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COUNTY OF YUBA

VIEWS: 35 PAGES: 11

									COUNTY OF YUBA HOUSING REHABILITATION ASSISTANCE PROGRAM
It is our policy to provide equal housing opportunities to all qualified persons without regard to race, age, color, sex, religion, national origin, marital status, or handicap. APPLICANT: 1) Single Head of Household Investor-Owned Handicapped/Disabled

⌂ Yes ⌂ No ⌂ Yes ⌂ No ⌂ Yes ⌂ No ⌂ Rental Units

TYPE OF PROPERTY: ⌂ Single Family, Owner Occupied TYPE: ⌂ Duplex

⌂ Single-Family

⌂ Resident-Owner

PROPERTY ADDRESS: ___________________________________________________________________________________________________ SIZE OF FAMILY: (Number of persons residing in household) CHECK APPLICABLE BOX:
 White  Black/African American  Asian  American Indian or Alaska Native  Native Hawaiian or Pacific Islander  American Indian or Alaska Native AND White  Asian AND White  Black/African American AND White  American Indian/Alaska Native AND Black/African HISPANIC/LATIINO ETHNICITY:  Yes  Yes, Mexican/Chicano  No  Yes, Puerto Rican  Yes, Other, Hispanic/Latino:

 Yes, Cuban

The information concerning minority group categories, sex, martial status, and age is required for statistical purposes so th e department may determine the degree to which its programs are being utilized by minority families and for other evaluation studies.

APPLICANT:
_____________________________________________________________________________________________________________________________________

First Name Current Street Address City Former Street Address Social Security No. DEPENDENTS: Number:_____

Middle Apt No. State Apt. No Home Telephone No. Ages: Under 12Yrs /  Married

Last Name Time at Address Zip Code Time at Address Drivers License No.

_____________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________

_______________________________________________________________________

EDUCATION: (CIRCLE ONE) BIRTH DATE: CO-APPLICANT: /

12 Yrs

13-15 Yrs

16 Yrs - +

 Unmarried (Include single, separated, divorced, widowed)

_____________________________________________________________________________________________________________________________________

First Name Current Street Address City Former Street Address Social Security No. DEPENDENTS: Number:_____

Middle Apt No. State Apt. No Home Telephone No. Ages: Under 12Yrs /

Last Name Time at Address Zip Code Time at Address Drivers License No.

_____________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________

_______________________________________________________________________

EDUCATION: (CIRCLE ONE) BIRTH DATE: /

12 Yrs

13-15 Yrs

16 Yrs - +

 Married  Unmarried (Include single, separated, divorced, widowed)

EMPLOYMENT AND INCOME INFORMATION (Attach a copy of payroll stub). If self-employed or commissions, attach financial statement and a signed copy of most recent income tax return. *Spousal, child support or maintenance income need not be listed unless it is to be considered for granting credit. APPLICANT (INCOME): _________________________________________________________________________________________ Current Employer (Include Employee I. D. No. if applicable) _________________________________________________________________________________________ Address City State Zip Yrs. Mos. _$____________________ Employed Telephone Number Monthly Income (Gross) $ ____________________ Other Income (Earned) Monthly Income (Gross) __________________________________________________________________________________________ Position/Title/Type of Business Is any of this income likely to be reduced before the credit requested is paid off? (If yes, explain how long and the amount involved on a separate sheets). CO-APPLICANT (INCOME): ____________________________________________________________________________________________ Current Employer (Include Employee I. D. No. if applicable) ____________________________________________________________________________________________ Address City State Zip ____$___________________ Monthly Income (Gross) ____$_________________ Other Income (Earned) Monthly Income (Gross) _____________________________________________________________________________________________ Position/Title/Type of Business Telephone Number Yrs. Mos. Employed

Is any of this income likely to be reduced before the credit requested is paid off? ⌂ Yes ⌂ No (If yes, explain how long and the amount involved on a separate sheet). ADDITIONAL INFORMATION (Please completed the attached Assets and Liabilities Form) Alimony, Child Support, Separate Maintenance, Payment Obligations to whom paid: _________________________ _______________________________________________________________________________________________ How long paid? Amount Paid? _________________________________________ Have you ever applied for credit in another name? ⌂Yes Are all debts listed? ⌂ No If yes, what name: ___________________________

⌂ Yes ⌂ No Is any debt past due? Have you ever filed a petition under the bankruptcy act? ⌂ Yes ⌂ No

⌂Yes ⌂ No

Have you ever had a loan collateral repossessed? PROPERTY INFORMATION

⌂ Yes

⌂ No

Property to be improved - A.P.: ________________________________________________________________ Property Address: __________________________________________ Date Purchased: ________________ Purchased Price: _____________________________ Estimated Value: ________________ _______________ 1st Mortgage Balance: Monthly Payment: Name/Address Mortgagee: ____________________________________________________________ nd 2 Mortgage Balance: Estimated Value: Name/Address Mortgagee: Lot Size: Age of Property: Bedrooms: Baths:

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AVERAGE HOUSING EXPENSES: Hazard Insurance: UTILITIES: Gas/Electric: Garbage:

(Property to be improved) Property Taxes: __________________ Water: Maintenance: Sewer: _______ __________

FORECLOSURE: Has any obligations for home loan or home improvement loan resulted in foreclosure, deed in lieu of foreclosure or judgment  Yes  No INSURANCE: Insurance Company: Policy No.: ________ Agent: CERTIFICATION: I hereby certify that I have read the foregoing information, or it has been read to me, and the information given is complete, true, and correct to the best of my knowledge and belief. I have no objections to inquiries being made for the purpose of verifying the statements made herein. The rehabilitation assistance program has been explained to me and I understand the following approval of any assistance, I will be required to pay certain fees necessary for the completion of the assistance transaction. I hereby indicate that I am willing to pay all such fees as the lot book report, title report fee, title insurance fee, escrow account fee, credit report fee(s), appraisal fee and recording fees. In addition, I understand that I will be required to provide proof of adequate fire and personal liability insurance coverage in order to receive any assistance from Yuba County.

Address:

______________

Amount of coverage: $____________

Date

_______________________ Applicant Signature

Date

___________________________ Co-Applicant Signature

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ASSETS AND LIABILITIES
This statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Borrower section was completed about a spouse, this Statement and supporting schedules completed about that spouse also.___ Completed Jointly _____ Not Completed____________ Liabilities and Pledged Assets. List the creditor’s name, address, and acct. no for all debts, including loans, revolving charge, real estate loans Alimony, child support, stock pledges. Use continuation sheet if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of Real estate owned or upon refinancing of the subject property.

ASSETS Description
Cash deposit toward purchase held by:

CASH OR MARKET VALUE
$ ______________

___________________________________________________LIABILITIES List checking and savings accounts below Name & Address of Bank, S & L or Credit Union Name and Address of Company

MONTHLY PAYMENTS $ Payments/Mos.

UNPAID BALANCE $_________________

Name & Address of Bank, S & L or Credit Union

Name and Address of Company

$ Payments/Mos.

$_________________

Name & Address of Bank, S & L or Credit Union

Name and Address of Company

$ Payments/Mos.

$______ _________

Name & Address of Bank, S & L or Credit Union

Name and Address of Company

$ Payments/Mos.

$___________________

Stocks & Bonds (Company Name/Number & Description)

Name and Address of Company

$ Payments/Mos.

$__________________

Life Insurance Net Cash Value $ ______

Name and Address of Company

$ Payments/Mos.

$__________________

Real Estate owned (enter market value from schedule of real estate owned $ ________

Vested interest in retirement fund Net worth of business(es) owned (attach financial statement) Automobiles owned (make and year)

$

Name and Address of Company

$ Payments/Mos

___ $________________

$__________________________________________________________________________

______________________________________________ Other Assets (Itemize) $

Name and Address of Company

$ Payments/Mos________$__________________

Name and Address of Company

$ Payments./Mos

$__________________

______________________________________________ COMMENTS:

______________________________________________________________
Alimony/Child Support/Separate Maintenance Payments Owed to: $

_______________________ _______________________________________
Job Related Expenses (child care, union dues, etc.)

$

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COUNTY OF YUBA COMMUNITY DEVELOPMENT & SERVICES AGENCY

APPLICANT INFORMATION Applicant: Co-Applicant: Household Members Relationship __________ __________ __________ _________ ____ ____ Age ____ ____ ____ ____ Age: _______ SSN: _______________

Age: ________ SSN: _______________ SSN ____________ ____________ ____________ ____________ School _________________ _________________ _________________ _________________

Indicate sources of and amount of household income. Include copies of payroll stubs for past four months and private signed copies of Federal Tax Returns for the past two years. Source: $ ____________

Source: $ ________________ (Attach a separate sheet if you need to provide additional information) How long have you lived within the Yuba County Area? ______________

I/We understand that by signing this form that the County of Yuba through its representatives, may verify all the information given in this application. I/We understand that any misinterpretation may result in disqualification from the program. ______________________________________ Applicant Signature ______________________________________ (Printed Applicant Name) ______________________________________ Date Co-Applicant Signature

Date

(Printed Co-Applicant Name)

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COUNTY OF YUBA COMMUNITY DEVELOPMENT & SERVICES AGENCY FAIR LENDING NOTICE
TO: All applicants for financial assistance for the purchase, construction, rehabilitation, improvement or refinancing of one-to-four family residences.

At is unlawful, under the Housing Financial Discrimination Act of 1977, for a public agency to consider any of the following in determining whether or not, or under what terms and conditions, to provide or arrange for financial assistance: 1. Neighborhood characteristics (such as the average age of the homes or the income level in the neighborhood), to a limited extent necessary to avoid an unsafe and unsound business practice. Race, sex, color, religion, marital status, national origin, or ancestry.

2.

It is also unlawful to consider, in appraising a residence, the racial, ethnic, or religious composition of a particular neighborhood or whether or not such a composition is undergoing change or is expected to undergo change. If you wish to file a complaint, or if you have questions about your rights, contact: Comptroller of the Currency Administrator of National Banks Fourteenth National Bank Region Consumer Complaint Department Steuart Street Tower, Suite 2101 One Market Plaza San Francisco CA 94105 I/We have read this notice and understand a copy is available to me/us.

__________________________________________ Applicant Signature Date

________________________________________ Co-Applicant Signature Date

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COUNTY OF YUBA COMMUNITY DEVELOPMENT & SERVICES AGENCY 915 8th Street, Marysville CA 95901 (530) 741-5460 - Fax (530) 749-5464
Applicant Name: Date of Birth: ________________________________________________________ ___________________________________________________________ ___________________________________________________

Social Security Number: Co-Applicant Name: Date of Birth:

______________________________________________________

__________________________________________________________

Social Security Number:

___________________________________________________

Physical Address: __________________________________________________________________________ Address City State Zip Code ________________________________________________________________________ Mailing Address: (if different) _________________________________________________________________________ P.O. Box City State Zip Code

By signing below, I/We authorize Yuba County Community Development Department to verify any an all sources of income, assets and expenses as required determining my/our eligibility for the Community Development Block Grant Housing Rehabilitation Assistance Program. In addition, I/We authorize Yuba County Community Development Department to provide my/our name, address and telephone number to Community Resource Project so they may contact me/us regarding possible rehabilitation grants. I agree photocopies of this authorization may be used for the purposes stated. This authorization shall be effective for six (6) months from the date of signature. ________________________ Applicant Signature ____ Date ________________________ Co- Applicant Signature

Date

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Authorization for the Release of Information U. S. Department of Housing Privacy Act Notice and Urban Development
to the U. S. Department of Housing and Urban Development (HUD) Office of Public and Indian Housing and the Yuba County Community Development Department
PHA requesting release of information: (Cross out space if none) (Full address, name of contact person, and date) IHA requesting release of information: (Cross out space if none) (Full address, name of contact person, and date)

YUBA COUNTY COMMUNITY DEVELOPMENT CDBG - REHABILITATION PROGRAM TH 938 14 STREET MARYSVILLE CA 95901

Authority: Section 904 of the Stewart B. McKinney Homeless Assistance Amendments Act of 1988, as amended by Section 903 of the Housing and Community Development Act of 1992 and Section 3003 of the Omnibus Budget Reconciliation Act of 1993. This law is found a 42 U.S.C. 3544. This law requires that you sign a consent form authorizing: (1) HUD and the Housing Agency/Authority (HA) to request verification of salary and wages from current or previous employers: (2) HUD and the HA to request wage and unemployment compensation claim information from the state agency responsible for keeping that information: (3) HUD to request certain tax return information from the U.S. Social Security Administration and the U. S. Internal Revenue Service. The law also requires independent verification of income information. Therefore, HUD or the HA may request information from financial institutions to verify your eligibility and level of benefits. Uses of Information to be Obtained: HUD is required to protect the income information it obtains in accordance with the Privacy Act of 1974.5 U.S.C. 552a. HUD may disclose information (other than tax return information) for certain routine uses, such as to other government agencies for law enforcement purposes, to Federal agencies for employment suitability purposes and to Has for the purpose of determining housing assistance. The HA is also required to protect the income information it obtains in accordance with any applicable State privacy law. HUD and HA employees may be subject to penalties for unauthorized disclosures or improper uses of the income information that is obtained based on the consent form. Private owners may not request or receive information authorized by this form. Who Must Sign the Consent Form: Each member of your household who is 18 years of age or older must sign the consent form. Additional signatures must be obtained from new adult members joining the household or whenever members of the household become 18 years of age. Persons who apply for or receive assistance under the following programs are required to sign this consent form: PHA-owned rental public housing Turnkey III Homeownership Opportunities Mutual Help Homeownership Opportunity Section 23 and 19(c) leased housing Section 23 Housing Assistance Payments HA-owned rental Indian Housing

Section 8 Rental Certificate Section 8 Rental Voucher Section 8 Moderate Rehabilitation

Failure to Sign Consent Form: Your failure to sign the consent form may result in the denial of eligibility or termination of assisted housing benefits, or both. Denial of eligibility or termination of benefits is subject to the HA’s grievance procedures and Section 8 informal hearing procedures. Sources of Information To Be Obtained: State Wage Information Collection Agencies (This consent is limited to wages and unemployment compensation I have received during period(s) within the last 5 years when I have received assisted housing benefits.) U. S. Social Security Administration (HUD only) (This consent is limited to the wage and self employment information and payments of retirement income as referenced at Section 6103(1) (7) (A) of the Internal Revenue Code.) U. S. Internal Revenue Service (HUD only) (This consent is limited to unearned income [i.e.: interest and dividends].) Information may also be obtained directly from: (a) current and former employers concerning salary and wages and (b) financial institutions concerning unearned income (i.e.: interest and dividends). I understand that income information obtained from these sources will be used to verify information that I provide in determining eligibility for assisted housing programs and the level of benefits. Therefore, this consent form only authorizes release directly from employers and financial institutions of information regarding any period(s) within the last 5 years when I received assisted housing benefits.

Consent: I consent to allow HUD or the HA to request and obtain income information from the sources listed on this form for the purpose of verifying my eligibility and level of benefits under HUD’s assisted housing programs. I understand that Has that receive income information under this consent form cannot use it to deny, reduce or terminate assistance without first independently verifying what the amount was, whether I actually had access to the funds and when the funds were received. In addition, I must be given an opportunity to contest those determinations. This consent form expires 15 months after signed. Signatures:

Head of Household

___________________ Date
Social Security Number (if any) of Head of Household

Other Family Member over age 18 Date

Spouse

Date

Other Family Member over age 18

Date

Other Family Member over age 18

Date

Other Family Member over age 18

Date

Other Family Member over age 18

Date

Other Family Member over age 18

Date

Privacy Act Notice. Authority: The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S. Housing Act of 1937 (42 U.S.C. 1437 et.seq.). Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and by the Fair Housing Act (42 U.S.C. 3601-19). The Housing and Community Development Act of 1987 (42 U.S.C. 3543) requires applicants and participants to submit the Social Security Number of each household member who is six years old or older. Purpose: Your income and other information are being collected by HUD to determine your eligibility, the appropriate bedroom size, and the amount your family will pay toward rent and utilities. Other Uses: HUD uses your family income and other information to assist in managing and monitoring HUD-assisted housing programs, to protect the Government’s financial interest, and to verify the accuracy of the information you provide. This information; may be released to appropriate Federal, State, and local agencies, when relevant, and to civil, criminal, or regulatory investigators and prosecutors. However, the information will not be otherwise disclosed or released outside of HUD, except as permitted or required by law. Penalty: You must provide all of the information requested by the HA, including all Social Security Numbers of all household members six years of age and older is mandatory, and not providing the Social Security Numbers will affect your eligibility. Failure to provide any of the requested information may result in a delay or rejection of your eligibility approval.

Penalties for Misusing this Consent:

HUD, the HA and any owner (or any employee of HUD, the HA or the owner) may be subject to penalties for unauthorized disclosures or improper uses of information collected based on the consent form. Use of the information collected based on the form HUD 9886 is restricted to the purposes cited on the form HUD 9886. Any person, who knowingly or willfully requests, obtains or discloses any information under false pretenses concerning an applicant or participant may be subject to a misdemeanor and fined not more than $5,000. Any applicant or participant affected by negligent disclosure of information may bring civil action for damages, and seek other relief, as may be appropriate, against the officer or employee of HUD, the HA or the owner responsible for the unauthorized disclosure or improper use.

Original is retained by the requesting organization

ref. Handbooks 7420.7 7420.8 & 7465.1

form HUD-9886 (7/94)

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U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Section 8 Rental Assistance Programs/CDBG Rehabilitation Programs HOMES CONSTRUCTED PRIOR TO 1978 If this housing was constructed before 1978, there is a possibility that it may contain lead based paint. WATCH OUT FOR LEAD PAINT POISONING

Children get lead poisoning when they eat bits of paint that contain lead. If a child eats enough lead paint, his brain will be damaged. He/she may become mentally retarded or even die. Older houses and apartments often have layers of lead paint on the walls, ceilings and woodwork. When the paint chips off or when the plaster breaks, there is read danger for babies and young children. Outdoors, lead paints and primers have been used in many places, such as on walls, fences, porches, and fire escapes. If you have seen your child putting pieces of paint or plaster in his mouth, you should take him/her to a doctor, clinic, or hospital as soon as possible. In the beginning stages of lead poisoning, a child may not seem really sick. Do no wait for signs of poisoning. Of course, a child might eat paint chips or chew on a pointed railing or window sill while parents aren’t around. Has your child been especially cranky? Is he eating very little? Does he throw up or have stomachaches often? These could be signs of lead poisoning. Take him/he to a doctor’s office or to a clinic. Be sure to tell the rest of your family and people who baby-sit for you about the danger of lead poisoning. Look at your walls, ceilings and woodwork. Are there places where the paint is peeling? If, so, get a broom or stiff brush and remove all the pieces of paint from the walls, woodwork and ceilings. Sweep up all the pieces of paint and plaster. Put them in a paper bag or wrap them in newspaper and put the package in the trash can. Always keep the floor clear of the loose bits of paint and plaster. Children will pick loose paint off walls, so be extra careful about keeping the lower parts of the walls free of loose paint. Report peeling paint to the management office immediately. Beware that when lead based paint is removed by scraping or sanding, a dust is created, which may be hazardous. The dust can enter the body by either breathing or swallowing. The use of heat or paint removers could create a vapor or fume which may cause poisoning if inhaled over a longer period of time. The removal of lead based paint should take place when there are no children and pregnant women on the premises. If you want to know more about how to keep your child safe from lead poisoning, talk to your doctor, public health nurse, or social worker at the clinic or health department. WHAT YOU CAN DO TO PROTECT YOUR CHILD AGAINST LEAD POISONING This dwelling may contain lead based paint. Lead is dangerous, especially to children under 7 years of age and to pregnant women and their fetuses. Even low levels of lead can slow a child’s normal development and cause learning and behavioral problems. You can help protect your child against lead poisoning by taking these steps: HAVE YOUR CHILD TESTED FOR LEAD POISONING _ Children with lead poisoning may have no signs or symptoms. If they complain, it may be about general things such as headaches or stomachaches. _ Because there are no signs or symptoms, you must have your child tested for lead poisoning on a regular basis. Simple blood tests to detect lead poisoning are available from health departments, clinics and private doctors. HELP YOUR CHILD AVOID LEAD IN PAINT AND DUST _ Keep your children away from peeling paint. Notify the housing authority right away when paint begins to peel. _ Wet mop floors and clean window sills and other surfaces to remove dust that may contain lead, using a cleaner high in phosphates if possible. Do not use a conventional vacuum cleaner, which can spread the very small lead dust around the home/apartment, for cleaning window wells or sills. Other areas where there is a lot of dust should be cleaned with a wet mop and a high phosphate detergent before vacuuming. _ Wash children’s hands before they eat. _ Wash objects that infants and children frequently put in their mouths. MAKE SURE YOUR CHILD EATS PROPERLY _ Make sure your child eats at least three meals a day; children’s stomachs absorb more lead when they are empty. _ Give your child foods rich in iron (lean meats, tuna, beans, eggs, greens), which protect the body against lead. _ Give your child foods rich in calcium (milk, cheese), which protect the child’s bones against lead. _ Avoid giving your child fatty foods (fried foods, chips), which allow the body to absorb lead faster.

CERTIFICATION I have received a copy of the Notice entitled “WATCH OUT FOR LEAD BASED PAINT POISONING”.

YUBA COUNTY HOUSING AUTHORITY 938 14 Street Marysville CA 95901
th

___________________________________ Print Full Name

_________________________________ Signature ____________________________________

Date

Date

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COUNTY OF YUBA 2007 COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM NOTICE TO APPLICANTS FOR REHABILITATION LOANS PLEASE READ CAREFULLY This notice is intended to provide basic information about the Community Development Block Grant Program (CDBG). The loan is intended to provide the necessary financial assistance to enable you to rehabilitate your home to bring it into compliance with local code requirements. This notice is intended to provide basic information about the CDBG loan. It is not a commitment for a loan. GENERAL INFORMATION: In applying for a CDBG loan, as with any loan, you will be asked to sign loan documents. When you have signed those documents and the loan is made, you will be bound by the terms of those loan documents, particularly the Promissory Note and Deed of Trust. You should become familiar with and understand the provision of the loan described in this notice. INTEREST RATE: The loan, offered by the County of Yuba with funds obtained from the State Department of Housing and Community Development, is a fixed-rate mortgage. Interest is calculated on the unpaid principal. The amount of interest will be decided by the Loan Committee at the time of approval. (3% to 5%). MONTHLY PAYMENT: Your payments of principal and interest will begin 30 days after close of escrow. There is no prepayment penalty on this loan. LOAN TERMS: Loan terms will be decided by the Loan Committee and may be fully amortized, partially amortized and partially deferred, or fully deferred. Depending on your economic condition, a deferred loan may be made that must be repaid only at the time of sale, conveyance, death, or transfer of ownership of the home, or in the event of default under the loan documents. All deferred loans are subject to five-year reviews, and may be changed to amortized loans if your economic conditions change. Deferred loans are not available to investor/owners. Amortized loans are generally for 15 years. COLLATERAL FOR LOAN: The loan advanced to you will be secured by a lien recorded against your home. The lien against your property will be in the form of Deed of Trust and will remain until such time AS ALL SUMS DUE ARE PAID IN FULL. LOAN AMOUNT: The maximum loan amount is $40,000, except for historic properties, which may be approved for a loan up to $50,000. The maximum loan amount may be waived only with approval to permit compliance with health and safety standards only if other program funds are available for the rehabilitation work. CONTRACTORS: Only licensed contractors in good standing with the California Contractors State License Board can be used to rehabilitate the unit. Contractors must have worker’s compensation and public liability insurance. INSURANCE: The applicant must maintain fire insurance on the property for the duration of the loan. In addition, the owner is required to maintain flood insurance on properties in areas designated by the U. S. Department of Housing and Urban Development (HUD) as flood prone. ELIGIBILITY CRITERIA: You are eligible for a CDBG loan if you meet the following requirements: 1. You own and occupy your home or your own a rental unit and agree to sign a Rent Limitation Agreement for a period of 5 years after the rehabilitation is completed. You hold title to your home or the rental unit, which is located within a designated program target area with Yuba County. Your income, or your tenant’s income, does not exceed the lower-income level as established for Yuba County and household size. Please contact the Yuba County Community Development Department at (530) 741-6390 to arrange an appointment to originate your loan. Yuba County has entered into an agreement with the State Department of Housing and Community Development regarding what their duties are in originating the loan with you. The consultant will answer any questions in connection with the loan. This notice is intended for informational purposes only. It is not a commitment or loan approval. Important information relating specifically to your loan will be contained in the loan documents.

I ACKNOWLEDGE THAT I HAVE READ THE ABOVE INFORMATION CONCERNING THE CDBG LOANS.

Applicant Co-Applicant Signature

__________________ Date _________________ Date

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