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					                                    Housing Assista
                                           Loan Fu

                                          Table of Co


                                        **** IMPORT

PLEASE READ THE PROGRAM DESCRIPTION D
COMPLETING THIS APPLICATION.


                                    Microsoft Excel Work

This workbook contains the following application wo
you directly to the worksheet or the related webpage f
if you selected "Disable Macros," please exit and re-op
functionality of the workbook.
   Program Description
      Eligible Applicants
      Eligible Uses of Funds
      Loan Rates & Terms
      Loan Limits
      Application Rating Criteria
      Tips for Sucessful Applications
      Loan Review Process, Due Date
      Application Format



  RHLF Workbook Instructions - Page 1
                                 Housing Assista
                                        Loan Fu

                                          Table of Co


   Application
   Application Information
   HAC Loan History (if current or previous borrower)
   Project Information
   Summary of Loan Request
   Project Funding/Financing Contact List
   Project Development Budget/Sources and Uses of Funds
   Application Narrative
         Part I:   Organizational Capability and Experience
         Part II: Financial Capability and Experience
         Part III: Quality of Program Design
         Part IV: Leveraging of Public/Private Resources
         Part V: Underserved Areas or Populations
         Part VI: Empowerment Zones/Enterprise Comm
         Required Information Checklist
         Application Certification
   Appendices
         Forms
   A. Disclosure of Lobbying Activities
   B. Certification of Payments to Influence Federal Transac


RHLF Workbook Instructions - Page 2
                                Housing Assista
                                       Loan Fu

                                        Table of Co
   C. Certification Regarding Debarment and Suspension
   D. Certification of No Material Changes
   E. Corporate Borrowing Resolution
   F. Site Information
   G. Guideform Notice - Disclosure to Seller w/Voluntary,
   H. Environmental Questionnaire




RHLF Workbook Instructions - Page 3
                              Housing Assista
                                     Loan Fu

                                      Table of Co

                                         Workbook


 1. Each worksheet contained in this workbook is "
    unprotect the worksheets. Please contact HAC
    The password is case-sensitive. To unprotect th
    Sheet, then type in the password obtained from
 2. Fill in ALL Yellow boxes, if applicable. Fields i
    may be directly linked to other spreadsheet cell

 3. Amounts fields are automatically set to round t

4. The narrative portion of the application may be
   processing software may be more effective.

5. Fields with additional comments/instructions a
   hand corner of the cell. Roll the cursor over the




                                           Assistanc



RHLF Workbook Instructions - Page 4
                             Housing Assista
                                    Loan Fu

                                      Table of Co
HAC staff is available to address questions on the c
Microsoft Excel workbook. Do not hesitate to cont
national office at (202) 842-8600 if you would benef




RHLF Workbook Instructions - Page 5
                          Housing Assistance Council
                                 Loan Fund
                       Program Description and Application
                              Table of Contents


                                 **** IMPORTANT ****

E READ THE PROGRAM DESCRIPTION DOCUMENT IN ITS ENTIRETY BEFORE
ETING THIS APPLICATION.


                             Microsoft Excel Workbook Materials

rkbook contains the following application worksheets (clicking on the hyperlink will take
ctly to the worksheet or the related webpage for the required form). Upon opening this fi
lected "Disable Macros," please exit and re-open again. Select "Enable Macros" to obtain f
ality of the workbook.
am Description
gible Applicants
gible Uses of Funds
an Rates & Terms
an Limits
pplication Rating Criteria
ps for Sucessful Applications
an Review Process, Due Date
pplication Format



                                         RHLF Workbook Instructions - Page 6
                            Housing Assistance Council
                                   Loan Fund
                         Program Description and Application
                                Table of Contents


pplication
pplication Information
AC Loan History (if current or previous borrower)
oject Information
mmary of Loan Request
oject Funding/Financing Contact List
oject Development Budget/Sources and Uses of Funds
pplication Narrative
    Part I:   Organizational Capability and Experience
    Part II: Financial Capability and Experience
    Part III: Quality of Program Design
    Part IV: Leveraging of Public/Private Resources
    Part V: Underserved Areas or Populations
    Part VI: Empowerment Zones/Enterprise Communities
    Required Information Checklist
    Application Certification
ppendices

 Disclosure of Lobbying Activities
 Certification of Payments to Influence Federal Transactions


                                             RHLF Workbook Instructions - Page 7
                        Housing Assistance Council
                               Loan Fund
                     Program Description and Application
                            Table of Contents
Certification Regarding Debarment and Suspension
Certification of No Material Changes
Corporate Borrowing Resolution
Site Information
Guideform Notice - Disclosure to Seller w/Voluntary, Arm's Length Purchase Offer
Environmental Questionnaire




                                          RHLF Workbook Instructions - Page 8
                      Housing Assistance Council
                             Loan Fund
                   Program Description and Application
                          Table of Contents

                                   Workbook Instructions


ach worksheet contained in this workbook is "password-protected." A password is requir
nprotect the worksheets. Please contact HAC if you experience problems and need the pa
 he password is case-sensitive. To unprotect the worksheet, go to Tools, Protection, Unpro
heet, then type in the password obtained from HAC.
ll in ALL Yellow boxes, if applicable. Fields in "tan" automatically calculate. Some inform
ay be directly linked to other spreadsheet cells or worksheets.

mounts fields are automatically set to round to the nearest dollar.

he narrative portion of the application may be completed in MS Excel, however, a word
 ocessing software may be more effective.

 elds with additional comments/instructions are denoted with a red triangle in the upper-
and corner of the cell. Roll the cursor over the triangle to reveal the comment.




                                     Assistance Needed?



                                       RHLF Workbook Instructions - Page 9
                      Housing Assistance Council
                             Loan Fund
                   Program Description and Application
                          Table of Contents
 staff is available to address questions on the completion of the RHLF application and this
osoft Excel workbook. Do not hesitate to contact Jann Yankauskas, Senior Loan Officer, at
nal office at (202) 842-8600 if you would benefit from such assistance.




                                     RHLF Workbook Instructions - Page 10
tance Council
Fund

Contents


 TANT ****

 DOCUMENT IN ITS ENTIRETY BEFORE



 rkbook Materials

worksheets (clicking on the hyperlink will take
e for the required form). Upon opening this file,
 pen again. Select "Enable Macros" to obtain full




                                     RHLF Workbook Instructions - Page 11
tance Council
Fund

Contents




                RHLF Workbook Instructions - Page 12
tance Council
Fund

Contents




                RHLF Workbook Instructions - Page 13
tance Council
Fund

Contents

k Instructions


  "password-protected." A password is required to
C if you experience problems and need the password.
 the worksheet, go to Tools, Protection, Unprotect
m HAC.
 in "tan" automatically calculate. Some information
lls or worksheets.

 to the nearest dollar.

be completed in MS Excel, however, a word


 are denoted with a red triangle in the upper-right
he triangle to reveal the comment.




nce Needed?



                                     RHLF Workbook Instructions - Page 14
tance Council
Fund

Contents
e completion of the RHLF application and this
ntact Jann Yankauskas, Senior Loan Officer, at HAC's
 efit from such assistance.




                                    RHLF Workbook Instructions - Page 15
                                            Housing Assistance Council
                                          Loan Fund Program Description

                                             HAC is an equal opportunity lender.

                                          GENERAL PROGRAM INFORMATION

The Housing Assistance Council's loan fund provides low-cost financing to developers of affordable housing in rural
communities nationwide. Funds are currently available at 5.0% interest for non-profit entities, 8.0% interest for for-profit
entities, with a 1.0% service fee. Maximum loan term is five years. Maximum loan amounts apply for the following loan
products: Construction ($750,000), Land Banking ($750,000). Loans may not exceed available collateral.

Loans must be for projects which include provisions for serving low-income people as defined by federal guidelines. Projects
serving low- and very-low income persons will receive priority. At least 51% of the resulting housing units must be
affordable housing units to low- or very-low income people. HAC loan funds may not be used to refinance houisng units
that serve people above 115% of the areawide median income ("moderate income"). The proposed projects must be located
in areas which are rural in character, with a preference for projects located in towns with populations of less than 25,000.

Loans may be made for hard an soft costs associated with land acquisition, site development, and unit construction. Loans
must be recoverable from the permanent financing project. Operating and administrative expenses of the applicant cannot be
included in HAC loans. Loans are also made for guarentees, collaterilizations, and compensating deposits to enable
developers of low-income housing to obtain private financing from local banks when they are otherwise unable to obtain
such credit.

HAC loans may be used to support single- or multi-family housing, including but not limited to self-help housing, farm-
labor and elderly housing, and tax credit projects. Funds can support fee simple ownership, rental and lease-purchase
housing, cooperatives, condominiums, and housing on trust land.

Loan applications are reviewed by HAC staff and acted upon by a Loan Committee comprised of members of HAC's Board
of Directors. Technical assistance (TA) in completing this application is available: please refer to the contact information at
the end of the program description.

                                                   ELIGIBLE APPLICANTS

Eligible borrowers of the loan fund include, but are not limited to, nonprofit corporations, partnerships, public and private
developers, tribal authorities, units of state and local government, cooperatives, and farmworker organzations.

                                                 ELIGIBLE USES OF FUNDS


HAC funds may be used for hard and soft costs associated with the predevelopment, land acquisition, site development, or
construction of affordable housing in rural communities. Specifically, loan funds may be used for land options, down
payments, land purchase, site development, architectural and engineering fees, site surveys, soil test, borings, market
studies, appraisals, environmental engineering studies, archeological clearances, and legal expenses related to site
acquisition; site development; construction financing, preservation of multi-family housing, working capital and
construction bonds. In certain circumstances, loans may also be used as compensating deposits, loan guarentees, and letters
of credit for bonding or to meet tax credit equity requirements.
                                                 LOAN RATES AND TERMS




                                                                                            RHLF Program Description - Page 1
The current interest rate on HAC loans for non-profit entities, which is subject to change, is 5.0%. The current interest rate
for for-profit entities, which is subject to change, is 8.0%. A service fee of 1% of the loan amount approved is due at loan
closing. Borrowers are responsible for paying costs associated with closing the HAC loan. Dependent upon the project,
repayment of principal and any accrued interest may be due quarterly, or a pro-rata share may be due upon lot sales or close
of construction or permanent financing, or repayment may be made via a balloon payment as permanent financing is closed,
or before if other financing is taking our HAC's loan. Repayment terms are approved by HAC's Loan Committee. Standard
loan terms are one to five years.
                                                             LOAN LIMITS

Maximum loan amounts apply for certain loan products. Please contact HAC Loan Fund Staff regarding applicable loan
limits at (202) 842-8600. HAC requires that its loans be secured by the best security available with Loan to Value (LTV) no
greater than 100%.


                                                HAC LOAN UNDERWRITING CRITERIA



Applications will be ranked competitively by the following criteria; please review the Application Narrative for more
information regarding specific requirements under each criteria:


        Operational Capability and Experience of the Applicant (20 points)

        Financial Capability and Experience of the Applicant (20 points)

        Quality of Program Design (40 points)

        Leveraging of Public/Private Resources (20 points)

        Underserved Areas or Populations (5 Bonus points)

                                                  LOAN REVIEW PROCESS, DUE DATE


Applications are accepted on a rolling basis and are reviewed by the HAC Loan Committee. Completed HAC loan
applications are due in HAC’s national office in accordance with the calendar noted below. The address of HAC’s national
office is:
                                                 Housing Assistance Council
                                                   Attn: Senior Loan Officer
                                                  1025 Vermont Avenue NW
                                                           Suite 606
                                                    Washington, DC 20005


Please submit applications in a 3-ring binder, with divider tabs corresponding to the "HAC Application Submission
Checklist", to aid in review of the application. You need only submit one copy of the application. The application narrative
may not exceed 20 single-spaced, typed pages. There is no page limitation on required and option information submitted
with the application. No electronic and/or facsimile submissions of application materials will be accepted due to the
volume of attachments required.


                                     Application Deadlines               Loan Committee Dates

                    December 17, 2009                           February 5, 2010

                    February 4, 2010                            March 26, 2010

                    April 1, 2010                               May 20, 2010

                    July 8, 2010                                August 27, 2010

                    August 5, 2010                              September 24, 2010

                    September 16, 2010                          November 5, 2010




                                                                                                RHLF Program Description - Page 2
HAC staff are available to provide techncial assistance in completion of the HAC application. Please contact Dierdra
Pressley, Loan Officer, jann Yankauskas, Senior Loan Officer, or Tanisha Jacob, Loan Fund Assistant, at (202) 842-8600,
regarding HAC Loan Fund application questions.

                                                 TECHNICAL DEFICIENCIES


Applications for HAC funding are subject to approval, deferral, or rejection in accordance with HAC’s established loan fund
procedures and the selection criteria outlined in this application. HAC Loan Fund staff will contact each applicant during
the course of underwriting loans and may request additional information as needed to clarify item(s) in the application or to
correct technical deficiencies. Examples of curable (correctible) technical deficiencies include inconsistencies in the funding
request and project development budget, outdated organizational financial statements, or a failure to submit the proper
certifications. In each case, HAC will notify you in writing by describing the clarification or technical deficiency, via mail, or
e-mail. Clarifications or corrections to technical deficiencies must be submitted within ten (10) business days of receipt of
the HAC notification.
Please review the HAC Application Submission Checklist for further guidance on required items and items that are
considered as technical deficiencies. HAC recommends that you retain a copy of your HAC Application Submission
Checklist for your reference.




                                                                                             RHLF Program Description - Page 3
                                   APPLICANT INFORMATION




SECTION I: CONTACT INFORMATION

Organization name:
Organization acronym:
Executive Director's name:
Executive Director's e-mail:
Application contact person:
Position title:
Address line 1:
Address line 2:
City:
State:
Zip:
Phone number:                                                       Ext.:
Fax number:
Contact person's e-mail:
Website:

SECTION II: ORGANIZATION INFORMATION

Type of organization:                1
Date incorporated (mm/yy):
Tax exempt status:
Federal Tax ID #:
Fiscal year end (mm/dd):
No. of FTE/PTE                                 No. of volunteers:
No. of minority staff:                         % of minority staff:                #DIV/0!
No. of housing development staff               No. of board members:
No. of minority board members                  % of minority board members:        #DIV/0!
Congressional district no.:
Congressional representative's name:

SECTION III: TECHNICAL ASSISTANCE PROVIDER INFORMATION (IF APPLICABLE)

Provider organization:
Contact person:
Position Title:
Phone number:                                                       Ext.:




                                                                   RHLF Program Application Page-4
                                             FINANCIAL INFORMATION


Enter financial data in the yellow areas of the table below from the earliest to the lastest fiscal year. Any Key
Ratio with a percentage change over/under 20% must be explained in the narrative section under Part II:
Financial Capability and Experience. Financial data should be entered from the earliest to the most recent year
(i.e, Y1=9/30/03; Y2=9/30/04; Y3=9/30/05; Interim=3/31/06)


Enter Type of Financial Statements                    Audited         Audited         Interim   1       Recent Interim        % Change
                                                            Y1              Y2              Y3            Interim           Y2-Y1    Y3-Y2
                       Enter Period Ended:
What is the organization's current fiscal year's operating budget?
Statement of Financial Position or Balance Sheet
Current Assets                                                                                                             #DIV/0!   #DIV/0!
Cash & Equivalents                                                                                                         #DIV/0!   #DIV/0!
Fixed Assets                                                                                                               #DIV/0!   #DIV/0!
Land and Buildings                                                                                                         #DIV/0!   #DIV/0!
       Total Assets                                                                                                        #DIV/0!   #DIV/0!
Current Liabilities                                                                                                        #DIV/0!   #DIV/0!
       Total Liabilities                                                                                                   #DIV/0!   #DIV/0!
Unrestricted Net Assets                                                                                                    #DIV/0!   #DIV/0!
Temporarily Restricted Net Assets                                                                                          #DIV/0!   #DIV/0!
Permanently Restricted Net Assets                                                                                          #DIV/0!   #DIV/0!
    Total Net Assets                                  -          -                                  -                    - #DIV/0!   #DIV/0!
Statement of Activities or Income Statement
Revenue                                                                                                                    #DIV/0!   #DIV/0!
Expenses                                                                                                                   #DIV/0!   #DIV/0!
       Change in Net Assets                           -          -                                  -                    - #DIV/0!   #DIV/0!
Key Ratios
     Current                                   #DIV/0!     #DIV/0!                        #DIV/0!           #DIV/0!        #DIV/0!   #DIV/0!      >1
     Unrestricted NA-Assets                    #DIV/0!     #DIV/0!                        #DIV/0!           #DIV/0!        #DIV/0!   #DIV/0!      2-4 mths short term/9 mths long term
     Debt-to-Equity                            #DIV/0!     #DIV/0!                        #DIV/0!           #DIV/0!        #DIV/0!   #DIV/0!      <50%
     Debt-to-Capitalization                    #DIV/0!     #DIV/0!                        #DIV/0!           #DIV/0!        #DIV/0!   #DIV/0!      >1
     Equity-to-Debt                            #DIV/0!     #DIV/0!                        #DIV/0!           #DIV/0!        #DIV/0!   #DIV/0!      <1



DEFINITION OF KEY RATIOS:
Current Ratio (liquidity) The ratio is an indicator of an organization's ability to pay its short-term liabilities (debt and payables) with its
short-term assets (cash, inventory, receivables). The higher the current ratio, the more capable the organization is of paying its
obligations. A ratio under 1 suggests that the organization would be unable to pay off its obligations if they came due within one year. (>
1 is desirable)
Unrestricted NA-Assets . This ratio measures the extent to which an organization has reserves to weather financial downturns. The
desirable range for short term is 2-4 months and long term is nine months. ( Unrestricted Net Assets x 12/total expenses) Also known as
reserve ratio.

Debt-to-Equity Ratio. This ratio indicates how much the organization is leveraged (in debt) by comparing what is owed to what is
owned. A high debt to equity ratio could indicate that the organization may be over-leveraged, and should look for ways to reduce its
debt. (percent less than 50% is desirable)

Debt-to-Capitalization Ratio. This ratio indicates the extent to which the organization is financed by debt. Also known as the debt ratio.
(total liabilities/total assets) A debt ratio of less than 1 indicates that a company has more debt than assets. (>1 is desirable)


Equity-to-Debt Ratio: This ratio measures the claims of creditors against the organization's resources and indicates that a percentage of
debt is covered by equity (Net Assets). (equity/total assets) a ratio of less than 1 or a lower ratio is desirable.




                                                                                                                                                         SHOP 2006 Program Application - Page 2
                                                        PROJECT INFORMATION

SECTION I: PROPOSED PROJECT

Project Type:                                                                                     1
Project name:
Number of proposed HAC funded units:
Total number of proposed project units:
Project acreage:
Lot size (sq. ft.)
Land acquisition cost:
Total site development cost:
Development cost per unit:                                                             #DIV/0!
Total project cost (includes unit construction) :
Total project cost per unit:                                                           #DIV/0!
Average finished unit cost to homebuyer:
For rental projects, attach rent schedule project proforma.
Average appraised value of completed unit:
Comparable Market Rate unit sales price:


SECTION II: PROJECT LOCATION

Town of proposed project:
Population of town(s):
County(s) served:
County(s) population:
County median income (AMI):
State(s):


SECTION III: COUNTY POPULATION BY PERCENTAGE

African American                                                    Native American:
Hispanic/Latino                                                     White:
Asian:                                                              Other:

                                           Total                      Total does not equal 100%


SECTION IV: ADDITIONAL PROJECT INFORMATION

Income served by project (% AMI):                                                                                                (Min. & Max. % AMI)
Is project within a SMSA (Metropolitan Statistical Area ):
Is project within an RC/EZ/EC:
Name of Renewal Community/Empowerment Zone/Enterprise Community:
Number of planned accessible/universal design project units:
Number of planned Energy Star and/or energy efficient project units:
For Self-Help Projects:
Average hours of Sweat Equity contributed by buyer household.
Average sweat equity hours contributed by volunteers:
% of total labor contributed by homebuyer household:
Estimated dollar value of sweat equity contribution per unit (unit appraised value minus the
permanent mortgage amount):


SECTION IV: PROJECT TIMELINE

SITE DEVELOPMENT                 Month/Year                                                                         Month/Year
Site Control:                                                                                     Household recruitment:
Environmental Review Complete:                                                                    Eligibility determined:
Engineering Complete:                                                                             Construction/perm. loan approval:
Zoning/permits approved:                                                                          Move-in/Full Occupancy:
Site development start:
Site development complete:
Unit construction/rehab start:
Unit constuction/rehab complete:




                                                                                                                      RHLF Program Application Page-6
                             SUMMARY OF LOAN REQUEST

Complete the following table in addition to submitting a complete development budget and
pro-forma if available. 'Please note: A full project development budget is also a required submission.
Complete the " Project Development Budget/Sources and Uses of Funds" worksheet on page 14 of this
application.

                        USES OF FUNDS
                                                                    HAC Loan Funds        Total Request
Pre-Development Costs
Site Appraisal
Market Study
Surveying/Engineering/Plats
Environmental Reports/Testing
Other (please list) :


                              Sub-Total Pre-Development Costs
Land Acquisition Costs
Land Option
Land Acquisition
Legal Expenses
Acquisition Closing Costs
Other (please list ):


                                   Sub-Total Acquisition Costs
Infrastructure Improvement Costs
Clearing/grading
Water/Sewer/Wells/Septic
Utility hook-ups
Roads
Street/curbs/sidewalks
Impact fees
Permit fees
Local Fees/Permits
Engineering
Architectural Fees
Legal expenses for site development
Contingency
Other (please list) :




                                  Sub-Total Infrastructure Costs
Unit Construction Costs
Unit Construction
Unit Rehab
Building Permits/Fees
Contingency
Other (please list ):



                              Sub-Total Unit Construction Costs

                  TOTAL AMOUNT OF REQUEST




                                                                                                RHLF Program Application Page-7
                                    PROJECT FUNDING/FINANCING CONTACT LIST
                                              (attach additonal copies as needed)



                           PRE-DEVELOPMENT                                                    ACQUISITION

Financing Source/Entity:                                          Financing Source/Entity:

Type of financing:                                                Type of financing:

Contact name:                                                     Contact name:

Contact phone number:                                             Contact phone number:

Amount of financing:                                              Amount of financing:

Financing Source/Entity:                                          Financing Source/Entity:

Type of financing:                                                Type of financing:

Contact name:                                                     Contact name:

Contact phone number:                                             Contact phone number:

Amount of financing:                                              Amount of financing:

                        SITE CONSTRUCTION                                                 UNIT CONSTRUCTION

Financing Source/Entity:                                          Financing Source/Entity:

Type of financing:                                                Type of financing:

Contact name:                                                     Contact name:

Contact phone number:                                             Contact phone number:

Amount of financing:                                              Amount of financing:

Financing Source/Entity:                                          Financing Source/Entity:

Type of financing:                                                Type of financing:

Contact name:                                                     Contact name:

Contact phone number:                                             Contact phone number:

Amount of financing:                                              Amount of financing:

                PERMANENT FINANCING SOURCES                                                  GRANT SOURCES

Financing Source/Entity:                                          Financing Source/Entity:

Type of financing:                                                Type of financing:

Contact name:                                                     Contact name:

Contact phone number:                                             Contact phone number:

Amount of financing:                                              Amount of financing:

Financing Source/Entity:                                          Financing Source/Entity:

Type of financing:                                                Type of financing:

Contact name:                                                     Contact name:

Contact phone number:                                             Contact phone number:

Amount of financing:                                              Amount of financing:




                                                                                                      RHLF Program Application Page-8
                                  PROJECT DEVELOPMENT BUDGET/SOURCES AND USES OF FUNDS


Project Name:                                                                            -     Developer:
Site Address:                                                                                  Applicant:
Total Project Units:          -                                                              Prepared by:                                           Date:
Project Start Date:                                                                 No. of Project Phases:


                        DEVELOPMENT BUDGET: SOURCES                                                                          DEVELOPMENT BUDGET: USES

Predevelopment                                                                                               Predevelopment
Sources                Security Interest     Term       Type         Status: Proposed,           Amount                                             Total           Per Unit
                       Position   Rate      (mos.) (Loan or Grant) Pending or Committed                      Site Appraisal                                          #DIV/0!
                                                                                                             Environmental Assessment                                #DIV/0!
                                                                                                             Surveying/Engineering/Plats                             #DIV/0!
                                                                                                             Other:                                                  #DIV/0!
                                                                         SUBTOTAL                                                    SUBTOTAL                       #DIV/0!

Acquisition                                                                                                  Acquisition
Sources                Security Interest Term           Type         Status: Proposed,           Amount                                             Total           Per Unit
                       Position   Rate      (mos.) (Loan or Grant) Pending or Committed                      Option                                                  #DIV/0!
                                                                                                             Land                                                    #DIV/0!
                                                                                                             Closing Costs                                           #DIV/0!
                                                                                                             Other:                                                  #DIV/0!
                                                                                                             Other:                                                  #DIV/0!
                                                                         SUBTOTAL                                                    SUBTOTAL                       #DIV/0!

Site Construction (Hard and Soft Costs)                                                                      Site Construction
Sources                Security Interest Term           Type         Status: Proposed,           Amount      Hard Cost                              Total           Per Unit
                       Position   Rate      (mos.) (Loan or Grant) Pending or Committed                      Clearing & Grading                                      #DIV/0!
                                                                                                             Water/Sewer/Wells/Septic                                #DIV/0!
                                                                                                             Roads                                                   #DIV/0!
                                                                                                             Streets/Curbs/Sidewalks
                                                                                                             Impact fees                                             #DIV/0!
                                                                                                             Tap Fees                                                #DIV/0!
                                                                                                             Utility Hook-ups                                        #DIV/0!
                                                                                                             Local fees/permits                                      #DIV/0!
                                                                                                             Other:                                                  #DIV/0!
                                                                         SUBTOTAL                            Contingency                                             #DIV/0!
                                                                                                                                     SUBTOTAL                       #DIV/0!

                                                                                                             Soft Cost                              Total           Per Unit
Total Site Development Cost                                                                                  Accounting and Audit                                    #DIV/0!
                                                                                                             Architect                                               #DIV/0!
Unit Construction                                                                                            Engineering Design & Admin.                             #DIV/0!
Sources                Security Interest Term           Type         Status: Proposed,           Amount      Construction Bond Fee                                   #DIV/0!
                       Position   Rate      (mos.) (Loan or Grant) Pending or Committed                      Construction Loan Interest                              #DIV/0!
                                                                                                             Construction Loan Fee                                   #DIV/0!
                                                                                                             Consultant Fees                                         #DIV/0!
                                                                         SUBTOTAL                            Developer's Fee                    %                    #DIV/0!
                                                                                                             Home Buyer Preparation                                  #DIV/0!
Permanent Financing                                                                                          Inspection Fees                                         #DIV/0!
Sources                Security Interest Term           Type         Status: Proposed,           Amount      Insurance Builder's Risk & Bldng                        #DIV/0!
                       Position   Rate      (mos.) (Loan or Grant) Pending or Committed                      Insurance Liability                                     #DIV/0!
                                                                                                             Legal Fees                                              #DIV/0!
                                                                                                             Financing Fees                                          #DIV/0!
                                                                                                             Marketing                                               #DIV/0!
                                                                                                             Soft Cost Contingency                                   #DIV/0!
                                                                               TOTAL                         Taxes                                                   #DIV/0!
                                                                                                             Title and Recording                                     #DIV/0!
Other Project Financing                                                                                      Other:                                                  #DIV/0!
Sources                Number     Price    Phase                                                 Amount      Other:                                                  #DIV/0!
                       of Units per Unit (1,2,3)                                                             Other:                                                  #DIV/0!
Lot Sale Proceeds                                                                                            Other:                                                  #DIV/0!
Unit Sale Proceeds                                                                                           Other:                                                  #DIV/0!
Borrower Equity                                                                                              Other:                                                  #DIV/0!
                                                                               TOTAL                         Contingency                                             #DIV/0!
                                                                                                                               SUBTOTAL                             #DIV/0!
          TOTAL SOURCES (not including Permanent Financing)                                                          SUBTOTAL Hard and Soft                         #DIV/0!
                                                                                                             Unit Construction
Appraised Value of Project Site                                                                                                                     Total           Per Unit
As is                                      Per lot     #DIV/0!    HAC Loan to Value                          Unit Construction                                       #DIV/0!
As -Developed                              Per lot     #DIV/0!    HAC Loan to Value                          Building Permits/fees                                   #DIV/0!
                                                                                                             Other:                                                  #DIV/0!
                                                     NO GAP                                                  Other:                                                  #DIV/0!
Notes: If Sources do not equal Uses, please explain how gap will be met.                                     Contingency                                             #DIV/0!
                                                                                                                                     SUBTOTAL                       #DIV/0!

                                                                                                                                   TOTAL USES                       #DIV/0!

                                                                                                                                                    RHLF Program Application Page-9
                                     APPLICATION NARRATIVE

Application materials should be organized by HAC RHLFevaluation criteria (Part I, II, III, IV, V, VI).
Submit clear narrative responses to each questions under each evaluation criteria. Provide as much detail
as possible to support your assertions; however, the application narrative may not exceed 20, single-spaced,
typed pages. There are required documents and forms related to each part of the narrative that must be
completed and included with your application. Please review the "HAC Loan Application Submission
Checklist." If a question does not apply, please respond with an "N/A".

        PART I: ORGANIZATIONAL CAPABILITY AND EXPERIENCE (20 Points)

A. Organizational Resume . 1) What is the organization's current resume regarding experience in affordable housing
   development? Identify number and types of units built, rehabbed, and/or managed. 2) Have there been any
   recent programmatic changes in services provided by the organization? If yes, please describe. 3) What is the
   composition of the organization's staff and board (diversity statement)? Provide an ethnic/gender breakdown
   of current board and staff.


B. Financial Partners. 1) List and describe (federal, state, local, or private) the financing and subsidy sources used,
   total development cost of previous and current affordable housing projects developed noted above. 2) Has the
   organization experienced any issues/delays with the financing sources identified in question B.1 that could
   impact the proposed project? If yes, please describe.



C. Development Team 1) Who are the key program staff and project development team for the proposed HAC
   funded project? List position title and summarize experience (bio). Do not attach job descriptions and/or staff
   resumes.


D. Current Status of HAC Funded Projects (if current HAC borrower) 1) What is the current status of the HAC assisted
   project? Provide an update from last quarterly report submitted which should include, by funding round, the
   current stage of development as follows: total proposed units, number of lots under development, number of
   units under construction, number of households qualified to participate, number of units completed and not
   occupied, and number of units completed and occupied. 2) Are there any issues/impediments that have
   effected the project timeline or repayment of the HAC loan(s)? If yes, please describe.



                        PART II: FINANCIAL CAPABILITY AND EXPERIENCE (20 Points)

E. Sources of Administrative Funding for Housing Program. 1) What is the source of administrative funding for the
   organization's housing program (s)? Include the amount of support provided, allowable uses/restrictions of the
   support, and dates of the funding period in relationship to the proposed project timeline. Attach evidence of
   admininstrative funding source commitment.


F. Financial Trend. 1) What has been the financial trend of the organization over the last three years? Explain
   substantial changes to size or sources of operating funds, current assets, unrestricted assets and in
   programs/services offered.




                                                                                               RHLF Program Application Page-10
                                     APPLICATION NARRATIVE
G. Internal Financial Systems. 1) Is a financial accounting system (software) used for tracking the organization's
   finances and activities? If yes, please describe. 2) How often are interim financial statements/reports prepared
   and reviewed by management and the organization's board of directors? 3) Is your organization currently in
   good standing with reporting requirements imposed by other funding agencies? If no, please explain. 4)
   Describe the specific financial systems and controls in place to administer multiple funding sources.


H. Financial & Internal Control/Compliance Issues. 1) Is an annual audit (financial and/or A-133 compliance)
   performed in a timely manner? If not, please explain. 2) Are there any substantial financial and internal
   control/compliance issues and corrective actions taken or pending since the previous audit? If yes, please
   describe. 3) If A-133 compliance audit completed, were there any findings? If yes, please describe.


                              PART III: QUALITY OF PROGRAM DESIGN (40 Points)

I    Project Summary. 1) Summarize the proposed project, including: number of units; number of phases, if multi-
     phase project; amenities/service enhancements (on-site social services, recreation areas, etc.); location; and
     targeted population (ethnic/racial make-up of targeted homebuyers and income level(s) to be served.



J.   Project Status. 1) Explain current status of project: status of site control, planning and zoning approvals,
     environmental review, and development plans. 2) Explain any forseeable issues that may impact the project
     development timeline.


K. Infrastructure Status. 1) Describe required infrastructure (public water/sewer, wells/septic systems) that are
   required to support the project. 2) Provide results of percolation tests, if applicable, or timeline for completing
   soils analysis.



L. Development Budget. 1) Complete "Project Development Budget/Sources and Uses of Funds" worksheet, or
   submit other format with similar line items. 2) Explain how project costs are determined (estimates, contractor
   bids or signed contracts). 3) What is the estimated timing of the organization's need for HAC Loan funds
   (anticipated disbursement schedule).


M. Project Timeline. 1) Describe the project timeline including timing of site acquisition, site development start and
   completion, unit construction and/or rehab, household recruitment, unit completion and move-in.



L. Market. 1) Describe the current real estate market in the community. 2) provide evidence of market demand for
   the proposed project. For Homeownership Projects: a. How many income eligible households are approved for
   construction-to-permanent financing for the proposed project? b. How many households have been determined
   eligible to participate in your proposed project? For Rental Projects: a. How many income eligible households
   are on the project waiting list? (for rehab projects) What is the current vacancy rate? 3) Compare finished unit
   cost to cost/value of market rate units. For rental projects: compare proposed rents to market rate rents in the
   project area. 4) What are the amounts and terms of subsidies available to the participant homebuyers/residents
   that achieve long-term affordability? 5) What marketing efforts and methods and materials are used to attract
   potential homebuyers/residents including very low- and low- income households, persons with disabilities, the
   elderly, minorities, and families with limited English proficiency? Include sample marketing materials.




M. Status of Project Financing. 1) Describe timeline for securing other project financing commitments for the project,
   including predevelopment, acquisition, site development, construction and permanent financing.




                                                                                              RHLF Program Application Page-11
                                     APPLICATION NARRATIVE
N. Accessible and Visitable Design and Construction . [Applicants are encouraged to incorporate vistability standards
   and universal design features in the construction of project units, where feasible. Completed HAC funded units
   must comply with local building safety codes and standards.] 1) Will the proposed units include accessible and
   universal design features? 2) Describe accessible design features of proposed house/unit plans.



O. Energy Efficient Design and Construction . 1) Will the proposed units be constructed to Energy Star standards? 2)
   Will the proposed units include Energy Star rated appliances and heating and cooling components? 3)To what
   extent will the proposed units incorporate other energy efficient design features and materials?


P. Security/Collateral . 1) What is the proposed security/collateral for the HACloan? 2) What method of valuation is
   used to determine the value of the collateral for the HAC loan (as-is and/or as-developed appraisal, tax
   assessment, market study, comparables)? Include documentation to support this information. 3)What are the
   sources and amounts of loans/grants, in priority lien position, to the HAC loan? 4) What will HAC's loan-to-
   value (LTV)* be for the HAC loan? 5) What additional security/collateral can the organization offer if HAC's
   LTV is greater than 100%?


   * LTV for the HAC loan is calculated by taking the sum of the requested HAC loan amount and any superior lien holder
   loan amounts and dividing this total by the value of the proposed collateral.


Q. Source and Timing of Repayment . 1) What is the requested term of the HAC loan? 2) What is the source and
   timing of the proposed repayment of the HAC Loan. 3) What is the status of this repayment source?




          PART IV: LEVERAGING OF PUBLIC/PRIVATE RESOURCES (20 Points)

R. Public Financial Support. 1) Has the project received any public financial support? Demonstrate the extent of
   public financial support for the project from the local, State and/or Federal government (donated land, waiver
   of fees or taxes, public works improvements, expedited processing of zoning and permit applications, loans,
   grants, etc.). Include Planning and Zoning Board Meeting Minutes, Letters of Commitment for financing
   and/or Memorandums of Understanding (MOUs) for services.


S. Private Financial Support. 1) Has the project received any private financial and/or in-kind support? Demonstrate
   the extent of private-sector support for the project from local businesses, commercial lenders, private entities
   and/or individuals in terms of in-kind donations of construction materials or volunteer time, and/or
   commercial financing or grants (i.e., bank financing, Federal Home Loan Bank AHP funds, etc.) or social
   services provided to the project. Include Letters of Commitment for financing and/or Memorandums of
   Understanding (MOUs) for services.


          PART V: UNDERSERVED AREAS OR POPULATIONS (5 Bonus Points)

T. Is the project located in a HAC designated underserved area? (Note: HAC's underserved areas are: Colonias,
   Mississippi Delta, Indian country and Appalachia).




                                                                                                RHLF Program Application Page-12
                              HAC Loan Fund Application Certification




I certify that the information on this Loan Application and attachments hereto is complete and current to the
best of my knowledge. Furthermore, I understand that intentional misrepresentation of factsmay be the basis
for the denial of funding.



    Name of Organization


    Signature of Person Preparing Application                                           Date


    Printed Name




    Signature of Executive Director/President                                           Date


    Printed Name




                                                                               RHLF Program Application Page -13
                      APPLICATION ASSURANCES AND CERTIFICATIONS
As part of your application for RHLF funding, you, as the official authorized to sign on behalf of your organization, must
provide the following assurances and certifications. By submitting this form, you are certifying that to the best of your
knowledge and belief, all assertions listed below are true and correct. Furthermore, you understand that intentional
misrepresentations of the facts may result in the rejection of the application or denial of funding.

1. The information contained in the RHLF application and related attachments hereto is current and
   complete.
2. As part of your application for RHLF funding, you, as the official authorized to sign on behalf of your
   organization, must provide the following assurances and certifications. By submitting this form, you
   are certifying that to the best of your knowledge and belief, all assertions listed below are true and
   correct. Furthermore, you understand that intentional misrepresentations of the facts may result in the
   rejection of the application or denial of funding.

 3 The organization is not currently debarred or suspending from receiving Federal contracts or certain
   subcontracts and from certain types of Federal financial or nonfinancial assistance and benefits or on
   the Excluded Parties List System (EPLS). (The EPLS is the electronic version of the List of Parties Excluded
   from Federal Procurement and Nonprocurement Programs - website: http://epls.arnet.gov/)

 4 The organization is in good legal standing as of the date of application submission. (If awarded RHLF
   funds, a "Certificate of Good Standing" must be submitted as part of the loan closing documents. An
   organization in good standing means all required reports and taxes have been filed and annual registration fees
   paid, as of the date the certificate has been issued, which officially proves the company has not been suspended or
   canceled.)
 5 No Federal funds appropriated have been paid, or will be paid, by or on behalf of the applicant, to any
   person for influencing or attempting to influence an officer or employee of any agency, a Member of
   Congress, and officer or employee of Congress, or an employee of a Member of Congress, in
   connection with awarding of RHLF loan or its extension, renewal, amendment or modification.
   (Complete SF-LLL, Disclosure of Lobbying Activities, to disclose lobbying activities pursuant to 31 U.S.C.
   1352. If not, applicable, indicate "non-applicable" on form.)
 6 The organization has legal authority to apply for Federal assistance, has the institutional, managerial
   and financial capability (including funds to pay the non-Federal share of program costs) to plan,
   manage and complete the project as described in the application and the governing body has duly
   authorized the submission of the application, and authorized me as the official representative of the
   organization to act in connections with the application and to provide any additional information as
   may be required. (A Corporate Borrowing Resolution may be submitted with the application or at loan
   closing, if approved.)

    Name of Organization


    Signature of Executive Director/President                                                             Date


    Printed Name
HAC LOAN APPLICATION SUBMISSION CHECKLIST
 (Check all items included and assemble your application package according
                           to this submission checklist)

     Application Cover Letter
     HAC Loan Application Submission Checklist [REQUIRED]


TAB 1 - HAC Loan APPLICATION
REQUIRED
     1. Applicant Information
     2. Financial Information
     3. Project Information
     4. Summary of Loan Request
     5. Project Development Budget/Sources and Uses of Funds or other acceptable format
     6. Project Funding/Financing Contact List or other acceptable format
     7. Application Narrative
     8. Application Assurances and Certifications


TAB 2 - ORGANIZATIONAL DOCUMENTS
REQUIRED
     1. Certification of No Material Changes [CURRENT HAC BORROWERS ONLY]

     2. Articles of Incorporation [NEW HAC APPLICANTS ONLY]

     3. Bylaws [NEW HAC APPLICANTS ONLY]
     4. IRS Determination Letter [NEW HAC APPLICANTS ONLY]
     5. Current List of Board of Directors, including contact information.
     6. Organizational Chart


OPTIONAL
    8. Corporate Borrowing Resolution [may be submitted with application or at loan closing, if approved]

     9. Annual Report


TAB 3 - FINANCIAL DOCUMENTS




                                               RHLF Program Application ~ 14
REQUIRED
   1. Organizational operating budget for current fiscal year
   2. Interim financial statements (must be within three months of the application submission date)
   3. Complete Financial Audit Report for the most recent fiscal year, and for each of the two prior fiscal yea

   4. IRS Form 990 if audit not required.
   5. Complete OMB Circular A-133 Audit Report for most recent fiscal year.
   6. Management Letter for most recent fiscal year, if applicable

   7. Evidence of administrative funding for housing programs efforts


TAB 4 - PROJECT DOCUMENTS
REQUIRED
   1. Site information sheet for each property
   2. Copy of Option or Purchase Contract or Settlement Statement for each property, if available

   3. Site approval letter from source of permanent financing, if available
   4. Documentation of as-is site value (i.e. current site appraisal or tax assessment/comparables)
   5. Comparable completed unit appraisal
   6. Sample unit plans for proposed units- max. of 3 samples

   7. Unit construction/rehabilitation budget for sample unit(s).
   8. Site map or plat for each property for subdivision project
   9. Location map for project(s)
   10. Site plans - for subdivisions only


OPTIONAL
  11. Market study
  12. Preliminary title report
  13. Phase I Environmental
  14. Site photos
  15. Feasibility study
   16. As-developed site appraisal, comparable


TAB 5 - LEVERAGING DOCUMENTS




                                             RHLF Program Application ~ 15
REQUIRED
  1. Commitment letters from project financing sources

  2. Commitment letters or MOU's from public or governmental entities, if applicable
  3. Commitment letters or MOU's from local business, commercial lenders, private individuals, other grant/




                                          RHLF Program Application ~ 16
To complete the Disclosure of Lobbying Activities, you must first print the document or go to:
                   http://www.hud.gov/offices/lead/grantfrm/sf_lll



                                                                                   Appendix A ~Page -15
Appendix A ~Page -16
To complete the following document, you must first print the document or go to:
      http://www.hud.gov/offices/lead/grantfrm/50071.pdf




                                                                                  Appendix B~Page-17
Appendix C~Page- 24
Appendix C~Page- 25
                         CERTIFICATE OF NO MATERIAL CHANGES
            (This forms must be certified by the Executive Director/President of the organization.)




I certify that
has previously submitted to the Housing Assistance Council the documents indicated below, and that
no material changes have occurred in the documents since the submission of the last application.




                                                                                   No Material
                                                           Year Document
                     Document                                                    Changes ("Yes" or
                                                             Submitted
                                                                                      "No")
Articles of Incorporation
Bylaws
IRS Determination Letter
Resumes of housing development and self-help staff

Please only submit items for which a "Yes" is indicated. If "No" to all, DO NOT resubmit
these documents.




Signature of Executive Director/President




Printed Name and Title



Date




                                                                                                 Appendix D~Page- 20
                                      CORPORATE BORROWING RESOLUTION




The Governing Board of Directors of

Hereby authorizes the submission of a loan application, the incurring of and indebtedness, the execution of a loan agreement and
any amendments thereto, a promissory note, and any other documents necessary to secure a loan from the Housing Assistance
Council.


Whereas,
                                                                                                           (name of corporation)
which is (hereinafter referred to as "Corporation") is a corporate entity established under the laws of the State of

                                          and empowered to own property, borrow money, and give security for loans.


Housing Assistance Council (hereinafter referred to as “HAC”) is authorized to make loans for hard and soft costs associated with
affordable housing development, including: predevelopment, land acquisition, site development, unit rehabilitation and
construction, working capital and equity capital.




The Corporation wishes to obtain from HAC a loan for the development of
(project type), (hereinafter referred to as “Project”) on the property located at
                                                                                                  (Address/location of property)


It is now resolved that the Corporation shall submit to HAC an application for a loan for the project to be developed in
 the County                                                               (county)      in the State of
of
(State).


If the loan is approved, the Corporation is hereby authorized to incur indebtedness in an amount not to exceed the amount
approved by HAC and to enter into a loan agreement with HAC for the purposes set forth in the loan application and approved by
HAC. It also may give a promissory note and execute security and other instruments required by HAC to evidence and secure the
indebtedness.

The Corporation is further authorized to request amendments, including increases in the loan amount up to the amounts approved
by HAC, and to execute any and all documents required by HAC to evidence and secure these amendments.




     The Corporation authorizes                              (Name and Title of Authorized Officer)


                                                             (Name and Title of Authorized Officer)


To execute in the name of the Corporation, the loan application and the loan agreement, promissory note, and any amendments
thereto.



     The Corporation authorizes                              (Name and Title of Authorized Officer)


                                                             (Name and Title of Authorized Officer)

To execute in the name of the Corporation, any and all documentation required by HAC for the disbursement of funds during the
term of the loan.



                                                                                                                          Appendix E~Page-21
                                        CORPORATE BORROWING RESOLUTION

Passed and adopted on this the                                 day of                    ,                        .   by the following vote:


                                            Ayes:                             Abstain:
                                            Nayes:                            Absent:


The undersigned, secretary of the Corporation does hereby by attest and certify that the foregoing is a true and full copy of a
resolution of the Governing Board of Directors adopted at a duly convened meeting on the date mentioned above, and that said
resolution has not been altered, amended or repealed.




  (Secretary)                                                                                            (Date)




* This is intended to be model for resolutions authorizing loan applications. Applicants may use their own format if it contains substantially all
the authorizations in the model.




                                                                                                                                 Appendix E~Page-22
                                        SITE INFORMATION SHEET
                                        (Complete a sheet for each property)



Location of property:

Legal description of site, if available:

Describe topography of site:

Past and current uses of site:

Describe uses of abutting property:


Site Control
Option or Purchase Contract (please attach):            Site Control:                            Yes       No

Closing Date:                                           Option Currently in Negotiation:         Yes       No

Terms:                                                  Sales Price:
Undeveloped Property- Property Information
Size (Acres):                                           Estimated Number of Lots:
Price Per Acre:                                         Price Per Lot:
Current Zoning/Use:                                     Proposed Zoning/Use:
Developed Lots/Site - Property Information

Number of Lots:                                         Price per Lot:
Average Size of Lots:                                   Zoning:
Site Market Value

Market Value of Site: $                                 Market Value of individual lots:
Valuation Method (choose one):
Appraisal:                Tax Assessment:               Comparables:
Site Feature - Availability and Distance to Parcel Line

Electricity:      Yes     No    Distance:               Natural Gas:             Yes   No    Distance:
Public Water:      Yes      No Distance:                Public Sewer:            Yes   No    Distance:
Individual septic systems:        Yes       No          Individual wells:        Yes   No

Percolation tests completed and accepted by authorities:          Yes    No

Parcel has road frontage:        Yes    No              Streets installed to City/County specs:          Yes    No

Streets accepted by City/County
                                                        Street Lights present:         Yes      No
for maintenance:     Yes   No

Curbs and gutters:        Yes      No                   Sidewalks present:             Yes      No

Elementary School Distance:                             Middle School Distance:
Senior High School Distance:                            Shopping District Distance:
Medical Services Distance:                              Employment Centers Distance:




                                                                                                     Appendix F~Page-23
                                         SITE INFORMATION SHEET
                                         (Complete a sheet for each property)



Location of property:

Legal description of site, if available:

Describe topography of site:

Past and current uses of site:

Describe uses of abutting property:


Site Control
Option or Purchase Contract (please attach):             Site Control:                            Yes       No

Closing Date:                                            Option Currently in Negotiation:         Yes       No

Terms:                                                   Sales Price:
Undeveloped Property- Property Information
Size (Acres):                                            Estimated Number of Lots:
Price Per Acre:                                          Price Per Lot:
Current Zoning/Use:                                      Proposed Zoning/Use:
Developed Lots - Property Information

Number of Lots:                                          Price per Lot:
Average Size of Lots:                                    Zoning:
Site Market Value

Market Value of Site: $                                  Market Value of individual lots:
Valuation Method (choose one):
Appraisal:                 Tax Assessment:               Comparables:
Site Feature - Availability and Distance to Parcel Line

Electricity:      Yes     No    Distance:                Natural Gas:             Yes   No    Distance:
Public Water:       Yes   No    Distance:                Public Sewer:            Yes   No    Distance:
Individual septic systems:         Yes      No           Individual wells:        Yes   No

Percolation tests completed and accepted by authorities:           Yes    No

Parcel has road frontage:        Yes     No              Streets installed to City/County specs:          Yes    No

Streets accepted by City/County
                                                         Street Lights present:         Yes      No
for maintenance:     Yes   No

Curbs and gutters:        Yes       No                   Sidewalks present:             Yes      No

Elementary School Distance:                              Middle School Distance:
Senior High School Distance:                             Shopping District Distance:
Medical Services Distance:                               Employment Centers Distance:




                                                                                                      Appendix F~Page-24
                                         SITE INFORMATION SHEET
                                         (Complete a sheet for each property)



Location of property:

Legal description of site, if available:

Describe topography of site:

Past and current uses of site:

Describe uses of abutting property:


Site Control
Option or Purchase Contract (please attach):             Site Control:                            Yes       No

Closing Date:                                            Option Currently in Negotiation:         Yes       No

Terms:                                                   Sales Price:
Undeveloped Property- Property Information
Size (Acres):                                            Estimated Number of Lots:
Price Per Acre:                                          Price Per Lot:
Current Zoning/Use:                                      Proposed Zoning/Use:
Developed Lots - Property Information

Number of Lots:                                          Price per Lot:
Average Size of Lots:                                    Zoning:
Site Market Value

Market Value of Site: $                                  Market Value of individual lots:
Valuation Method (choose one):
Appraisal:                Tax Assessment:                Comparables:
Site Feature - Availability and Distance to Parcel Line

Electricity:      Yes    No     Distance:                Natural Gas:             Yes   No    Distance:
Public Water:      Yes    No    Distance:                Public Sewer:            Yes   No    Distance:
Individual septic systems:         Yes      No           Individual wells:        Yes   No

Percolation tests completed and accepted by authorities:           Yes    No

Parcel has road frontage:        Yes     No              Streets installed to City/County specs:          Yes    No

Streets accepted by City/County
                                                         Street Lights present:         Yes      No
for maintenance:     Yes     No

Curbs and gutters:        Yes       No                   Sidewalks present:             Yes      No

Elementary School Distance:                              Middle School Distance:
Senior High School Distance:                             Shopping District Distance:
Medical Services Distance:                               Employment Centers Distance:




                                                                                                      Appendix F~Page-25
                                        SITE INFORMATION SHEET
                                        (Complete a sheet for each property)



Location of property:

Legal description of site, if available:

Describe topography of site:

Past and current uses of site:

Describe uses of abutting property:


SITE CONTROL
Option or Purchase Contract (please attach):            Site Control:                            Yes       No

Closing Date:                                           Option Currently in Negotiation:         Yes       No

Terms:                                                  Sales Price:
UNDEVELOPED PROPERTY - PROPERTY INFORMATION
Size (Acres):                                           Estimated Number of Lots:
Price Per Acre:                                         Price Per Lot:
Current Zoning/Use:                                     Proposed Zoning/Use:
DEVELOPED LOTS - PROPERTY INFORMATION

Number of Lots:                                         Price per Lot:
Average Size of Lots:                                   Zoning:
SITE MARKET VALUE
As- Developed Market                                    As- Developed Market Value
Value of Site: $                                        of Individual Lots: $

Valuation Method (choose one):
Appraisal:                Tax Assessment:               Comparables:
SITE FEATURES - AVAILABILITY & DISTANCE TO PARCEL LINE
Electricity:      Yes    No    Distance:                Natural Gas:             Yes   No    Distance:
Public Water:      Yes    No   Distance:                Public Sewer:            Yes   No    Distance:
Individual septic systems:        Yes      No           Individual wells:        Yes   No

Percolation tests completed and accepted by authorities for proposed no. of lots:                Yes           No

Parcel has road frontage:        Yes    No              Streets installed to City/County specs:          Yes        No

Streets accepted by City/County
                                                        Street Lights present:         Yes      No
for maintenance:     Yes       No

Curbs and gutters:       Yes       No                   Sidewalks present:             Yes      No

Elementary School Distance:                             Middle School Distance:
Senior High School Distance:                            Shopping District Distance:
Medical Services Distance:                              Employment Centers Distance:



                                                                                                     Appendix F~Page-26
                              Guideform Notice - Disclosures to Seller with
                                Voluntary, Arm’s Length Purchase Offer



Dear                                                   :


This is to inform you that                                                 would like to purchase the
property located at                                            , if a satisfactory agreement can be reached.
We are prepared to pay                     for clear title to the property under the conditions described
in the attached proposed contract of sale.

Because Federal funds may be used in the purchase, however, we are required to disclose to
you the following information:


        1.                                                does not have the power to acquire your property by
                 condemnation (i.e., eminent domain), and will not use the power of eminent domain to
                 acquire
                 the property. If negotiations fail to result in an amicable purchase agreement, we will not
                 acquire
                 your property.

        2. We estimate the fair market value of the property to be                   .

        3. If you are the seller-occupant of the property and we purchase the property, you will not be
             eligible for relocation payments or other relocation assistance under the Uniform Relocation
             Assistance and Real Property Acquisition Policies Act of 1970 (URA), or any other law or
             regulation. (The acquisition would be a voluntary, arm's length transaction.)

If you are willing to sell the property under the conditions described in the attached contract of
sale, please sign the contract and return it to us. As indicated in the contract of sale, this offer is
made on the condition that no tenant will be permitted to occupy the property before the sale is
completed.


If you have any questions about this matter, please                                                       at
contact               .

Sincerely,



Name and Title




                                                                                            Appendix G~Page27
                          Housing Assistance Coun
                              Loan Fund
          Environmental Questionnaire and Discl


Due to increasing nationwide attention to the issue
as it relates to liability and real estate ownership, th
(HAC) requires applicants to complete an Environm
Disclosure Statement as a condition for consideratio
approach this assessment seriously and diligently th
on the ownership and uses of the site and by intervi
at the state, county and local level. Careful complet
prospect of loss from environmental damage and lia
and to HAC.
It is in your interest to refrain from entering into an
until you have completed such an investigation and
little or no danger of liability from an environmenta
do otherwise, your legal documents should contain
interest in this regard.



                      Appendix I~Page-29
Answer all questions completely, or insert “unknow
thorough investigation, you are unable to answer. A
not adequate to describe a particular situation. Plea
used to arrive at the answers to the questionnaire by
of interviews you had with individuals, public utilit
government employees, etc., and the public and pri
to reach your conclusions.

Tips on how to construct land use history and what
helpful are included at the end of this statement.




                     Appendix I~Page-30
                               Housing Assistance Coun
                                 Loan Fund
             Environmental Questionnaire and Discl


Applicant:

Address of Subject Property:

City and State:

Nearest Street Intersection:

Present Owner:

Present Occupant:

Are there any structures or improvements on the property? P




                         Appendix I~Page-31
The present and previous uses of the property are:




Has the property or any adjacent property ever been used fo
processingIf so, please describe.
purposes?




                        Appendix I~Page-32
Is there now or has there ever been any land fill activity, disp
involving hazardous wastes on the property or within one-h
If so, please describe.




                     Asbestos. Urea Formaldehyde Insulation



Do any buildings on property contain asbestos?
Do any buildings on property contain urea formalydehyde insulation

Do any buildings on property contain lead-based paint?




                           Appendix I~Page-33
Has a survey or other study ever been conducted to assess
type, amount, location, condition, and or possibility of remova
or encapsulation of asbestos, urea formaldehyde, or lead-based
paint? If so, please report.
*if yes, attach detailed information



                                         Polychlorinated Bipheny



Is PCB present on the property in electrical transformers, capacitors, o
other equipment?
Is PCB present in electrical transformers, capacitors, or other
equipment not on the property but servicing the property?
Has there every been a PCB leak , spill, or other contamination
on the property?
*if yes, attach detailed information




                             Appendix I~Page-34
                                      Storage Tanks, Drums, and



Are there any above or below ground gasoline, diesel, or other storag
tanks located on the property or adjacent property?
Have any tanks been inspected for leakage?

Are any tanks known to leak now or to have leaked in the pas
Are any chemicals or fuels stored on the property, or on
adjacent property, in drums or other containers?
Have any drums or other containers been inspected or tested for
leakage?
Are any drums or other containers known to leak now or to have
leaked in the past?
Are any above or below ground pipelines located on the
property?
Have any pipelines been inspected or tested for leakage?
Are any pipelines known to leak now or to have leaked in the
past?
Have there been any spills, leaks, or other releases of chemicals on th
property?
Attach copies of any permits or licenses to any tanks or pipelines or t
*if use, attach detailed information
the yes, handling, or disposal of chemicals on the property.




                             Appendix I~Page-35
                                                   Air Emissions



Are any air emissions generated on the property (i.e., fuel burning
equipment)? Describe air pollution control equipment used to reduce
emissions for each source of air emissions.

Are air emissions monitored? If so, describe in text box below.

Attach copies of any air permits or licenses pertaining to
operations on the property.
*if yes, attach detailed information

Explain: Are air emissions monitored?




                            Appendix I~Page-36
                                                 Water Discharges



Describe all sources of waste water discharges to surface waters, sept
systems, or holding ponds, including average daily flow.

Describe all sourves of waster water discharges to public sewer
systems, including average daily flow.


Attach copies of any water discharge permits or licenses
pertaining to operations on the property.




                                                  Waste Disposal



Describe any solid or liquid wastes that have ben disposed of or
buried on the property.
Describe the types of liquid wastes (other than waste water described
above) and solid wastes generated at the property.




                            Appendix I~Page-37
Describe how the liquid and sold wastes generated at the
property are disposed.




                             Pesticides, Herbicides and Agricul



Have pesticides, herbicides, or agricultural chemicals ever been
applied to the property?
Have pesticides, herbicides, or agricultural chemicals ever been mixe
formulated, rinsed, or disposed of on the property?

*if yes, attach detailed information



                                                       Radon



Has an EPA-approved short-term radon test been performed in the
basement within the last six months?

Is there any evidence that nearby structures have elevated indoor
levels of radon or radon property?



                            Appendix I~Page-38
Have local water supplies been found to have elevated levels o
radon or radium?

Is the property located on or near sites that currently are or
formerly were used in uranium, thorium or radium extraction
or for phosphate processing?
*if yes, attach detailed information




                         Appendix I~Page-39
                  Studies, Reports, Citations, and Enforceme
Please attach a complete dated copy of each test, study, report
or prepared with respect to the property's soil, air, or water co
other environmental condition or contamination affecting the


Has any public agency ever investigated or cited the property
environmental law or commenced an enforcement or clean up
respect to the property? If so, please describe.




Has any public agency ever listed the property as a site requir
environmental law? If so, please describe.



                          Appendix I~Page-40
Applicant certifies that the forgoing is true, complete, and co

Applicant
Organization:
      By:
                Signature


      Title:




                            Appendix I~Page-41
                              Housing Assistance C
                   Tips for Conducting a Site Enviro

Avoid potentially hazardous sites on, adjacent to or ne

Farms, Groves and Orchards
Auto Graveyards, Junkyards
Petroleum Refineries
Oil/Gasoline/Kerosene Storage Tanks
Above or Underground
Oil/Gas Pipelines
Oil or Gas Pumping Stations



                      Appendix I~Page-42
Gasoline Filling Stations or Pumps
Auto Repair Shops or Garages
Backyard Mechanics
Electroplating or Anodizing Plants
Electronics Manufacturing Plants
Heavy/Light Manufacturing Plants
Chemical Plants
Commercial Dry Cleaning Plants

Wonder where to go to check public and private record
other knowledgeable individuals about a particular sit

       < Tax Assessors Office for map and parcel numbe
       their addresses, property boundaries, and sizes o
       structures, site plans, old pictures of the property
       < Registry of Deeds for property ownership recor
       title exists from a previous title search.

       < Town Building Department for records of constr
       permits. Records note type of building or signs




                      Appendix I~Page-43
< Historical Commission or Society for old pictures
properties or industrial history and processes.
< Planning Department for zoning changes and g

< Town Engineer for information and maps on dr
groundwater and water and sewer systems, plus

< Conservation Commission for information on w
significant bodies of water.
< Town Clerk or Licensing Board or Commission for
and chemical storage (in underground or above

< Town Fire Chief or Fire Prevention Officer for rec
and any discharges from such tanks, as well as a
inspections on particular sites.

< Local Health Department or Sanitarian for histor
may have or continue to contaminate groundwa
drinking water supplies, records of any health re
area.




                Appendix I~Page-44
  Housing Assistance Council
          Loan Fund
tal Questionnaire and Disclosure Statement


 nwide attention to the issue of environmental health and safety
and real estate ownership, the Housing Assistance Council
ants to complete an Environmental Questionnaire and
 s a condition for consideration of a loan request. Please
ent seriously and diligently through research of public records
uses of the site and by interviews with knowledgeable persons
  local level. Careful completion of this task will reduce the
nvironmental damage and liability to both your organization


refrain from entering into an option or purchase agreement
 ed such an investigation and are satisfied that the site poses
ability from an environmental point of view. If you choose to
al documents should contain clauses which protect your




                                 Appendix I~Page-45
ompletely, or insert “unknown” or “not applicable” if, after
 , you are unable to answer. Add pages if the space allotted is
be a particular situation. Please document the process that you
 swers to the questionnaire by preparing a narrative description
with individuals, public utility and corporate representatives,
s, etc., and the public and private records you searched in order
ons.

 ct land use history and what information sources might be
 the end of this statement.




                                 Appendix I~Page-46
 Housing Assistance Council
          Loan Fund
tal Questionnaire and Disclosure Statement




                                            ZIP:




improvements on the property? Please describe.




                                    Appendix I~Page-47
uses of the property are:




jacent property ever been used for industrial, manufacturing, refining or
cribe.




                                      Appendix I~Page-48
ver been any land fill activity, disposal facilities, dump sites or facilities
s on the property or within one-half mile of the property in any direction?




os. Urea Formaldehyde Insulation and Lead-Based Paint

                                          No       Yes*
contain asbestos?
contain urea formalydehyde insulation?

ty contain lead-based paint?




                                         Appendix I~Page-49
  ever been conducted to assess
dition, and or possibility of removal
s, urea formaldehyde, or lead-based




          Polychlorinated Biphenyl (PCB)

                                               No     Yes*
 in electrical transformers, capacitors, or


nsformers, capacitors, or other
 but servicing the property?
 leak , spill, or other contamination




                                              Appendix I~Page-50
       Storage Tanks, Drums, and Pipelines

                                              No     Yes*
ground gasoline, diesel, or other storage
 r adjacent property?
 for leakage?

k now or to have leaked in the past?
 tored on the property, or on
  or other containers?
ainers been inspected or tested for


ners known to leak now or to have


 und pipelines located on the

spected or tested for leakage?
 leak now or to have leaked in the

ks, or other releases of chemicals on the


r licenses to any tanks or pipelines or to
of chemicals on the property.




                                             Appendix I~Page-51
                    Air Emissions

                                          No     Yes*
d on the property (i.e., fuel burning
 tion control equipment used to reduce
r emissions.

f so, describe in text box below.

mits or licenses pertaining to




monitored?




                                         Appendix I~Page-52
                  Water Discharges

                                                      Description
 ater discharges to surface waters, septic
 uding average daily flow.

water discharges to public sewer
ly flow.


discharge permits or licenses
the property.




                    Waste Disposal

                                                      Description
astes that have ben disposed of or


stes (other than waste water described
ted at the property.




                                             Appendix I~Page-53
d sold wastes generated at the




Pesticides, Herbicides and Agricultural Chemicals

                                            No     Yes*
 agricultural chemicals ever been


 agricultural chemicals ever been mixed,
d of on the property?




                        Radon

                                            No     Yes*
rm radon test been performed in the
onths?

by structures have elevated indoor
rty?



                                           Appendix I~Page-54
een found to have elevated levels of


r near sites that currently are or
ium, thorium or radium extraction
 ?




                                       Appendix I~Page-55
Reports, Citations, and Enforcement and Clean Up Actions
ted copy of each test, study, report, or assessment which has been performed
 the property's soil, air, or water conditions or quality or with respect to any
ion or contamination affecting the property.


 investigated or cited the property for violation or possible violation of any
menced an enforcement or clean up action under environmental law with
o, please describe.




 listed the property as a site requiring or qualifying for clean up under any
 ease describe.



                                         Appendix I~Page-56
forgoing is true, complete, and correct:




                                           Printed Name


                               Date:




                                       Appendix I~Page-57
      Housing Assistance Council
for Conducting a Site Environmental Review

dous sites on, adjacent to or near active or abandoned:

                      Military Weapons Plants
                      Military Weapons Storage Facilities
                      Nuclear Generators
Storage Tanks         Scrap Metal Dumps
                      Garbage or Rubbish Dumps
                      Landfills
                      Toxic Waste Dumps



                                   Appendix I~Page-58
                     Airfields:
                                 Commercial
                                 Private
                                 Military
                     Agricultural Chemical Businesses
                     Crop Dusting Businesses/Airstrips
                     Public Utilities


heck public and private records and interview public officials,
dividuals about a particular site?

 ffice for map and parcel numbers, present and property owners and
property boundaries, and sizes of lots; perhaps information on
 ans, old pictures of the property.
s for property ownership records. Or ask current owner if a chain of
 previous title search.

Department for records of construction, occupancy and demolition
s note type of building or signs installed on the property.




                                   Appendix I~Page-59
mission or Society for old pictures and maps, books on notable
 ustrial history and processes.
tment for zoning changes and general land use of a site.

 for information and maps on drainage basin, topography, geology,
d water and sewer systems, plus assessor's maps.

 mmission for information on water quality issues and discharges into
s of water.
icensing Board or Commission for records of permits issued for fuel
rage (in underground or above ground storage tanks).

 or Fire Prevention Officer for records of underground storage tanks,
ges from such tanks, as well as accidental spills and of periodic
articular sites.

partment or Sanitarian for historical use of on-site septic system which
tinue to contaminate groundwater, location and quality of nearby
upplies, records of any health related complaints registered in the




                                     Appendix I~Page-60
 tatement


  onmental health and safety
  ng Assistance Council
Questionnaire and
 oan request. Please
 research of public records
 th knowledgeable persons
 his task will reduce the
 o both your organization


 or purchase agreement
 isfied that the site poses
 of view. If you choose to
  which protect your




                               Appendix I~Page-61
 not applicable” if, after
ges if the space allotted is
ument the process that you
ring a narrative description
 orporate representatives,
 ords you searched in order


ation sources might be




                               Appendix I~Page-62
tatement




           Appendix I~Page-63
al, manufacturing, refining or




                                 Appendix I~Page-64
ilities, dump sites or facilities
of the property in any direction?




d-Based Paint
                   Source of
                  Information




                                    Appendix I~Page-65
 Source of
Information




              Appendix I~Page-66
s
     Source of
    Information




                  Appendix I~Page-67
 Source of
Information




              Appendix I~Page-68
Description




Description




              Appendix I~Page-69
emicals
           Source of
          Information




           Source of
          Information




                        Appendix I~Page-70
Appendix I~Page-71
 ean Up Actions
sment which has been performed
or quality or with respect to any



 ion or possible violation of any
nder environmental law with




alifying for clean up under any




                                    Appendix I~Page-72
Appendix I~Page-73
al Review

 or abandoned:

s Plants
s Storage Facilities
 rs
ps
sh Dumps

ps



                       Appendix I~Page-74
mercial
te
ary
mical Businesses
 inesses/Airstrips




terview public officials,


nt and property owners and
erhaps information on


sk current owner if a chain of


occupancy and demolition
 on the property.




                                 Appendix I~Page-75
aps, books on notable


and use of a site.

basin, topography, geology,
 r's maps.

 ity issues and discharges into

 of permits issued for fuel
storage tanks).

underground storage tanks,
 l spills and of periodic


of on-site septic system which
 ion and quality of nearby
mplaints registered in the




                                  Appendix I~Page-76
CERTIFICATION OF CONSISTENCY WITH THE RC/EZ/EC-Iis STRATEGIC
             PLAN              FORM HUD-2990



APPLICANT ORGANIZATIONS PROVIDING A VALID FORM HUD-2990 FOR PROJECTS LOCATED IN
CURRENT ENTERPRISE ZONES OR ENTERPRISE COMMUNITIES RECEIVE UP TO FIVE (5) BONUS
POINTS IN THE SCORING OF THEIR APPLICATION.



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