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Scotts Valley Town Center Collection Application Affidavit 2012-11-12

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Scotts Valley Town Center Collection Application Affidavit 2012-11-12 Powered By Docstoc
					Scotts Valley Affordable Housing Program
C/O Housing Authority of the County of Santa Cruz
2931 Mission Street                                                                  FTH#
Santa Cruz, CA 95060-5709
(831) 454-9455
                                                                                     Applicant:



                  Scotts Valley Affordable Housing Program Application / Application Affidavit

             THERE ARE IMPORTANT LEGAL CONSEQUENCES TO THIS LEGAL AFFIDAVIT:
                            READ IT CAREFULLY BEFORE SIGNING

I (We) the undersigned, as part of my (our) application for the Scotts Valley Affordable Housing Program ("AHP")
submitted to the Housing Authority of the County of Santa Cruz, ("Authority"), on behalf of the City of Scotts Valley
(“City”) to determine that I (we) are eligible to purchase an affordable home in the City of Scotts Valley, being first
duly sworn, state the following:

        I (We) certify that the following are:

        a. My (Our) legal name(s)
                                          Buyer's/Renter’s Name                                    Social Security Number



                                          Buyer's/Renter’s Name                                    Social Security Number


        b. Current residence:
                                          Current Street Address                        City, State, Zip Code



                                          Phone numbers where you can be contacted


1.      PREFERENCE CRITERIA
I (We) understand that this project is developed in accordance with the Scotts Valley Affordable Housing Program and
as such the following Preference Criteria is used in the determination of purchaser/renter eligibility to participate in
the Affordable Housing Program. Based on the information contained herein, a determination will be made regarding
the appropriate preference criteria for the household.

1.      Live and Work in Scotts Valley - A household which currently includes at least one adult member whose
        primary work location is with the city limits of the City of Scotts Valley and who has been working in Scotts
        Valley for a minimum of six (6) months, and the household has resided in the City of Scotts Valley for a
        minimum of six (6) months prior to the date of application for eligibility to participate in the Scotts Valley
        Affordable Housing Program.

2.      Live in Scotts Valley - A household which currently has resided within the city limits of the City of Scotts
        Valley for a minimum of six (6) months prior to the date of application for eligibility to participate in the Scotts
        Valley Affordable Housing Program.




                                                                                                                            Pg. 1 of 8
3.     Work in Scotts Valley - A household which currently includes at least one adult member whose primary work
       location has been within the city limits of the City of Scotts Valley for a minimum of one (1) year prior to the
       application for eligibility to participate in the Scotts Valley Affordable Housing Program, and includes at least
       one adult household member who shall be working within the city limits in the City of Scotts Valley at the time
       of occupancy of the unit.

4.     Live and Work in Santa Cruz County: A household which currently contains at least one (1) adult member who
       works within the County of Santa Cruz and the household has resided in the County of Santa Cruz for a
       minimum of one (1) year prior to the date of application for eligibility to participate in the Scotts Valley
       Affordable Housing Program.

5.     Live in Santa Cruz County: A household which currently has resided in the County of Santa Cruz for a
       minimum of six (6) months prior to the date of the application for eligibility to participate in the Scotts Valley
       Affordable Housing Program.

6.     Work in Santa Cruz County - A household which currently includes at least one adult member whose primary
       work location has been in the County of Santa Cruz for a minimum of one (1) year prior to the application for
       eligibility to participate in the Scotts Valley Affordable Housing Program, and includes at least one adult
       household member who shall be working in the County of Santa Cruz at the time of occupancy of the unit.

7.     All Others: A household which does not meet any of the above listed Preference Criteria.

2.     FIRST TIME HOME BUYER (section 1. This section only applies to those individuals applying to purchase
       a home)

I (We) understand that I (we) am (are) not eligible under this program, if I (we) individually or together had an
ownership interest in a residence within three years prior to                            (date of application). I (We) also
understand that I (we) cannot have a present ownership interest in a residence between the date of application and
closing. For this purpose, a residence includes a single-family residence, condominium, share in a housing cooperative,
any manufactured home or mobile home (as defined under federal and state law), or occupancy in a two to four family
residence owned by me (us). For this purpose, a present ownership interest means ownership by any means, whether
outright or partial, including property subject to mortgage or other security interest. A present ownership interest also
means a fee simple ownership interest, a joint ownership interest by joint tenancy in common, or tenancy by the
entirety, or a life estate interest. I (We) certify that I (we) have listed below all places of residence, whether owned or
not, for a three-year period prior to(date of application) ________________________________.

       Previous Residences (Over the Preceding Three-year Period)

        Address, City, State of              Indicate If Unit Was Owned,              Date of Residency (From/To:)
             Residence                      Rented, or Other * (See Below)




       *All answers of "Other" must be fully explained; use additional paper if necessary.




                                                                                                              Pg. 2 of 8
Name, Address and Telephone of the Owner or Landlord Who Can Verify Each Residence Listed Above Which Was
Not Owned by the Applicant:
      Name                               Address, City, State               Telephone




2.   INCOME

      INCOME DEFINITION
      The `gross income' of an applicant (as defined by Revenue Ruling 86-124 of the Internal Revenue Code) is the
      applicants annualized gross income. Annualized gross income is the sum of monthly income multiplied by 12.
      Gross monthly income is the sum of monthly gross pay; any additional income from overtime, part-time
      employment, bonuses, dividends, interest, royalties, pensions, Veterans Administration (VA) compensation,
      net rental income, etc.; and other income (such as alimony, child support, public assistance, sick pay, social
      security benefits, unemployment compensation, income received from trusts, and income received from
      business activities or investments).

      The income to be taken into account in determining `gross income' is income of the applicant (borrowers) and
      any other person who is expected to either (1) live in the residence being financed and/or (2)for purchasing,
      to be secondarily liable on the First Mortgage Loan. If the co-applicant, co-signer, or co-habitant meets either
      of the requirements in the sentence above, include his/her income in your gross income calculations. Income
      includes the income of both spouses.

      The City of Scotts Valley reserves the right, for purchasers, to approve, on a case by case basis, any proposed
      co-borrower or co-signer who does not intend to occupy the residence.

      NOTE: Complete each statement/question as applicable. If a statement/question is not applicable, write
      “not applicable” in the space provided.

      Buyer's/Renter’s Employer Name

      Employer Street Address
                                     City                          Zip Code

      Address where work performed if different from above

      Employer Phone (      )                             Employment Start Date

      Number of hours worked per week

      Gross Income (before deductions) $
      Circle one: hour/week/month/annual (Please include overtime, tips, commissions, bonuses, etc.

      Co-Buyer's/Co-Renter’s Employer Name

      Employer Street Address
                     City                        Zip Code

                                                                                                         Pg. 3 of 8
       Address where work performed if different from above

       Employer Phone (          )                                Employment Start Date

       Number of hours worked per week

       Gross Income (before deductions) $
       Circle one: hour/week/month/annual (Please include overtime, tips, commissions, bonuses, etc.)

       Telephone:       (work)                           (home)

       OTHER INCOME

       Source of other income                                         Amount received $
       (AFDC, Social Security, SSI, Family Support, etc.)                                   (weekly/monthly)

       Name of Recipient(s)

       Child Support Income $                                (weekly/monthly)

       TOTAL GROSS YEARLY INCOME OF ENTIRE HOUSEHOLD:                                     $___________________

3.     ASSETS

       The actual earned income from assets, or an imputed annual earned interest of two percent (2%), will be
       considered when determining annual income for program applicants.

       List all assets of all household members. Examples: house, lots and acreage, stocks, bonds, certificates of
       deposit, mobile home, inheritance, promissory notes from selling property, cash in safety box.

     Bank Name & Address                         Acct.                   Acct. Type         Balance/Account Value

                                                                             Checking



                                                                              Savings




       Additional Asset                                           Value $
       Additional Asset                                           Value $




                                                                                                                    Pg. 4 of 8
4.     FAMILY COMPOSITION

     Name                                           Birth date:               Social Security Number:                   Relation to Applicant:

                                                                                                                        APPLICANT




5.     PROPERTY INFORMATION / RESIDENCE BEING PURCHASED/RENTED

       The Residence being purchased/rented is located at the following address:

       ______________________________________________________________________________________
                            Street Address


       ______________________________________________________________________________________
                            City, State, Zip Code


       Assessor’s Parcel Number (APN), which is the nine-digit number located on the real property tax bill ___________ – ___________ – _______

       Approximate square footage _______________________

       Number of bedrooms ___________                         Number of bathrooms _______________

       Type of residence    _______ Single Family Home              Condominium              Other



6.     CERTIFICATIONS

Section A for purchasors only

       A1.       I (We) certify by signature(s) below that the Residence will be occupied and used as my (our) principal
                 place of residence within sixty (60) days after the date of the acquisition loan closing. I (We) certify
                 that the Residence will not be used as an investment property, vacation home, or recreational home and
                 that not more than 15% of the area of the Residence will be used in a trade or business. I (We) certify
                 that I (we) will notify all concerned parties, including but not limited to the Housing Authority, The
                 City, and the lender providing the acquisition loan, in writing , if the residence ceases to be my (our)
                 principal Residence. I (We) understand that the City may impose conditions on occupancy of the
                 residence based upon the Covenants, Conditions and Option to Purchase Agreement which is required
                 pursuant to the City’s Affordable Housing Program.

       A2.       I (We) certify by signature(s) below that we are required to and will hereby submit true and complete
                 copies of my (our) actual signed federal tax returns as filed for the preceding three (3) tax years or such
                 other written verification that is acceptable to the City’s Affordable Housing Program.
                                                                                                                                            Pg. 5 of 8
       A3.     I (We) certify by signature(s) below that the total purchase price of the residence and land as a
               completed residence, including, if applicable, all construction items, all commissions, all builder's fees,
               hook-up and tap-in fees, permits, architectural fees, all site improvements, discount points paid by the
               seller, work credit, subcontracted items, or construction loan interest, but excluding any closing costs
               and permanent financing charges, will be $____________.

       A4.     I (We) further certify by signature(s) below that no additional agreement, either verbal or written, or
               understood, is presently contemplated for the completion of or for the addition to this Residence unless
               the estimated cost of the completion and/or addition is included in the purchase price.

       A5.     I (We) certify by signature(s) below that no portion of the financing of the acquisition of the Residence
               is or will be provided from the proceeds of a qualified mortgage bond. No person related to me (as
               defined in applicable federal or state laws and regulations) has or is expected to have, an interest as a
               creditor in the acquisition loan being acquired for the Residence.
       A6.     I (We) understand and agree by signature(s) below that I may seek financing from any lender of my
               choosing and that I (we) am (are) in no way prohibited from seeking financing from any potential
               lender.

       A7.     I (We) understand by signature(s) below that the decision to make an acquisition loan is completely
               within the discretion of the lender to whom I (we) apply for a loan. Neither of the City nor The Housing
               Authority of the County of Santa Cruz play a role in the primary lender’s decision to make an
               acquisition loan nor the amount of that loan.

Section B for purchasors and renters
       B1.     I (We) understand by signature(s) below that I (we) am (are) not eligible to participate in the City’s
               Affordable Housing Program unless my (our) gross annual household income as defined below (State
               of California Income Limits for Santa Cruz County, Effective February 1, 2012), does not exceed the
               amounts listed in the row which has been circled:

                    Household Size     1          2         3         4          5          6          7            8

                      80% Median     $53,700   $61,350   $69,000   $76,650    $82,800    $88,950    $95,050      $101,200
                      Low-Income

                    120% Median      $73,100   $83,500   $93,950   $104,400   $112,750   $121,100   $129,450     $137,800
                  Moderate-Income


       B2.     I (We) certify by signature(s) below that my (our) current gross annual household income as defined
               above is $                .

       B3.     I (We) understand by signature(s) below that the decision to make an acquisition loan is completely
               within the discretion of the lender to whom I (we) apply for a loan. Neither of the City nor The Housing
               Authority of the County of Santa Cruz play a role in the primary lender’s decision to make an
               acquisition loan nor the amount of that loan.

       B4..    (We) acknowledge and understand by signature(s) below that this Affidavit will be relied upon for
               purposes of determining my (our) eligibility for participation in the Affordable Housing Program. I
               (We) acknowledge that a material misstatement negligently made in this affidavit or in any other
               statement made by me (us) in connection with an application for participation in the Affordable Housing
               Program will result in a denial of my (our) application for participation.
                                                                                                               Pg. 6 of 8
7.       CERTIFICATION/SIGNATURE

       I (We) understand that the information provided in this City of Scotts Valley Affordable Housing Program
       Application/Application Affidavit will be used to determine my (our) eligibility for the City’s Affordable Housing
       Program. I (We), therefore, certify that all the information herein is true and correct to the best of my (our)
       knowledge. I (We) also indicate by signing below that we understand the terms and conditions of the City of
       Scotts Valley Affordable Housing Program as described in this Application Affidavit.



                 Applicant Signature                                                Date




                 Co-Applicant Signature                                             Date


       Social Security #(s)___________________ _________________________

       Witness

       Witness


 (Please be sure to complete #8and #9 below).


 8.       LENDER'S CERTIFICATION (for purchasors only)

 The Lender hereby certifies that to the best of its knowledge and belief each of the foregoing statements is
 true and correct and each of them is consistent with the information submitted by the applicant in connection
 with his/her application for a loan.

 Dated

 Lender/Mortgage Company Name:            ________________________________________________

 By:                                                     Title

 NOTE: This form MUST be signed, dated, and witnessed.




                                                                                                           Pg. 7 of 8
9.
                                       INFORMATION FOR GOVERNMENT MONITORING PURPOSES


The following information is requested by the Federal Government for certain types of programs related to a dwelling, in order
to monitor the Program's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws.

You are not required to furnish this information, but are encouraged to do so. The law provides that you may not be
discriminated against on the basis of this information, nor based on whether or not you choose to furnish it. Under Federal
regulations, if applicable, this Program Administrator is required to note race and sex on basis of visual observation or surname.
If you do not wish to furnish the above information, please check the box below.

                           APPLICANT                                                         CO-APPLICANT


                G I do not wish to furnish this information                       G I do not wish to furnish this information

                Race:                                                             Race:

                G American Indian/Alaskan Native                                  G American Indian/Alaskan Native

                G Asian                                                           G Asian

                G Black/African American                                          G Black/African American

                G W hite                                                          G W hite

                G Native Hawaiian/Other Pacific Islander                          G Native Hawaiian/Other Pacific Islander

                Ethnicity:                                                        Ethnicity:

                G Hispanic                                                        G Hispanic

                G Non-Hispanic                                                    G Non-Hispanic

                Gender:                                                           Gender:

                GFemale                                  GMale                    GFemale                    GMale




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