITORY/BANK)                           City of Corona Redevelopment Agency
                                           Home Improvement Program
                                           400 S. Vicentia Ave. #310, Corona, CA 92882
3. NAME OF LENDER   4. TITLE               5. DATE                   6. LENDER’S NUMBER
CONTACT                                                              (OPTIONAL)

7. INFORMATION TO BE VERIFIED
TYPE OF       ACCOUNT IN THE NAME OF                                         ACCOUNT NUMBER                                     BALANCE
ACCOUNT
CHECKING                                                                                                                        $
SAVINGS                                                                                                                         $
 OTHER                                                                                                                          $
TO DEPOSITORY: I have applied for a mortgage loan and stated in my financial statement that the balance on
deposit with you is shown above. You are authorized to verify this information and to supply the lender identified
above with information requested in items 10 through 12. Your response is solely a matter of courtesy for which no
responsibility is attached to your institution or any of your officers.
8. NAME & ADDRESS OF APPLICANT(S)                                            9. SIGNATURE OF APPLICANT(S)




                        PART II– VERIFICATION OF DEPOSITORY
10. DEPOSIT ACCOUNTS OF APPLICANT(S)
     TYPE OF       ACCOUNT             CURRENT          AVERAGE                                                              DATE OPENED
    ACCOUNT        NUMBER              BALANCE        BALANCE FOR
                                                     PREVIOUS TWO
                                                        MONTHS



11. LOAN               DATE OF               INSTALLMENTS
                                          ORIGINAL CURRENT    SECURED     NUMBER
NUMBER                  LOAN                   MONTHLY /
                                          AMOUNT BALANCE         BY       OF LATE
                                               QUARTERLY                 PAYMENTS
                                           $         per
                                           $         per
                                           $         per
12. ADDITIONAL INFORMATION WHICH MAY BE OF ASSISTANCE IN DETERMINATION OF CREDIT
WORTHINESS (PLEASE INCLUDE INFORMATION ON LOANS PAID-IN-FULL AS IN ITEM 11 ABOVE)

13. SIGNATURE OF DEPOSITORY                                 14. TITLE                                           15. DATE

The confidentiality of the information you have furnished will be preserved except where disclosure of this information is required by applicable law.
The form is to be transmitted directly to the lender and is not to be transmitted through the applicant or any other party.
                                                                                                                                                    13
                                                                     EXHIBIT I

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                               REQUEST FOR EMPLOYMENT & SALARY VERIFICATION
INSTRUCTIONS
APPLICANT: COMPLETE ONLY ITEMS 1, 7, AND 8 IN PART I.
EMPLOYER: COMPLETE EITHER PART II OR PART III AS APPLICABLE. SIGN & RETURN DIRECTLY TO
LENDER NAMED IN ITEM 2.
                        PART I – REQUEST FOR EMPLOYMENT & SALARY VERIFICATION
1. TO (NAME & ADDRESS OF EMPLOYER)                                           2. FROM (NAME & ADDRESS OF LENDER)
                                                                             City of Corona Redevelopment Agency
                                                                             Home Improvement Program
                                                                             400 S. Vicentia Ave. #310, Corona, CA 92882
3. EMPLOYER CONTACT                   4. TITLE                               5. DATE                        6. PHONE NUMBER

TO EMPLOYER: I have applied for a mortgage loan and stated that I am currently or was formerly employed by you.
My signature below authorizes verification of this information.
7. NAME & ADDRESS OF APPLICANT                                  8. SIGNATURE OF APPLICANT
(INCLUDE EMPLOYEE #)


                                  PART II– VERIFICATION OF PRESENT EMPLOYMENT
           EMPLOYMENT DATA                                                                   PAY DATA
9. APPLICANT’S DATE OF EMPLOYMENT                  12A. CURRENT BASE PAY                                      12C. MILITARY PERSONNEL ONLY
                                                                             ______ANNUAL                                PAY GRADE
                                                                             _______HOUR
10. PRESENT POSITION                                                         ______MONTH                          TYPE         MONTHLY
                                                                             _______WEEK                                       AMOUNT
                                                   $_____________________    ______OTHER:                     BASE PAY         $
11. PROBABILITY OF CONTINUED                                      12B. EARNINGS                               RATIONS          $
EMPLOYMENT                                         TYPE            YEAR TO       PAST YEAR                    FLIGHT OR        $
                                                                   DATE                                       HAZARD
13. IF OVERTIME OR BONUS IS                        BASE PAY        $             $                            CLOTHING          $
APPLICABLE, IS ITS CONTINUANCE
LIKELY?                                            OVERTIME              $               $                    QUARTERS          $
OVERTIME                                           COMMISSIONS           $               $                    PRO PAY           $
____________ YES      ____________ NO
BONUS                                              BONUS                 $               $                    OVERSEAS          $
____________ YES       ____________ NO                                                                        OR COMBAT

14. REMARKS (If paid hourly, please indicate average hours worked each week during current and past year)

                                 PART III– VERIFICATION OF PREVIOUS EMPLOYMENT
15. DATES OF EMPLOYMENT                            16. SALARY/WAGE AT TERMINATION (PLEASE SPECIFY PER YEAR, MONTH, WEEK,
VERIFICATION OF PRESENT                            ETC.)


17. REASON FOR LEAVING                             18. POSITION HELD

                                                       EMPLOYER SIGNATURE
19. SIGNATURE OF EMPLOYER                                    20. TITLE                                          21. DATE

The confidentiality of the information you have furnished will be preserved except where disclosure of this information is required by applicable
law. The form is to be transmitted directly to the lender and is not to be transmitted through the applicant or any other party.




                                                                                                                                                    14
                                                    EXHIBIT J

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                              LEAD-BASED PAINT WARNING STATEMENT

Homes built prior to 1978 may contain lead-based paint on the walls, ceilings, windowsills, and doorframes.
Lead-based paint and primers may also have been used on outside porches, railings, and garages. When
lead-based paint chips, flakes, or peels off, a great danger of lead poisoning exists if the paint is ingested
or otherwise absorbed by infants and children. Lead poisoning is a very serious condition, which can
cause mental retardation, blindness, and learning disabilities.

Symptoms of lead poisoning include chronic stomachaches, loss of appetite, vomiting, headaches, lack of
energy, slow down of playful activity, and slowness in development of young children.

If you suspect that your child has eaten chips of paint, you should contact your doctor, clinic, or poison
control center and follow their recommendations.

I/We have read and understand the information written above. I/We have received a copy of the most
recent version of a lead hazard information pamphlet, as prescribed by the Administrator of the
Environmental Protection Agency under section 406 of the Toxic Substances Control. I/We understand that
false statements may disqualify me/us from participation in the Program.

Applicant Signature:                        Date:       Co-Applicant Signature:                      Date:




                                                                                                             15
                                                 EXHIBIT K

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                                   MANDATORY IMPROVEMENTS

To assure an efficient use of the funds available, properties participating in the Home Improvement
Program must meet minimum housing quality standards upon the completion of the work. Properties that
cannot meet these standards after the exhaustion of all available funds are therefore ineligible for
participation in those programs and other housing assistance options may be explored.

Improvements that are necessary in order to meet the minimum housing standards are known as
“mandatory improvements.” Once your eligibility has been determined, the Home Improvement Program
Specialist will inspect your property and determine the mandatory improvements.

Mandatory improvements generally include, but are not limited to:
  • Code Correction repairs
  • Installation of windows in unventilated rooms
  • Lead-based paint repairs—lead-based paint inspection may be required of any home built before
     1978
  • Asbestos removal
  • Modifications which aid the mobility of the elderly or physically disabled
  • Health and Safety items—smoke detectors, carbon monoxide detectors, water heater straps
  • Exterior paint
  • Anchorage of structure to the foundation
  • Fumigation and treatment of termites and pest control
  • Repair or replacement of major systems—roof, electrical, plumbing, air conditioning/heating
     systems
  • Energy efficient items—dual glazed windows, insulation, energy efficient light fixtures

During the inspection, the Home Improvement Program Specialist may determine that some of the
mandatory improvements listed above are not required in your particular case.

       Please indicate the type of repairs/improvements you are requesting assistance for:

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

I/We have read and received a copy of this explanation of mandatory improvements and understand that
those improvements described as mandatory improvements must be completed if the application is
approved.

Applicant Signature:                     Date:       Co-Applicant Signature:                 Date:




                                                                                                     16
                                         EXHIBIT L

                             CITY OF CORONA REDEVELOPMENT AGENCY
                HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
    400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                                     IRS FORM 8821
                                   TAX AUTHORIZATION

INSTRUCTIONS FOR FILLING OUT THE FOLLOWING FORM—IRS FORM 8821

PLEASE COMPLETE LINES 1 AND 7 ONLY ON THE FOLLOWING PAGE:




                                                                                           17
       8821
                                                                                                                                          OMB No. 1545-1165

Form                                             Tax Information Authorization                                                            For IRS Use Only
                                                                                                                               Received by:
(Rev. August 2008)                    Do not sign this form unless all applicable lines have been completed.
                                                                                                                               Name
Department of the Treasury
                                      Do not use this form to request a copy or transcript of your tax return.                 Telephone (           )
Internal Revenue Service
                                                   Instead, use Form 4506 or Form 4506-T.                                      Function
                                                                                                                               Date              /         /
 1     Taxpayer information. Taxpayer(s) must sign and date this form on line 7.
Taxpayer name(s) and address (type or print)                                            Social security number(s)          Employer identification number




                                                                                        Daytime telephone number           Plan number (if applicable)

                                                                                        (          )


 2 Appointee. If you wish to name more than one appointee, attach a list to this form.
Name and address                                                          CAF No.
                                                                          Telephone No.
                                                                          Fax No.
                                                               Check if new: Address          Telephone No.      Fax No.
 3 Tax matters. The appointee is authorized to inspect and/or receive confidential tax information in any office of the IRS for
   the tax matters listed on this line. Do not use Form 8821 to request copies of tax returns.
                  (a)
                                                          (b)                                   (c)
            Type of Tax                                                                                                              (d)
                                                   Tax Form Number                     Year(s) or Period(s)
 (Income, Employment, Excise, etc.)                                                                                    Specific Tax Matters (see instr.)
                                                 (1040, 941, 720, etc.)          (see the instructions for line 3)
           or Civil Penalty




 4 Specific use not recorded on Centralized Authorization File (CAF). If the tax information authorization is for a specific
   use not recorded on CAF, check this box. See the instructions on page 4. If you check this box, skip lines 5 and 6

 5 Disclosure of tax information (you must check a box on line 5a or 5b unless the box on line 4 is checked):
   a If you want copies of tax information, notices, and other written communications sent to the appointee on an ongoing
     basis, check this box

   b If you do not want any copies of notices or communications sent to your appointee, check this box
 6 Retention/revocation of tax information authorizations. This tax information authorization automatically revokes all
   prior authorizations for the same tax matters you listed on line 3 above unless you checked the box on line 4. If you do
   not want to revoke a prior tax information authorization, you must attach a copy of any authorizations you want to remain
   in effect and check this box
   To revoke this tax information authorization, see the instructions on page 4.

 7 Signature of taxpayer(s). If a tax matter applies to a joint return, either husband or wife must sign. If signed by a
   corporate officer, partner, guardian, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify
   that I have the authority to execute this form with respect to the tax matters/periods on line 3 above.
      IF NOT SIGNED AND DATED, THIS TAX INFORMATION AUTHORIZATION WILL BE RETURNED.

         DO NOT SIGN THIS FORM IF IT IS BLANK OR INCOMPLETE.



     Signature                                                     Date            Signature                                                              Date




     Print Name                                          Title (if applicable)      Print Name                                                Title (if applicable)




                                     PIN number for electronic signature                                             PIN number for electronic signature


For Privacy Act and Paperwork Reduction Act Notice, see page 4.                                Cat. No. 11596P                    Form      8821         (Rev. 8-2008)
Form 8821 (Rev. 8-2008)                                                                                         Page    2

General Instructions                                            Use Form 4506, Request for Copy of Tax Return, to
                                                             get a copy of your tax return.
Section references are to the Internal Revenue Code             Use Form 4506-T, Request for Transcript of Tax
unless otherwise noted.                                      Return, to order: (a) transcript of tax account
                                                             information and (b) Form W-2 and Form 1099 series
Purpose of Form                                              information.
Form 8821 authorizes any individual, corporation, firm,         Use Form 56, Notice Concerning Fiduciary
organization, or partnership you designate to inspect        Relationship, to notify the IRS of the existence of a
and/or receive your confidential information in any          fiduciary relationship. A fiduciary (trustee, executor,
office of the IRS for the type of tax and the years or       administrator, receiver, or guardian) stands in the
periods you list on Form 8821. You may file your own         position of a taxpayer and acts as the taxpayer.
tax information authorization without using Form 8821,       Therefore, a fiduciary does not act as an appointee
but it must include all the information that is requested    and should not file Form 8821. If a fiduciary wishes to
on Form 8821.                                                authorize an appointee to inspect and/or receive
  Form 8821 does not authorize your appointee to             confidential tax information on behalf of the fiduciary,
advocate your position with respect to the federal tax       Form 8821 must be filed and signed by the fiduciary
laws; to execute waivers, consents, or closing               acting in the position of the taxpayer.
agreements; or to otherwise represent you before the         When To File
IRS. If you want to authorize an individual to represent
you, use Form 2848, Power of Attorney and                    Form 8821 must be received by the IRS within 60 days
Declaration of Representative.                               of the date it was signed and dated by the taxpayer.




    Where To File Chart

                     IF you live in . . .                   THEN use this address . . .             Fax Number*
    Alabama, Arkansas, Connecticut, Delaware,        Internal Revenue Service                       901-546-4115
    District of Columbia, Florida, Georgia,          Memphis Accounts Management Center
    Illinois, Indiana, Kentucky, Louisiana, Maine,   PO Box 268, Stop 8423
    Maryland, Massachusetts, Michigan,               Memphis, TN 38101-0268
    Mississippi, New Hampshire, New Jersey,
    New York, North Carolina, Ohio,
    Pennsylvania, Rhode Island,
    South Carolina, Tennessee, Vermont,
    Virginia, or West Virginia

    Alaska, Arizona, California, Colorado,           Internal Revenue Service                       801-620-4249
    Hawaii, Idaho, Iowa, Kansas, Minnesota,          1973 N. Rulon White Blvd. MS 6737
    Missouri, Montana, Nebraska, Nevada,             Ogden, UT 84404
    New Mexico, North Dakota, Oklahoma,
    Oregon, South Dakota, Texas, Utah,
    Washington, Wisconsin, or Wyoming

    All APO and FPO addresses, American              Internal Revenue Service                       215-516-1017
    Samoa, nonpermanent residents of Guam            International CAF DP: SW-311
    or the Virgin Islands**, Puerto Rico (or if      11601 Roosevelt Blvd.
    excluding income under section 933), a           Philadelphia, PA 19255
    foreign country, U.S. citizens and those
    filing Form 2555, 2555-EZ, or 4563.

    *These numbers may change without notice.
    **Permanent residents of Guam should use Department of Taxation, Government of Guam, P.O. Box 23607,
    GMF, GU 96921; permanent residents of the Virgin Islands should use: V.I. Bureau of Internal Revenue,
    9601 Estate Thomas Charlotte Amalie, St. Thomas, V.I. 00802.
Form 8821 (Rev. 8-2008)                                                                                                     Page   3

Where To File                                                      Specific Instructions
Generally, mail or fax Form 8821 directly to the IRS. See the
Where To File Chart on page 2. Exceptions are listed below.
                                                                   Line 1. Taxpayer Information
  If Form 8821 is for a specific tax matter, mail or fax it to        Individuals. Enter your name, TIN, and your street address
the office handling that matter. For more information, see the     in the space provided. Do not enter your appointee’s address
instructions for line 4.                                           or post office box. If a joint return is used, also enter your
                                                                   spouse’s name and TIN. Also enter your EIN if applicable.
   Your representative may be able to file Form 8821
electronically with the IRS from the IRS website. For more           Corporations, partnerships, or associations. Enter the
information, go to www.irs.gov. Under the Tax Professionals        name, EIN, and business address.
tab, click on e-services–Online Tools for Tax Professionals. If      Employee plan or exempt organization. Enter the name,
you complete Form 8821 for electronic signature                    address, and EIN of the plan sponsor or exempt
authorization, do not file a Form 8821 with the IRS. Instead,      organization, and the plan name and three-digit plan number.
give it to your appointee, who will retain the document.
                                                                     Trust. Enter the name, title, and address of the trustee,
                                                                   and the name and EIN of the trust.
Revocation of an Existing Tax Information
Authorization                                                        Estate. Enter the name, title, and address of the
                                                                   decedent’s executor/personal representative, and the name
If you want to revoke an existing tax information                  and identification number of the estate. The identification
authorization and do not want to name a new appointee,             number for an estate includes both the EIN, if the estate has
send a copy of the previously executed tax information             one, and the decedent’s TIN.
authorization to the IRS, using the Where To File Chart on
page 2. The copy of the tax information authorization must         Line 2. Appointee
have a current signature and date of the taxpayer under the
original signature on line 7. Write “REVOKE” across the top        Enter your appointee’s full name. Use the identical full name
of Form 8821. If you do not have a copy of the tax                 on all submissions and correspondence. Enter the nine-digit
information authorization you want to revoke, send a               CAF number for each appointee. If an appointee has a CAF
statement to the IRS. The statement of revocation or               number for any previously filed Form 8821 or power of
withdrawal must indicate that the authority of the appointee       attorney (Form 2848), use that number. If a CAF number has
is revoked, list the tax matters and periods, and must be          not been assigned, enter “NONE,” and the IRS will issue one
signed and dated by the taxpayer or representative. If the         directly to your appointee. The IRS does not assign CAF
taxpayer is revoking, list the name and address of each            numbers to requests for employee plans and exempt
recognized appointee whose authority is revoked. When the          organizations.
taxpayer is completely revoking authority, the form should           If you want to name more than one appointee, indicate so
state “remove all years/periods” instead of listing the specific   on this line and attach a list of appointees to Form 8821.
tax matters, years, or periods. If the appointee is
withdrawing, list the name, TIN, and address (if known) of the        Check the appropriate box to indicate if either the address,
taxpayer.                                                          telephone number, or fax number is new since a CAF number
                                                                   was assigned.
  To revoke a specific use tax information authorization,
send the tax information authorization or statement of
revocation to the IRS office handling your case, using the
                                                                   Line 3. Tax Matters
above instructions.                                                Enter the type of tax, the tax form number, the years or
                                                                   periods, and the specific tax matter. Enter “Not applicable,”
Taxpayer Identification Numbers (TINs)                             in any of the columns that do not apply.
TINs are used to identify taxpayer information with                  For example, you may list “Income, 1040” for calendar year
corresponding tax returns. It is important that you furnish        “2006” and “Excise, 720” for “2006” (this covers all quarters
correct names, social security numbers (SSNs), individual          in 2006). For multiple years or a series of inclusive periods,
taxpayer identification numbers (ITINs), or employer               including quarterly periods, you may list 2004 through (thru
identification numbers (EINs) so that the IRS can respond to       or a hyphen) 2006. For example, “2004 thru 2006” or “2nd
your request.                                                      2005-3rd 2006.” For fiscal years, enter the ending year and
                                                                   month, using the YYYYMM format. Do not use a general
Partnership Items                                                  reference such as “All years,” “All periods,” or “All taxes.”
                                                                   Any tax information authorization with a general reference will
Sections 6221-6234 authorize a Tax Matters Partner to              be returned.
perform certain acts on behalf of an affected partnership.
                                                                      You may list the current year or period and any tax years
Rules governing the use of Form 8821 do not replace any
                                                                   or periods that have already ended as of the date you sign
provisions of these sections.
                                                                   the tax information authorization. However, you may include
                                                                   on a tax information authorization only future tax periods that
Representative Address Change                                      end no later than 3 years after the date the tax information
If the representative’s address has changed, a new Form            authorization is received by the IRS. The 3 future periods are
8821 is not required. The representative can send a written        determined starting after December 31 of the year the tax
notification that includes the new information and their           information authorization is received by the IRS. You must
signature to the location where the Form 8821 was filed.           enter the type of tax, the tax form number, and the future
                                                                   year(s) or period(s). If the matter relates to estate tax, enter
                                                                   the date of the decedent’s death instead of the year or
                                                                   period.
Form 8821 (Rev. 8-2008)                                                                                                     Page   4
   In column (d), enter any specific information you want the       All others. See section 6103(e) if the taxpayer has died, is
IRS to provide. Examples of column (d) information are: lien      insolvent, is a dissolved corporation, or if a trustee, guardian,
information, a balance due amount, a specific tax schedule,       executor, receiver, or administrator is acting for the taxpayer.
or a tax liability.
   For requests regarding Form 8802, Application for United
States Residency Certification, enter “Form 8802” in column       Privacy Act and Paperwork Reduction Act
(d) and check the specific use box on line 4. Also, enter the     Notice
appointee’s information as instructed on Form 8802.
                                                                  We ask for the information on this form to carry out the
Note. If the taxpayer is subject to penalties related to an       Internal Revenue laws of the United States. Form 8821 is
individual retirement account (IRA) account (for example, a       provided by the IRS for your convenience and its use is
penalty for excess contributions) enter, “IRA civil penalty” on   voluntary. If you designate an appointee to inspect and/or
line 3, column a.                                                 receive confidential tax information, you are required by
                                                                  section 6103(c) to provide the information requested on Form
Line 4. Specific Use Not Recorded on CAF                          8821. Under section 6109, you must disclose your social
                                                                  security number (SSN), employer identification number (EIN),
Generally, the IRS records all tax information authorizations     or individual taxpayer identification number (ITIN). If you do
on the CAF system. However, authorizations relating to a          not provide all the information requested on this form, we
specific issue are not recorded.                                  may not be able to honor the authorization.
   Check the box on line 4 if Form 8821 is filed for any of the     The IRS may provide this information to the Department of
following reasons: (a) requests to disclose information to loan   Justice for civil and criminal litigation, and to cities, states,
companies or educational institutions, (b) requests to            the District of Columbia, and U.S. possessions to carry out
disclose information to federal or state agency investigators     their tax laws. We may also disclose this information to other
for background checks, (c) application for EIN, or (d) claims     countries under a tax treaty, to federal and state agencies to
filed on Form 843, Claim for Refund and Request for               enforce federal nontax criminal laws, or to federal law
Abatement. If you check the box on line 4, your appointee         enforcement and intelligence agencies to combat terrorism.
should mail or fax Form 8821 to the IRS office handling the
matter. Otherwise, your appointee should bring a copy of            You are not required to provide the information requested
Form 8821 to each appointment to inspect or receive               on a form that is subject to the Paperwork Reduction Act
information. A specific-use tax information authorization will    unless the form displays a valid OMB control number. Books
not revoke any prior tax information authorizations.              or records relating to a form or its instructions must be
                                                                  retained as long as their contents may become material in
Line 6. Retention/Revocation of Tax                               the administration of any Internal Revenue law.
Information Authorizations                                          The time needed to complete and file this form will vary
Check the box on this line and attach a copy of the tax           depending on individual circumstances. The estimated
information authorization you do not want to revoke. The          average time is: Recordkeeping, 6 min.; Learning about the
filing of Form 8821 will not revoke any Form 2848 that is in      law or the form, 12 min.; Preparing the form, 24 min.;
effect.                                                           Copying and sending the form to the IRS, 20 min.
                                                                    If you have comments concerning the accuracy of these
Line 7. Signature of Taxpayer(s)                                  time estimates or suggestions for making Form 8821 simpler,
                                                                  we would be happy to hear from you. You can write to
   Individuals. You must sign and date the authorization.
                                                                  Internal Revenue Service, Tax Products Coordinating
Either husband or wife must sign if Form 8821 applies to a
                                                                  Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
joint return.
                                                                  NW, IR-6526, Washington, DC 20224. Do not send Form
  Corporations. Generally, Form 8821 can be signed by: (a)        8821 to this address. Instead, see the Where To File Chart
an officer having legal authority to bind the corporation, (b)    on page 2.
any person designated by the board of directors or other
governing body, (c) any officer or employee on written
request by any principal officer and attested to by the
secretary or other officer, and (d) any other person authorized
to access information under section 6103(e).
   Partnerships. Generally, Form 8821 can be signed by any
person who was a member of the partnership during any part
of the tax period covered by Form 8821. See Partnership
Items on page 3.
                                                  EXHIBIT M

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                                 HISTORICAL ASSESSMENT FORM
                       REQUIRED ONLY FOR HOMES MORE THAN 40 YEARS OLD

Complete this form ONLY if your home is estimated to be at least forty (40) years old. Please complete as
many of the questions on this form as possible. The Home Improvement Program Specialist will assist you
with those questions that you cannot answer.

 PROPERTY
 ADDRESS                ______________________________________________________________

 USE OF                    Commercial                 Residential                   Industrial
 STRUCTURE
 OR PROPERTY               Other ________________________________________________________

 YEAR OF
 ORIGINAL
 CONSTRUCTION           ____________________          Actual                        Estimated

 ARCHITECT
 AND/OR
 ORIGINAL
 BUILDER                ____________________       ____________________             Unknown

 ARCHITECTURAL
 STYLE OF THE
 BUILDING               ____________________

 LIST ANY OCCUPANTS OR PREVIOUS OCCUPANTS THAT MAY BE OF HISTORICAL SIGNIFICANCE

 ________________________________________________________________________________

 DESCRIBE ANY UNIQUE FEATURES OF THE STRUCTURE THAT EXIST NOW OR THAT MAY HAVE
 EXISTED AT ONE TIME THAT MAY HELP US DETERMINE THE AGE OR THE ERA OF CONSTRUCTION

 ________________________________________________________________________________


Applicant Signature:                      Date:       Co-Applicant Signature:                    Date:




                                                                                                         22
                                                   EXHIBIT N

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                                   NON-WORKING OCCUPANT FORM

Any occupant of the property who is OVER the age of 18 and is NOT working or does not receive any
income MUST sign below. Applicant and co-applicant must also sign.

I certify that I do not receive any income from any source and that I have been living at the address stated
in this application for at least twelve months. Evidence that I live in the property is attached. I also
acknowledge that a material misstatement or omission made by me regarding my income or residency will
be grounds for immediate revocation by the Agency of any loan associated with this application and will
result in the immediate demand for repayment of all amounts due under the Promissory Note and/or the
Unsecured Promissory Note executed by the principal applicant and co-applicant in conjunction with the
Agency’s Home Improvement Program.


THE FOLLOWING PERSONS ARE OVER THE AGE OF 18 AND DO NOT RECEIVE ANY INCOME:


PRINT NAME:                                                      SOC. SEC. #:

SIGNATURE:                                                                 DATE:


PRINT NAME:                                                      SOC. SEC. #:

SIGNATURE:                                                                 DATE:


PRINT NAME:                                                      SOC. SEC. #:

SIGNATURE:                                                                 DATE:



Applicant Signature:                       Date:       Co-Applicant Signature:                     Date:




                                                                                                           23
                                                            EXHIBIT O

                                 CITY OF CORONA REDEVELOPMENT AGENCY
                    HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
        400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                               AUTHORIZATION FOR RELEASE OF INFORMATION

I/We,  ___________________________________________________,                  the undersigned, hereby authorize
       PRINT NAME(S)
_____________________________________________________________, to release without liability to the
TO BE FILLED IN BY AGENCY OR AGENT
Redevelopment Agency of the City of Corona or its agents, any and all information that may be requested.
                                            INFORMATION COVERED
I understand that, depending on program policies and requirements, previous or current information regarding my
household or myself may be needed. Verification and inquiries that may be requested include, but are not limited to:

    Identity and Marital Status                  Medical or Child Care Allowance               Residences and Rental Activity
    Employment, Income, and                      Credit and Criminal Activity
    Assets
                                GROUPS OR INDIVIDUALS THAT MAY BE ASKED
The groups or individuals that may be asked to release information include, but are not limited to:

    Previous Landlords                           Courts and Post Offices                        Schools and Colleges
    (including Public Housing
    Agencies)
    Law Enforcement Agencies                     Support and Alimony Providers                  Past and Present Employers
    Welfare Agencies                             State Unemployment Agencies                    Social Security Administration
    Medical and Child Care                       Banks and other Financial                      Retirement Systems
    Providers                                    Institutions
    Credit Providers and Credit                  Utility Companies                              Veterans Administration
    Bureaus

I understand that this authorization cannot be used to obtain any information about me that is not pertinent to my
eligibility for, and continued participation in, the Agency’s Home Improvement Program.

CONDITIONS—I agree that a photocopy of this authorization may be used in place of the original for the purposes stated above.
The original of this authorization is on file and will remain in effect for a year and one month from the date signed. I understand I
have a right to review my file and correct any information that I can prove is incorrect.
SIGNATURES REQUIRED—Applicant, Co-Applicant, and ALL Adult Household Members

PRINT NAME:                                                                  SOC. SEC. #:

SIGNATURE:                                                                            DATE:

PRINT NAME:                                                                  SOC. SEC. #:

SIGNATURE:                                                                            DATE:

PRINT NAME:                                                                  SOC. SEC. #:

SIGNATURE:                                                                            DATE:

PRINT NAME:                                                                  SOC. SEC. #:

SIGNATURE:                                                                            DATE:
25
                                                   EXHIBIT Q

                                CITY OF CORONA REDEVELOPMENT AGENCY
                   HOME IMPROVEMENT PROGRAM GRANT/LOAN APPLICATION
       400 S. VICENTIA AVE. #310, CORONA, CA, 92882 PHONE (951) 736-2260 FAX (951) 736-2488

                               CONSENT TO RELEASE PHOTOGRAPHS


APPLICANT NAME: ____________________________________________________________________

I, the undersigned, give my consent for the City of Corona Home Improvement Program to release before
and after photographs of my residence located at:

____________________________________________________________________________________.
(Address of property to be improved)


I realize that said photographs may/will be presented by the City of Corona and the Redevelopment
Agency of the City of Corona for promotional purposes, flyers, and in presentations of various types. Also, I
understand that the Agency will withhold my name and address in order to maintain my privacy.


Applicant Signature:                       Date:       Co-Applicant Signature:                      Date:




                                                                                                            26

				
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