FHLBank Topeka AHP OWNER REHABILITATION
PO Box 176 DISBURSEMENT REQUEST
Topeka, KS 66601 Shaded sections not applicable to rehab disbursement
(785) 233-0507 Fax (785) 234-1765 requests
A. FHLB Member B. Owner
1. AHP Project # 1. Name
2. Project Name 2. Property Address
3. Institution 3. County
4. Contact 4. City, State Zip
5. Phone 5. Annual Income
6. Fax 6. Monthly Income
7. Email 7. % of Area Median
8. Household Size
C. Monthly Housing
1. Payment (P & I)
2. Taxes 7. Loan Amount
3. Insurance 8. Term in Months
4. Mortgage Insurance 9. Interest
6. Total Housing Cost 0 10. Front Ratio #DIV/0!
(Housing Cost/Monthly Income)
D. Uses of Funds E. Sources of Funds
1. Purchase Price 1. First Mortgage Lender Name
2. Rehabilitation Costs 2. First Mortgage Loan Amount
3. Closing Costs 3. Second Mortgage Loan
4. Homebuyer Counsel Fee 4. Borrower Down Payment
5. Other Specify_________ 5. Other Specify____________
6. Other Specify_________ 6. Other Specify____________
7. Other Specify_________ 7. AHP Funds Requested
8. Total Uses [Sum 1 - 7] $0.00 8. Total Sources [Sum 2 - 7] $0.00
Total Sources and Uses Must Be Equal and Should Agree To Closing/Settlement Statement
F. Required Documentation
Check if attached
1. Loan Application Form signed by borrower 5. Invoices, Bids Estimates to support rehab costs
2. Draft AHP Note and Mortgage/Deed of Trust 6. AHP Eligibility Checklist
3. Verification of Income Documentation 7. Closing date: ______________________________ Is at least
4. FHLB Income Calculation Worksheet 10 business days after submission of complete disbursement request?
G. Application Commitments and AHP Eligibility
Check all of the following scoring factors that apply to this unit or borrower and that have supporting documentation attached.
Application commitments are detailed in AHP Agreement.
1.Targeting: Household Income 10. Urban: Infill (post-2006)
< 50% of median Urban Rehabilitation
< 60% of median 11. Community Involvement: Tax Abatement
< 70% of median Fee Waiver
< 80% of median Volunteer Labor
2. Donated Property Private Contributions
3. Homeless Unit Zoning Changes/Variances (post-2006)
4. Empowerment: Mandatory Homeownership Counseling Infrastructure Improvements
Sweat Equity Private Contributions
5. Stability: Rehabilitation of Existing Home 12. District Priority
Infill Construction (pre-2007) Support Services: Health Services
Neighborhood Revitalization Plan Support Services: Credit Counseling
Other______________________ Support Services: Other
6. Rural Financial Support: HUD Pgms HOME, CDBG
7. Member Financial Participation___________________ Financial Support: Native Amer. Self Det Act
8. First-time homebuyer Check this box to certify that Financial Support: USDA
borrower is a first-time buyer Employment Related: Farm Worker
9. Special Needs: Large Units 3-BR (pre-2007) Employment Related: Employer Assisted
Disabled Employment Related: Non-metro econ. growth
Handicapped Accessible Housing 3-BR or larger
AHP Eligibility Check the following boxes to confirm compliance with these AHP eligibility requirements.
11. Retention Documents – Member acknowledge that the original executed note, final, signed settlement statement and
original executed and recorded AHP mortgage/deed of trust will be provided to FHLBank Topeka within 60 days of disbursement.
12. Project Sponsor – Project sponsor continues to be integrally involved in the projects as described in the approved application
13. Fair Housing – The affirmative fair housing marketing commitments made in the approved application remain in place for this project.
H. The above information concerning this homeowner or buyer is correct to the best of my knowledge.
This disbursement request meets AHP eligibility requirements, AHP regulations and is consistent with the commitments and terms of the approved
AHP application. AHP funds not provided to borrower within 60 days of disbursement must be returned to FHLBank Topeka.
Signature of Stockholder Representative Authorized to Sign for FHLB Topeka Borrowings Date
Printed Name and Title
For FHLB Use: Complete information was received to process this request on: _________________________________________________
Federal Home Loan Bank of Topeka
AHP Owner Disbursement Request
Section Item Instruction/Issues
A. FHLBank Member
A-1 AHP Project # Enter the AHP project number e.g. 2001B1022
A -2 Project Name Enter the project name
A-3 Institution Name Provide the name of the FHLB member stockholder institution
approved to participate in the AHP.
A-4 Contact Provide the name of the individual to be contacted with questions
regarding the AHP disbursement request submitted.
A-5 Phone Provide the area code and phone number of the contact person.
Please include extension if applicable.
A-6 Fax Provide the area code and fax number of the contact person.
A-7 Email Provide the email address of the contact person.
B-1 Name Provide the complete name/names of purchaser.
B-2 Property Address Provide the address of the property being purchased (do not list
purchaser's current address).
B-3 City, State, Zip List the city, state and zip for the property being purchased.
B-4 Annual Income Provide the borrower/borrowers current annual income. This
amount should agree to the income information submitted with
the disbursement request (i.e., pay stubs, VOE, child support,
SSI, etc.) If this amount does not equal documentation
submitted, please provide explanation.
B-5 Monthly Income Provide the borrower/borrowers current monthly income.
B-6 % of Area Median Using the most current income limits, find the appropriate county
and household size. Divide the annual income by the median
AMI for that household size. All borrowers must have incomes at
or below the income limits detailed in the AHP Agreement.
B-7 Household size Provide the number of people that will be living in the household.
This number should equal the household size indicated on the
C. Monthly Housing Costs
C-1 Payment (P&I) Provide the amount of the principal and interest payment. If this
amount is not a standard calculation please provide an
explanation of how P&I was calculated (i.e., subsidized
payments, Rural Development loans, etc.)
C-2 Taxes Provide the amount of the monthly tax payments. If detailed on
the settlement statement or good faith estimate, the amount
should be the same as indicated on the AHP disbursement
C-3 Insurance Provide the amount of the monthly insurance payments. If
detailed on the settlement statement or good faith estimate, the
amount should be the same as indicated on the AHP
C-4 Mortgage Insurance Provide the amount of the monthly mortgage insurance premium
if applicable. If detailed on the settlement statement or good faith
estimate, the amount should be the same as indicated on the
AHP disbursement request.
C-5 Other List other housing related expenses such as flood insurance, 2nd
mortgage payment amounts, homeowners association dues etc.
Utilities and other non-housing related debt should not be
C-6 Total Housing Cost This amount should equal the total of the monthly housing costs
listed in C-1 through C-5.
C-7 Loan Amount Provide the first mortgage loan amount. This amount must
agree to the amount detailed on the settlement statement or
good faith estimate.
C-8 Term Provide the term of the first mortgage.
C-9 Interest Provide the interest rate of the first mortgage.
C - 10 Front Ratio Total housing cost/monthly income. Please attach explanation if
front ratio is over 33%. Calculate this ratio by dividing Item C6 by
D. Use of Funds
D -1 Purchase Price Provide the purchase price of the property. This amount must
agree to the purchase price detailed on the settlement statement
or good faith estimate.
D-2 Rehabilitation Costs Provide the amount of rehabilitation costs if applicable. This
amount should be the same as the amount of rehabilitation costs
detailed on the settlement statement or good faith estimate.
Please provide invoices, contracts, signed bids or estimates to
substantiate rehabilitation costs. If the loan is closed at the time
of disbursement and a signed settlement statement is submitted,
receipts are not required.
D-3 Closing Costs Provide the amount of estimated closing costs. If the loan has
closed, please provide a copy of the final, signed settlement
D-4 Homebuyer Provide the amount to be paid for homeownership counseling
Counseling/Education fee and education.
D - 5 D - 6 D - 7 Other Costs Specify Provide the amount and an explanation of any other costs
associated with the use of funds.
D-8 Total Uses (The total amount of uses of funds). This amount must be equal
to the total sources of funds.
E. Sources of Funds
E-1 First Mortgage Loan Provide the name of the first mortgage lender.
E-2 First Mortgage Loan Provide the amount of the first mortgage. This amount must
Amount agree with the first mortgage loan amount indicated on the
settlement statement and should agree to line C - 7.
E-3 Second Mortgage Loan Provide the amount of the second mortgage loan if applicable.
This amount must agree with the amount shown on the
settlement statement or good faith estimate.
E-4 Borrower down payment Provide the amount of the borrower down payment. This amount
should be at least $500 and agree with the amount shown on the
settlement statement or good faith estimate. If money is going
back to the borrower, please ensure that the borrower's down
payment will still be at least $500. If there are charges Paid
Outside of Closing (POC) please indicate the amount of the
POC. The POC must be evident on the settlement statement.
E - 5 and
E-6 Other Specify Provide the amount of other sources of funds and specify what
they are (i.e. taxes)
E-7 AHP Funds Requested Provide the amount of AHP funds requested. This amount must
agree to the amount provided on the settlement statement or
good faith estimate.
E-8 Total Sources (The total amount of sources of funds) This amount must be
equal to the total uses of funds.
F. Required Documentation
F-1 Loan Application Form Provide the loan application signed by the borrower or the
signed by borrower interviewer. The total number of people in the household shown
on the loan application should be the same number entered in B-
7 (household size) on the AHP disbursement request.
F-2 Draft AHP Note and Provide a copy of the draft AHP Note and Mortgage/Deed of
Mortgage/Deed of Trust Trust. The documents must be filled out correctly and consistent
with the information provided on the AHP disbursement request
form. After the loan has closed, an original note and recorded
deed of trust/mortgage must be returned to FHLBank within 60
days of closing.
F-3 Verification of Income Provide verification of the annual income of the
Documentation borrower/borrowers (i.e., VOE/VOI, pay stub, child support, SSI,
etc.). The total amount of the documents submitted must equal
the amount listed on B-4 of the AHP disbursement request form.
If the amounts are different, please provide an explanation.
F-4 Invoices, Bids, Estimates If the AHP disbursement request includes rehabilitation
to support rehab costs expenses, provide invoices, contracts, signed bids or estimates
to substantiate rehabilitation costs. If the loan is closed at the
time of disbursement and a signed settlement statement is
submitted, receipts are not required.
F-5 Final Draft or Signed Provide a final draft of the closing/settlement statement if loan
Closing/Settlement has not closed. The amounts detailed on these documents
Statement should agree to the information submitted on the AHP
disbursement request form. If the loan is closed at the time of
disbursement, please provide the final, signed settlement
F-6 Homeownership If applicable, enclose a copy of the certification or equivalent
Education/Counseling documentation that the household completed a homeownership
Certification education training session. This requirement applies to all owner
programs that committed to mandatory homebuyer education in
the Empowerment portion of the application.
G. AHP Requirements
The purpose of section G is to identify the characteristics of the home buying household that are
consistent with the commitments made by the applicant in the AHP application that must be met in
order to comply with the terms of the AHP Agreement. The appropriate boxes should be checked that
correspond to the commitments that apply to this project.
G-1 Targeting Indicate which level of median income the homebuyer household
falls within. The % of area median should be calculated and
shown on line B - 6.
G-2 Donated Property Check this box if the property or land was donated.
G-3 Homeless Unit Check this box if the household to occupy the unit meets the
definition of homeless household.
G-4 Empowerment Check the appropriate box for the empowerment characteristic of
this household. Check the homebuyer counseling box if the
homebuyer has completed a homebuyer education/counseling
program prior to AHP funds disbursement. A certificate signed
by the trainer must be included in the AHP funds disbursement
documentation submitted by the FHLB stockholder. Check the
sweat equity box if the homebuyer has completed the sweat
equity requirement for their participation in this program.
G-5 Community Stability Check the applicable box that applies to this buyer for
commitments made for this project.
G-6 Rural Check this box if the property being purchased is located in a
G-7 Member Financial Check this box if the member institution is providing financing
Participation other than the pass through of AHP funds. Type in the nature of
the financing provided such as first mortgage loan.
G-8 First-Time Homebuyer Check this box if the borrower is a first-time homebuyers
according to the AHP guidelines definition of a first-time
G-9 Special Needs Check the applicable box if the homebuyer or the home meet
one of the special needs categories such as 3-BR home.
G - 10 Community Support Check the applicable boxes if any of the listed community
support criteria apply to this households purchase of a home.
e.g. The CDBG/HOME box should be checked if the sources of
funds for this household's purchase includes HUD Home or
H. Member Certification
H Member Certification The disbursement form must be signed by an officer or
employee of the FHLBank member institution who is on the list of
persons authorized to execute credit transaction with the
FHLBank of Topeka. Please be sure to provide the typed or
printed name of the signer.