Post Purchase Survey

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					                2010 FUNDING ROUND
SELF-HELP HOMEOWNERSHIP OPPORTUNITY PROGRAM (SHOP)
             APPLICATION FORMS PACKAGE




                   Housing Assistance Council
              1025 Vermont Avenue, NW Suite 606
                     Washington, DC 20005
           Phone: (202) 842-8600 Fax: (202) 347-3441
                       www.ruralhome.org


                HAC is an equal opportunity lender
                                                HOUSING ASSISTANCE COUNCIL
                         2010 Self-Help Homeownership Opportunity Program (SHOP)
                                                          Application Forms
                                                           **** IMPORTANT ****

Please read the SHOP FY 2010 Program Description and Application Instructions document in its entirety. Before proceeding, all applicants
must complete the Eligibility Questionnaire (Form 2).


                                                               INSTRUCTIONS

 1 Fill in ALL Yellow boxes, if applicable. Fields in "tan" automatically calculate. Some information may be directly linked to other
   spreadsheet cells or worksheets.

 2 Amounts fields are automatically set to round to the nearest dollar.

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


 4 Use the "Page Up/Down" , "Tab" and "Enter" and arrow keys to maneuver through the worksheets. After entering a field of information,
   hit "Enter", not the "Tab" key.


                                                         APPLICATION DUE DATE

SHOP applications are due in HAC's national office no later than 4:00 p.m. Eastern time on FRIDAY, MAY 6, 2011. Absolutely no exceptions
will be made to this due date. Applications postmarked by MAY 6, 2011 and received after that date will not be considered. The address of
HAC's national office is:

                                                          Housing Assistance Council
                                                     Attention: SHOP 2010 Funding Round
                                                     1025 Vermont Avenue, NW, Suite 606
                                                             Washington, DC 20005


                                                          ASSISTANCE NEEDED?

HAC staff is available to address questions on the completion of the SHOP application, as well as respond to technical problems associated
with the application forms. Do not hesitate to contact Tanisha Jacob (ext.128), Loan Fund Assistant, at HAC's National Office at (202) 842-8600
or by email at Tanisha@ruralhome.org.

                                                            SHOP 2010 FORMS

This workbook contains the following application forms. Clicking on the hyperlink will take you directly to the worksheet or the related
webpage for the required form. Upon opening this file, if you selected "Disable Macros," please exit and re-open again. Select "Enable Macros"
to obtain full functionality of the workbook.

       FORM 1: Application Submission Checklist
       FORM 2: Eligibility Questionnaire
       FORM 3: Organization Information
       FORM 4: Application Narrative
       FORM 5: Financial Information
       FORM 6: Project Development Budget (Sources and Uses of Funds)
       FORM 7: SHOP Properties Information
       FORM 8: Certification of Consistency with the RC/EZ/EC-Iis Strategic Plan (form HUD-2990)
       FORM 9: Application Assurances and Certifications
       FORM 10: Corporate Borrowing Resolution
       FORM 11: Disclosure of Lobbying Activities (SL-LL)
       FORM 12: Authorization to Incur SHOP 2010 Eligible Expenses
                                                      APPLICATION SUBMISSION CHECKLIST
                                                                                  (Form 1)
DUE TO THE COMPETITIVE NATURE OF HAC'S SHOP 2010 FUNDING ROUND, FAILURE TO PROPERLY COMPLETE AND SUBMIT ALL FORMS
REQUIRED, UNLESS OTHERWISE NOTED AS "OPTIONAL", ON THIS CHECKLIST MAY RESULT IN THE REJECTION OF YOUR APPLICATION.
CHECK ALL ITEMS INCLUDED AND ASSEMBLE YOUR APPLICATION PACKAGE ACCORDING TO THIS SUBMISSION CHECKLIST.



Organization name:


TAB 1 - APPLICATION FORMS
    a) Application Submission Checklist (Form 1)
    b) Eligibility Questionnaire (Form 2)
    c) Organization Information (Form 3)

    d) Project Narrative (Form 4)
    e) Financial Information (Form 5)
    f ) Project Development Budget, Sources and Uses of Funds (Form 6)
    g SHOP Properties Form (Form 7)
    h) Certification of Consistency with the RC/EZ/EC-Iis Strategic Plan - form HUD-2990 (Form 8)
    i) Application Assurances and Certifications (Form 9)
     j) Corporate Borrowering Resolution (Form 10)
     k) Disclosure of Lobbying Activities- SF-LLL (Form 11)
     l) Authorization to Incur SHOP 2010 Eligible Costs (Form 12) [MARKET SURVEY PARTIPANTS ONLY]

        ORGANIZATIONAL DOCUMENTS
TAB 2 -Corporate
    a) Articles of Incorporation
    b) Bylaws
    c) IRS Determination Letter/Nonprofit Determiniation Letter
    d) Current List of Board of Directors, including contact information.
    e) Organizational Chart
    f) Section 3 Compliance Plan, if SHOP loan requested for site development is $200,000 or more; see Appendix B.
    g) Annual Report, brochures (optional)


TAB 3 - FINANCIAL DOCUMENTS
    a) Organizational operating budget for current fiscal year
    b) Interim financial statements (as of March 31, 2011 or later)
    c) Complete financial audit report for most recent fiscal year or IRS Form 990 if not required to complete an audit
    d) Complete OMB Circular A-133 compliance audit for the most recent fiscal year, if applicable
    e) Management Letter for most recent fiscal year, if applicable
    f) Evidence of administrative funding for self-help housing efforts (i.e., executed copy of USDA RD 523 grant agreement, evidence of state funding)
    g) Quarterly Loan Status Report for quarter ended March 31, 2011, if not already submitted [EXISTING SHOP AFFILIATES ONLY]


TAB 4 - PROJECT DOCUMENTS
    a) Copy of option or purchase contracts or settlement statements for each property, if available
    b) Site approval letter from source of permanent financing, if available
    c) Documentation of "as-is" site value (i.e., current site appraisal, tax assessment, comparables)

    d) Comparable completed unit appraisal
    e) Sample house plans for proposed units (maximum of 3 samples)
    f) Unit construction budget for sample unit(s).
    g) Site map or plat for each property for subdivision project
    h) Location map for project(s)
    i) Subdivision site plans
    j) Completed HUD Environmental Review - RROF form HUD-7015.15, if available [required prior to disbursement of SHOP funds] See Appendix C.

    k) Copy of Section 3 Compliance Plan- Required in have more than $200,000 in site development supported by federal funds.
    l) Market study (optional)
    m) Preliminary title report (optional)
    n) Phase I Environmental (optional)
    o) Site photos (optional)
    p) Feasibility study (optional)
    q) As-developed site appraisal, comparable (optional)


TAB 5 - LEVERAGING DOCUMENTS
    a) Commitment letters from project financing sources

    b) Commitment letters or MOU's from public or governmental entities, if applicable
    c) Commitment letters or MOU's from local business, commercial lenders, private individuals, other grant/loan sources, if applicable
                                                 ELIGIBILITY QUESTIONNAIRE
                                                                (Form 2)
APPLICANT ORGANIZATIONS MUST RESPOND TO ALL QUESTIONS BELOW. THE QUESTIONNAIRE MUST BE INCLUDED AS PART OF
THE APPLICATION SUBMISSION.
Please select the appropriate response.

         1. Is your organization a public or private nonprofit organization under federal or state law?


          2. Will eligible homebuyer households be low income individuals and families whose household incomes do not exceed 80% of
               the median income for the areas, as established by HUD?

          3. Will your organization have clear title of the SHOP property after purchase and/or at which time SHOP infrastructure
               improvements will be made?

          4. Will all SHOP units be made available at prices below the prevailing market prices and sold below the appraised value?

          5. Will eligible homebuyers contribute a minimum number of sweat equity hours (100 hours for more than one individual and
               50 hours for one individual) towards the construction or rehabilitation of the homebuyer's SHOP units and/or the homes of
               other homebuyers participating in the self-help homeownership program administered by your organization?

          6. Will your self-help program involve community participation in which volunteers assist in the construction or rehabilitation
             of dwellings? (Volunteers are non-building group members or members of the building group working on a home other than
             his/her own).
          7. Will the eligible homebuyer receive the full value of the homebuyer's sweat equity contribution as an equity contribution and
             a reduction in the sales prices towards the purchase of the homebuyer's SHOP unit.


          8. Will eligible homebuyers not be required to make any financial contributions towards the purchase of a SHOP unit, other than
               cash contributed for down payment and reasonable and customary closing costs?

          9. Will all new construction and gut-rehabilitation completed SHOP units in buildings up to three stories: (a) meet the guidelines
               for Energy Star Qualified New Homes, as certified by a qualified Home Energy Rating System (HERS) rater; and (b) have
               Energy Star labeled products?

         10. Will all SHOP units in buildings over three stories exceed, by 20 percent, the minimum energy-efficiency requirements defined
               by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Standard 90.1-2007, Appendix
               G: Performance Rating Method? (Note:"NO"- means SHOP units are in buildings will three or less stories).

         11. Will all new construction and gut-rehabilitation completed SHOP units have installed water-usage products, including toilets,
               showers, and faucets, which bear the "WaterSense" label and are independently tested and certified by an EPA licenses
               certifying body to meet the water efficiency and performance established by the EPA?

         12. Will the organization comply with the SHOP environmental review requirements under the National Environmental Policy Act
               of 1969 and related federal environmental authorities and regulations at 24 CFR part 58 wherein no improvements can be
               done to the land prior to a HUD approved environmental review?

         13. Will your organization conduct work in accordance with the Occupational Safety and Health Administration (OSHA)
               regulations for your employees and with the applicable lead safe work practices requirements of HUD's Lead Safe Housing
               Rule (24 CFR part 35) and EPA's Renovation, Repair and Painting Rule (40 CFR Part 745)?

         14. Will your organization adopt and follow affirmative marketing requirements and procedures?


         15.   Will your organization not seek SHOP FY 2010 funding from another SHOP applicant?


                   If you responded "NO" to any of the above questions, your organization may not be eligible to receive HAC SHOP
                   2010 funding. Please contact jann Yankauskas, Senior Loan Officer, or Dierdra Pressley, Loan Officer, at (202)
                   842-8600 to provide clarification on your organization and/or project's eligibility.



                   If you responded "YES" to all of the above questions, please proceed with completing the SHOP 2010 application.
                                       ORGANIZATION INFORMATION
                                               (Form 3)
    Check here if New SHOP Applicant

SECTION I: CONTACT INFORMATION
Organization Name:
Organization Acronym:
Executive Director's Name:
Executive Director's E-mail:
Application Contact Person:
Application Contact E-mail:
Position Ttitle:
Address:
City, State, Zip:
Phone Number:
Fax Number:
Website:

SECTION II: ORGANIZATION INFORMATION
Type of organization:
Date incorporated (mm/yy):
Tax exempt status:
Federal Tax ID #:                                        Required
Duns and Bradstreet Number (DUNS):                       Required
Central Contract Registration Number                     Required
Congressional district no.:
Name of Congressperson:

SECTION III: SHOP 2010 PROJECT OVERVIEW
Project Name:
Number of Units Requested
SHOP Funds Requested:
      Land acquisition
      Infrastructure improvements
                    Total


HAC Loan Funds Requested:


Type of Project:
Type of Construction:

SECTION IV: SHOP 2010 PROJECT LOCATION

                                        COUNTY 1        COUNTY 2    COUNTY 3
               County Name:
                       State:
                         Town
                         Town
                         Town
                                    ORGANIZATION INFORMATION
                                            (Form 3)

                                     COUNTY 4        COUNTY 5          COUNTY 6
              County Name:
                      State:
                      Town
                      Town
                      Town

Site Address/Location ( if known)



SECTION V: TECHNICAL ASSISTANCE PROVIDER INFORMATION (IF APPLICABLE)
Provider Organization:
Contact Person:
Position Title:
Phone Number/Extension:
APPLICATION NARRATIVE
          (Form 4)

PLEASE RESPOND TO ALL QUESTIONS.



 CLICK HERE FOR LINK TO FORM
                                                         FINANCIAL INFORMATION
                                                                (Form 5)

SECTION I: ADMINISTRATIVE FUNDING
1) What is the organization's current fiscal year's operating budget?
2) What is the organization's anticipated fiscal year operating budget for next year?
3) What is your anticipated administrative budget for self-help activities under your SHOP 2010
proposal?
4) What sources of funding will support the administrative expenses of your SHOP 2010 activities? (Check all that
apply). Enter dollar amount from each sources, identify the status of the funds (e.g., committed, proposed)


                 Source of Administrative Funds                                   Amount Available                       Status
                 CHDO funds
                 Developer fees
                 HOME funds
                 Other organizational funds
                 USDA 523 TA grant
                 Other (describe below):




SECTION II: SECTION 523 GRANTEE STATUS
1) Are you a current Section 523 Grantee?
2) What is your current Section 523 status?
3) What are the dates of your current contract?                                                                     to
4) What is the amount of your current contract?
5) How many units does this support?


6) Do you plan to apply for 523 TA funds, if available, for SHOP 2010 units?
7) What will be the dates of your SHOP 2010 related contract?                                                       to
8) How much will you apply for?
9) How many units will this support?

SECTION III: FINANCIAL REPORTING STATUS:
1) Fiscal year end (mm/dd):
2) Does your organization file annual audits?
3) Does your organization file A-133 compliance audit?
4) Date of most recent fiscal year end audit:
5) What was the auditor's opinion:
6) Were there any audit findings? If yes, describe findings in the Application Narrative - Audit Matters.
7) Is there a Corrective Action Plan for resolving findings? If yes, describe in the Application Narrative - Audit Matters.
8) What software does your organization use to track financial information?
9) What software does your organization use to track unit/project construction costs?
10) What software does your organization use to track sweat equity labor hours?
11) How often are interim financial statements prepared?
12) How often are organizational financial statements reviewed by the board of directors?
                                                      FINANCIAL INFORMATION
                                                             (Form 5)

SECTION IV: REQUIRED ATTACHMENTS
HAC acknowledges that several of potential applicants are current affiliates of HAC. In response, please mark an "x" in the on record column if
documents have been submitted as part of a previous SHOP application or quarterly report. Mark an "x" if attached or providing updated
information.
                                                                                                                            Date
Document                                                                                                    On File                     Attached
                                                                                                                          submitted
Articles of Incorporation
                                                                                                          Submission is required.
Bylaws
                                                                                                          HAC is updating its files.
IRS Determination Letter/Nonprofit Determination Letter
2008 Financial and A-133 audit, if required to file
2009 Financial and A-133 audit, if required to file
2010 Financial and A-133 audit, if required to file
Interim Financial Statements (Balance Sheet, Profit/Loss Statement, Cash Flow) - no later than
3/31/11


SECTION V: FINANCIAL STATUS OF ORGANIZATION

ENTER FINANCIAL DATA IN THE AREAS BELOW FROM THE EARLIEST TO THE MOST RECENT FISCAL YEAR (I.E.,
Y1=9/30/08;Y1=9/30/09; Y3=9/30/10; INTERIM=03/31/11.


Enter Type of Financial Statements                                                                                              % Change
                                                              Y1              Y2              Y3           Interim         Y2-Y1         Y3-Y2
                                  Enter Period Ended:
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!
Debt-to-Equity                                                #DIV/0!         #DIV/0!         #DIV/0!        #DIV/0!        #DIV/0!       #DIV/0!
Debt Ratio                                                    #DIV/0!         #DIV/0!         #DIV/0!        #DIV/0!        #DIV/0!       #DIV/0!

FINANCIAL TRENDS
PLEASE GO TO APPLICATION NARRATIVE, FINANCIAL CAPABILITY AND EXPERIENCE SECTION, TO ANSWER THE FOLLOWING
QUESTIONS:

1) Describe any changes to your operating funds, assets, debt load and expenses that have occurred over the past three years.
2) Describe any changes to your operating funds, assets, debt load and expenses that are anticipated within the next three years.
                                                       FINANCIAL INFORMATION
                                                              (Form 5)

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.


 Debt-to-Equity Ratio (leveraging) : The debt-equity ratio is another leverage ratio that compares an organization's total liabilities to its total
 shareholders' equity (net assets). This is a measurement of how much suppliers, lenders, creditors and obligors have committed to the
 organization versus what the shareholders have committed.


 Debt Ratio (leveraging): The debt ratio compares an organization's total debt to its total assets, which is used to gain a general idea as to the
 amount of leverage being used by a company. A low percentage means that the organization is less dependent on leverage, i.e., money
 borrowed from and/or owed to others. The lower the percentage, the less leverage an organization is using and the stronger its equity position.
 In general, the higher the ratio, the more risk that organization is considered to have taken on.
                                                                     PROJECT DEVELOPMENT BUDGET
                                                                        Sources and Uses of Funds
                                                                                (Form 6 )

                              Organization Name:
                              Project Name:
                              Total Project Units



                          USES                                                       SOURCES                                    TOTALS   PER UNIT

         Name of Funder (abbrev.)                   SHOP 2010   HAC Loan Funds   Source 1      Source 2   Source 3   Source 4
                     Amount                                                                                                              #DIV/0!
                     Lien Position
                     Loan Term (months)
                     Interest Rate                                     5.00%
                     Status                          Proposed       Proposed

PREDEVELOPMENT
 Site Appraisal                                                                                                                          #DIV/0!
 Environmental/Assessment                                                                                                                #DIV/0!
 Engineering/Surveying                                                                                                                   #DIV/0!
 Other                                                                                                                                   #DIV/0!
 Other                                                                                                                                   #DIV/0!
 Other                                                                                                                                   #DIV/0!
                    Total Pre-Development                                                                                                #DIV/0!

ACQUISTION
 Land Option                                                                                                                             #DIV/0!
 Land Acquisition                                                                                                                        #DIV/0!
 Appraisal                                                                                                                               #DIV/0!
 Legal Expenses for Acquisition                                                                                                          #DIV/0!
 Acquisition Closing Costs                                                                                                               #DIV/0!
 Other                                                                                                                                   #DIV/0!
 Other                                                                                                                                   #DIV/0!
 Other                                                                                                                                   #DIV/0!
                          Total Acquisition                                                                                              #DIV/0!
                                                  PROJECT DEVELOPMENT BUDGET
                                                     Sources and Uses of Funds
                                                             (Form 6 )

                            Organization Name:
                            Project Name:
                            Total Project Units



                          USES                                 SOURCES           TOTALS   PER UNIT

INFRASTRUCTURE IMRPOVEMENTS
  Clearing/Grading                                                                        #DIV/0!
  Water/Sewer/ Wells/ Septic                                                              #DIV/0!
  Utility hook-ups/Connections                                                            #DIV/0!
  Streets/lights/Curbs/Sidewalks                                                          #DIV/0!
  Impact/Tap fees                                                                         #DIV/0!
  Permit Fees                                                                             #DIV/0!
  Removal of Environmental Hazards                                                        #DIV/0!
  Other                                                                                   #DIV/0!
  Other                                                                                   #DIV/0!
  Other                                                                                   #DIV/0!
       Total Infrastructure Improvements                                                  #DIV/0!

PROJECT-RELATED SOFT COSTS
  Accounting and Audit                                                                    #DIV/0!
  Architect                                                                               #DIV/0!
  Engineering Design                                                                      #DIV/0!
  Administration                                                                          #DIV/0!
  Construction Bond Fee                                                                   #DIV/0!
  Construction Loan Interest                                                              #DIV/0!
  Construction Loan Fee                                                                   #DIV/0!
  Consultant Fees                                                                         #DIV/0!
  Developer Fees                                                                          #DIV/0!
  Home Buyer Preparation                                                                  #DIV/0!
  Inspection Fees                                                                         #DIV/0!
  Insurance, Liability                                                                    #DIV/0!
  Legal Fees                                                                              #DIV/0!
  Financing Fees                                                                          #DIV/0!
  Marketing Fees                                                                          #DIV/0!
  Soft Cost Contingency                                                                   #DIV/0!
  Taxes                                                                                   #DIV/0!
  Title and Recording                                                                     #DIV/0!
  Other                                                                                   #DIV/0!
  Other                                                                                   #DIV/0!
  Other                                                                                   #DIV/0!
  Other                                                                                   #DIV/0!
  Other                                                                                   #DIV/0!
  Contingency                                                                             #DIV/0!
           Total Project-Related Soft Costs                                               #DIV/0!
                       PROJECT DEVELOPMENT BUDGET
                          Sources and Uses of Funds
                                  (Form 6 )

 Organization Name:
 Project Name:
 Total Project Units



USES                                SOURCES           TOTALS   PER UNIT
       Subtotal                                                #DIV/0!
                                                                 PROJECT DEVELOPMENT BUDGET
                                                                    Sources and Uses of Funds
                                                                            (Form 6 )

                            Organization Name:
                            Project Name:
                            Total Project Units



                          USES                                                          SOURCES                                                 TOTALS   PER UNIT

UNIT CONSTRUCTION
  Unit Construction                                                                                                                                      #DIV/0!
  Building Permits/Fees                                                                                                                                  #DIV/0!
  HERS inspection/certification costs                                                                                                                    #DIV/0!
  WaterSense inspection/certification costs                                                                                                              #DIV/0!
  Other                                                                                                                                                  #DIV/0!
  Other                                                                                                                                                  #DIV/0!
  Contingency                                                                                                                                            #DIV/0!
                   Total Unit Construction                                                                                                               #DIV/0!


                                   Total Development Costs (pre-development, acquisition, infrastructure improvements, project-related costs)            #DIV/0!
                Total Development Costs (pre-development, acquisition, infrastructure improvements, project-related costs, unit construction)            #DIV/0!

                                                                                                                       DEVELOPMENT GAP                   #DIV/0!
If there is a development gap between the Sources and Uses, please explain below.
                                  SHOP PROPERTIES OVERVIEW
                                          (Form 7)
SECTION I: DESCRIPTION OF SHOP PROPERTIES
1) What type(s) of housing units will be produced with SHOP 2010 funds? (Check all that apply)


                    TYPE OF HOUSING                            # OF STORIES         # OF UNITS
        Stick built/detached
        Stick Built/Townhouse or Condo
        Manufactured Housing/ detached
        Manufactured Housing/Townhouse or Condo
        Gut-Rehab/Detached
        Gut-Rehab/Townhouse or Condo


SECTION II: ENERGY CONSERVATION METHODS/ GREEN BUILDING TECHNIQUES
1) How does your organization measure energy efficiency in your self-help units:
    Do not have a measuring system                         Post purchase survey of homebuyers
    HERS inspection                                          Other Energy Efficiency Rater
    Other (please
    explain):


2) What energy efficiency percentage are your SHOP home designs expected to meet:
    Unknown                                              Over 20%
    10%                                                      Will generate own energy
    20%
    Other (please
    explain):


3) What energy conservation methods and green development will be incorporated in your SHOP 2010
    Units sized for all that apply)
production? (Checkmaximum energy efficiency and smallest carbon footprint
    Units sized to use natural light
    Use recycled content
    Employ material recycling methods on site
    Use natural, plentiful or renewable materials
    Buy products manufactured with resource-efficient processes
    Buy building materials locally
    Use durable materials with longer life expectancy than conventional products
    Use low or non-toxic materials that emit few or no carcinogens, reproductive toxicants, or irritants
    Use products that have minimal emissions of Volatile Organic Compounds (VOCs)
    Use Moisture resistant products and systems that resist moisture or inhibit the growth of biological
    contaminants
    Install materials, components and systems that require simple non-toxic, or low VOC methods of cleaning
    Install high-efficiency lighting systems with advanced lighting controls
    Use a properly sixed and energy-efficient heat/cooling system in conjunction with a thermally efficient
    building shell
                                   SHOP PROPERTIES OVERVIEW
                                           (Form 7)
    Maximize light colors for roofing and wall finish materials
    Install high R-value wall and ceiling insulation
    Use minimal glass on east and west exposure
    Minimize the electric loads from lighting, equipment and appliances
    Use alternative energy sources such as photovoltaics and fuel cells
    Design for dual plumbing to use recycled water for toilet flushing or a gray water system
    Minimize wastewater by using ultra low-flush toilets, low-flow shower heads, and other water conserving
    fixtures
    Use recirculating systems for centralized hot water distribution
    Install point-of-use hot water heating systems for more distant locations
    Use a water budget approach that schedules irrigation for landscaping
    Meter the landscape separately from buildings
    Use indigenous landscaping plants and products
    Use state-of-the-art irrigation controllers and self-closing nozzles on hoses
    Other (please
    explain):


4) Does your organization currently use Energy-Star labeled products and appliances in your housing units?
                             Yes                              No


5) What Energy-Star labeled products and appliances will be installed in the self-help unit? (Check all that apply)
    Clothes Washer                                            Ventilating fans
    Dehumidifier                                              Gas condensing water heater
    Dishwasher                                                Heat pump
    Refigerator                                               High-efficiency gas storage water heater
    Freezer                                                   Solar water heater
    Room AC                                                   Whole-home gas tankless water heater
    Room Air Cleaner                                          Reflective roof products
    Air-Source heat pump                                      Windows
    Central AC                                                Doors
    Furnace                                                   Skylights
    Geothermal heat pump                                      Light bulbs (CFLs)
    Home sealing (Insulation)                                 Fluorescent light fixtures
    Programmable thermostat                                   LED light fixtures
    Other (please
    explain):


6) What is the average cost of all qualified Energy-Star appliances installed in the self-help unit?


7) Does your organization currently use WaterSense labeled products and appliances in your housing units?
                             Yes                              No
                                   SHOP PROPERTIES OVERVIEW
                                           (Form 7)
8) What WaterSense labeled products and appliances will be installed in the self-help unit? (Check all that apply)
    Bathroom Sink Faucets/Accessories                          Flushing Urinals
    Toilets                                                    Showerheads


9) What is the average cost of all qualified Energy-Star appliances installed in the self-help unit?


10) What Green Building practices will be promoted in the construction of your SHOP 2010 units?
    None                                                       The National Green Building Standards
    Earthcraft                                                 Enterprise Green
    Build it Green                                             LEED ND (for larger scale neighborhood or subdivision)
    LEED for Homes
    Other (please
    explain):


SECTION III: ACCESSIBILITY/VISITABILITY/UNIVERSAL DESIGN METHODS
1) For the proposed SHOP 2010 project, how many units will be:
    Accessible
    Universal designed
    Visitable


2) What accessible features will be used in the design and construction of the SHOP units. (Check all that apply)
    Availability of one-story house plans
    36" wide entry doorways and hallways
    Extra blocking in bathroom to install ADA compliant handrails
    Walk-in showers
    60" turning radius in bathroom/kitchen layouts
    Lower cabinetry for wheelchair height accessibility
    Smoke detectors for hearing or sight-impaired
    Lower sink/counter tops and appliances for wheelchair height accessibility
    Lower light switches for wheel chair height accessibility
    Levered door handles
    Hard-service flooring instead of carpeting
    Covered entryways
    Other (please
    explain):
CERTIFICATION OF CONSISTENCY WITH THE RC/EZ/EC-Iis STRATEGIC PLAN -
                          FORM HUD-2990

                                         (Form 8)

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.



                                CLICK HERE FOR LINK TO FORM
                                 APPLICATION ASSURANCES AND CERTIFICATIONS
                                                                 (Form 9)

As part of your application for SHOP 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 SHOP 2010 application and related attachments hereto is current and complete.

 2. As part of your application for SHOP 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 will not require homebuyer families to make an up-front financial contribution to a housing unit other than cash
    contributed for down payment or closing costs at the time of acquisition.

 4. 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/)


 5. The organization is in good legal standing as of the date of application submission. (If awarded SHOP 2010 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.)


 6. 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 SHOP loan/grant 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.)



 7. 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.)


 8 The organization must incorporate energy-efficiency measures in the design and construction of self-help housing units. All newly
   constructed units assisted with SHOP funds under the NOFA must qualify and receive Energy Star and WagterSense Certification by
   independent Home Energy Rater (HERs) andWaterSense raters upon completions and only Energy Star and WaterSense labeled
   products and appliances may be used in these units.



     Name of Organization



     Signature of Executive Director/President                                                                     Date



     Printed Name


                                                                                                              SHOP 2010 Program Application
                                         CORPORATE BORROWING RESOLUTION
                                                    (Form 10)

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. Eligible applicants for SHOP funds include nonprofit organizations, Indian Tribes, housing authorities,
units of local government, and other entities eligible for federal funding.



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 of                                                            (county)     in the State 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 not 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)
                                         CORPORATE BORROWING RESOLUTION
                                                    (Form 10)

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.


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.
                        DISCLOSURE OF LOBBYING ACTIVITIES (SL-LL)
                                                    (Form 11)

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at
the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31
U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying
entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal
action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing
guidance published by the Office of Management and Budget for additional information.)



                                         CLICK HERE FOR LINK TO FORM
                           HOUSING ASSISTANCE COUNCIL
         FY 2010 SELF-HELP HOMEOWNERSHIP OPPORTUNITY PROGRAM (SHOP)
                 AUTHORIZATION TO INCUR SHOP 2010 ELIGIBLE COSTS
                                    (Form 12)

                                                     FAX FORM TO
                                           TANISHA JACOBS AT (202) 347-3441

Organization:                     0
Address:                          0
City, State, Zip:                 0
Phone no.                         0
Contact person:                   0
Email:                            0

         Project name/location: 0

SHOP eligible cost:
Description of costs:
Amount of costs:
Anticipated cost incur date:
NOTIFICATION (COMPLETED BY HAC)
            Authorized            Not Authorized
              Signature
              Date


SHOP eligible cost:
Description of costs:
Amount of costs:
Anticipated cost incur date:
NOTIFICATION (COMPLETED BY HAC)
           Authorized             Not Authorized
              Signature
              Date

SHOP eligible cost:
Description of costs:
Amount of costs:
Anticipated cost incur date:
NOTIFICATION (COMPLETED BY HAC)
            Authorized            Not Authorized
             Signature
             Date


Sign here on behalf of your organization
     By
 Name
   Title

				
DOCUMENT INFO
Description: Post Purchase Survey document sample