h.e.l.p. community development corporation · 2017. 10. 16. · h.e.l.p. community development...

H.E.L.P. Community Development Corporation

HOME BUYER MEMBERSHIP APPLICATION

63 E. Kennedy Boulevard, Suite 100B - Eatonville, FL 32751 -- Phone (407) 628-4832 Fax (321) 710-0470

Section For Office Use Only Membership # Membership Last Name, First Initial Payment Type

Membership Fee

Membership Fee Receipt Date Payment Type

Renewal Fee

Renewal Fee Receipt Date

MEMBER INFORMATION CO-MEMBER INFORMATION

First Name Last Name (include Jr. or Sr. if applicable) First Name Last Name (include Jr. or Sr. if applicable)

Social Security Number Phone Date of BirthYears of School Completed

Social Security Number Phone Date of Birth

Years of School Completed

Marital StatusNumber of Dependents (not listed by Co-Member) List Age(s) of Dependents Marital Status

Number of Dependents (not listed by Member) List Age(s) of Dependents

Street Address City, State & Zip Code Street Address City, State & Zip Code

Current Housing Type Number of Years in Present Housing Current Housing Type Number of Years in Present Housing

Member Mailing Address (Only if different from "Present Address" listed above)

Mailing Address City, State & Zip Code

Co-Member Mailing Address (Only if different from "Present Address" listed above)

Mailing Address City, State & Zip Code

If residing at "Present Address" for less than two years, complete the following:

Former Address City, State & Zip Code Former Address City, State & Zip Code

Former Housing Type Number of Years in Former Housing Former Housing TypeNumber of Years in Former Housing

EMPLOYMENT INFORMATION


Self Employed?

Yes No

Employment Dates

From To Self Employed?

Yes No

Employment Dates

From To

Present Employer Name Present Employer Address & Telephone Present Employer Name Present Employer Address & Telephone

Position/Title Type of Business Position/Title Type of Business

If employed in current position for less than two years or if currently employed in more than one position, complete the following:

Self Employed?

Yes

No

Monthly Income Employment Dates


Yes

No


From To

Employer Name Employer Address & Telephone Employer Name Employer Address & Telephone


HELP CDC HB APPLICATION - PAGE 2

EMPLOYMENT INFORMATION CONTINUED


Self Employed?

Yes

No



Yes

No

Monthly Income EmploymentDates

From To

Employer Name Employer Address & Telephone Employer Name Employer Address & Telephone


MONTHLY INCOME AND HOUSING EXPENSE INFORMATION

(1) MEMEBER & CO-MEMBER must complete the "Gross Monthly Income" & "Monthly Housing Expense" sections. Each applicant has a column to insert information. (2) Combine the MEMBER & CO-MEMBER amounts in the "TOTAL" for each line item. (3) Add up each column for the MEMBER, CO-MEMBER, & TOTAL at the bottom of each section. If additional spaces are needed for "Monthly Housing Expense" column, please write additional expenses on the back after printing Home Buyer Application.

GROSS MONTHLY INCOME

MEMBER CO-MEMBER TOTAL MONTHLY HOUSING EXPENSE MEMBER CO-MEMBER TOTAL

BASE MONTHLY INCOME*

RENT

Overtime

Bonuses

Commissions

Dividends/Interest

Other (before completing, see the notice in "describe other income" below)

Other

TOTAL (Each Column) TOTAL (Each Column)

* Self Employed Borrower(s) may be required to provide additional documentation such as TAX RETURNS and FINANCIAL STATEMENTS.

Describe "Other Income" NOTICE: Alimony, child support, or separate maintenance income need not be revealed if the Member (M) or Co-Member (C) does not choose to have it considered for repaying this loan.

M / C DESCRIPTION MONTHLY AMOUNT

If you answer "YES" to any of the questions A through L, please use continuation sheet for explanation.

A. Are there any outstanding judgments against you? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

B. Have you been declared bankrupt within the past seven years? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

C. Have you had property foreclosed upon or given title or deed-in-lieu thereof in the last seven years?

MEMBER YES NO CO-MEMBER YES NO EXPLANATION

D. Are you a party to a lawsuit? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

E. Have you directly or indirectly been obligated on any loan loan of which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "YES," provide details, including date, name, and address of Lender, FHA or VA case number, if any, and reasons for the action.)


F. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "YES," give details as described in the preceding question in the EXPLANATION box.


G. Are you obligated to pay alimony, child support, or separate maintenance? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

H. Is any part of the down payment borrowed? MEMBER YES NO CO-MEMBER YES NO EXPLANTION


QUESTIONS CONTINUED FROM PAGE 2

I. Are you a co-maker or endorser on a note? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

J. Are you a U.S. citizen? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

K. Are you a permanent resident alien? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

L. Do you intend to occupy the property as your primary residence? If "Yes," complete question N below.


M. Have you had an ownership interest in a property in the last three years? MEMBER YES NO CO-MEMBER YES NO EXPLANATION

MEMBER CO-MEMBER

What type of property did you own - principal residence, second home, or investment property? What type of property did you own - principal residence, second home, or investment property?

How did you hold title to the home - by yourself, jointly with your spouse, or jointly with another person? How did you hold title to the home - by yourself, jointly with your spouse, or jointly with another person?

ASSETS AND LIABILITIES

This STATEMENT and any applicable supporting SCHEDULES may be completed jointly by both married and unmarried MEMBERS if their assets and liabilities are sufficiently joined so that the STATEMENT can be meaningfully and fairly presented on a combined basis; otherwise, separate STATEMENTS and SCHEDULES are required. If the CO-MEMBER section was completed about a NON-APPLICANT SPOUSE or other person, this STATEMENT and supporting SCHEDULES must be completed about that spouse or other person also.

COMPLETED:

Jointly

Not Jointly

--- ASSETS ---

Cash deposit toward purchase held by : (Name & Amount) Cash deposit toward purchase held by : (Name & Amount)

List CHECKING & SAVINGS accounts below:

Account Holder Name & Address of Bank, S&L, or

Credit Union

Account Number Current Balance


Credit Union



Credit Union



Credit Union


Account Holder Stocks & Bonds (Company Name / Number

& Description)

Value of Stocks & Bonds

Account Holder Life Insurance Face Value Amount Life Insurance Net Cash Value

SUBTOTAL LIQUID ASSETS (All Amounts In This Column)

Account Holder Vested Interest In Retirement Fund

Account Holder Net Worth of Business(es) Owned (Attach Financial Statement)

Automobile Owner Automobile Owned (Make & Year) Amount Owed on Automobile

Automobile Owner Automobile Owned (Make & Year) Amount Owed on Automobile

Other Assets (Itemize)

TOTAL ASSETS (Subtotal plus the above section)


--- LIABILITIES ---

DO NOT FILL OUT THE LIABILITIES SECTION (H.E.L.P. CDC will obtain this information from your credit report)

Account Holder Name & Address of Company Account Number Monthly Payment Months Left to Pay Unpaid Balance






"OTHER" PAYMENTS BY Payment Type Monthly Payment Months Left to Pay






JOB RELATED EXPENSES FOR Expense Type - (Child Care, Union Dues, etc.) Monthly Payment

JOB RELATED EXPENSES FOR Expense Type - (Child Care, Union Dues, etc.) Monthly Payment

TOTAL LIABILITIES (MONTH) (Total of "Monthly Payment" Column)

TOTAL UNPAID BALANCE COLUMN


INFORMATION FOR MONITORING PURPOSES

The following information is requested so that H.E.L.P. CDC Home Buyers Program can develop a profile of its membership. You are not required to furnish this information, but are encouraged to do so.

MEMBER CO-MEMBER

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

Ethnicity: Hispanic or Latino Not Hispanic or Latino Ethnicity Hispanic or Latino

Not Hispanic or Latino

Race: Race:

Sex: Sex:

Statement of Understanding and Release

I understand and accept that H.E.L.P. CDC Home Buyers Program makes no promise or guarantee that I will become a homeowner or obtain a mortgage loan or any other financing for the purchase of a house, as a result of my being a member of the Program. In consideration of my becoming a member of H.E.L.P. CDC Home Buyers Program, I agree to release the program, its staff, volunteers, and directors from liability for any claims I may have related to Program operations and activities.

SIGNATURES

_____________________________________________________________ __________________ ____________________________________________________________ ___________________ MEMBER'S SIGNATURE DATE CO-MEMBER'S SIGNATURE DATE

Revised 4.27.2015

63 E. Kennedy Boulevard · Suite 100-B · Eatonville, FL 32751 Phone: 407.628.4832 Fax: 321.710.0470

“Helping Everyone Live Prosperously”

O R I E N TAT I O N I N F O R M AT I O N

General Information: Last Name__________________________________

First Name_________________________________

Middle Initial_______________________________

Address___________________________________

City_______________________________________

State____________ Zip _____________________

Phone Number (______) ______________________

E-Mail Address______________________________

Current Housing Location: City of_____________________________________ County of__________________________________ Current Housing Type: _____Rental _____Cooperative _____Public Housing _____Other________________________________ Household Information: Number of People in Household________________ _____ Two Heads of Household _____ Female/Male Head of Household _____ Single

Race: _____ White/Caucasian _____ African American/Black _____ Hispanic _____ Asian _____ Bi-Racial:__________________________ _____ Other_____________________________ Age: _____ Elderly (62+) _____ Non-Elderly _____ Physical or otherwise health impaired Financial Status: Employer__________________________________ Other Income Source_________________________ Monthly Income $___________________________ Please check Yes or No: _____ Yes, I am interested in becoming a member of the Home Buyers Program. Please contact me at the following number(s): (_____) _______________________ Ext. ________ (_____) ________________________ _____ No, I am not interested in becoming a member at this time because of the following: __________________________________________ __________________________________________ __________________________________________ How did you hear about us? ____ Agency _____ Lender/Realtor _____ Mailer ____ Restaurant _____ Walk in _____ Online ____ Radio _____ TV _____ DMV ____ Social Media ____ Other_________________________

This information is used for reports and updates for this agency only. Thank You!!!

"Helping Everyone Live Prosperously"

CREDIT REPORT AUTHORIZATION FORM

Authorization is hereby granted to H.E.L.P. Community Development Corporation, (hereinafter "H.E.L.P. CDC") to obtain a consumer credit report through a credit reporting agency chosen by H.E.L.P. CDC. I understand and agree that H.E.L.P. CDC intends to use the consumer credit report for the purpose of evaluating my financial readiness to purchase a home. My signature below authorizes the release to the credit reporting agency of financial information which I have supplied to H.E.L.P. CDC in connection with such evaluation. Authorization is further granted to the credit reporting agency to use a Photostat reproduction of this form if required to obtain any information necessary to complete my consumer credit report.

CLIENT #1 (Please Type or Print)

CLIENT #2 (Please Type or Print)

Client's Name Client's Name

Client's Signature Client's Signature

Street Address Street Address

City/State/Zip Code City/State/Zip Code

Social Security Number (no dashes) Social Security Number (no dashes)

Date of Birth (MM/DD/YYYY) Date of Birth (MM/DD/YYYY)

Today's Date (MM/DD/YYYY) Today's Date (MM/DD/YYYY)

Primary Telephone Number Primary Telephone Number

E-Mail Address E-Mail Address

63 E. Kennedy Blvd., Suite 100B, Eatonville, FL 32751 / Office (407) 628-4832 / FAX (321) 710-0470

PRIVACY STATEMENT

H.E.L.P. CDC is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations. Your “nonpublic personal information,” such as your total debt information, income, living expenses and personal information concerning your financial circumstances will be provided to creditors, program monitors and others only with your authorization and signature on the Counseling Agreement. We may also use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable research information and designing future programs. Types of information we gather about you:

Information we receive from you orally, on application or other forms, such as your name, address, social security number, assets and income.

Information about your transactions with us, your creditors, or others such as your account balance, payment history, parties to transactions and credit card usage.

Information we receive from a credit reporting agency, such as your credit history. You may opt-out of certain disclosures:

You have the opportunity to “opt-out” of disclosures of your nonpublic personal information to third parties (such as your creditors), that is, direct us not to make those disclosures.

If you choose to opt-out, we will not be able to answer questions from your creditors. If at any time you wish to change your decision with regard to your opt-out status, you may contact us to do so.

Release of your information to third parties:

So long as you have not opted-out, we may disclose some or all of the information that we collect, as described above, to your creditors or third parties where we have determined that it would be helpful to you, would aid us in counseling you, or is a requirement of grant awards which make our services possible.

We may also disclose any nonpublic personal information about you or former customers to anyone as permitted by law (e.g. if we are compelled by legal process).

Within the organization, we restrict access to nonpublic personal information about you to those employees who need to know that information to provide services to you: We maintain physical, electronic and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

*By signing below you acknowledge that you have read and received a copy of our privacy disclosure.*

____________________________________________________ ________________________ Borrower Signature Date ____________________________________________________ ________________________ Co-Borrower Signature Date

A HUD-Approved Affiliate of

Rev: 04/18/2016 63 E. Kennedy Blvd. - Suite 100B • Eatonville, FL 32751 • (407) 628-4832 • www.helpcdc.org

Rev. 12.07.2015

H.E.L.P. Community Development Corporation

HUD REQUIRED DISCLOSURE

H.E.L.P. Community Development Corporation (H.E.L.P. CDC) p r o v i d e s t h e f o l l o w i n g s e r v i c e s :

PRE-PURCHASE HOMEBUYER EDUCATION WORKSHOPS which is designed to determine if

homeownership meets the participants lifestyle, help determine mortgage affordability, how to read

credit reports and ideas on how to overcome obstacles to achieve homeownership goals. Workshops

can be obtained either online or at our monthly seminars.

PRE-PURCHASE HOMEBUYER COUNSELING (HOMEBUYERS CLUB) is a membership program that

provides homeownership counseling to potential homebuyers to address issues that may prevent, or

delay mortgage financing, while offering specific steps to help the client achieve their goal of

homeownership. H.E.L.P. CDC charge a non-refundable membership fee of $60.00 per individual and

$75.00 per couple for the first year and $40.00 renewal fee for each subsequent year.

FAIR HOUSING PRE-PURCHASE EDUCATION WORKSHOPS which is designed to empower participants

through education of Fair Housing Laws and protected classes covered within them. Costs vary.

MORTGAGE DELINQUENCY & DEFAULT RESOLUTION COUNSELING which is designed to help

participants resolve mortgage delinquency and/or prevent foreclosure. Counselors will help provide

hope to homeowners who are struggling with mortgage payments by presenting options and actions

needed to be taken by the homeowner to assist the resolution process.

RESOLVING/PREVENTING MORTGAGE DELINQUENCY which is designed to assist homeowners in a

group setting by providing education for those in imminent default, or delinquent. This education seeks

to provide general information on foreclosure, what to expect when missing mortgage payments and

programs to help avoid foreclosure.

FINANCIAL MANAGEMENT/BUDGET COUNSELING to assist individuals and/or groups with data and

tools to increase self-sufficiency. This counseling is a goal-oriented coaching approach that develops a

realistic budget, examines spending habits, reduces existing debt and guides the creation of savings

strategies to increase sustainability and the longevity of financial health for participants.

~continued on next page~

Rev. 12.07.2015

SERVICES FOR HOMELESS COUNSELING works in partnership with local homeless organizations to

provide comprehensive financial coaching and group education to aid the rebuilding process for

individuals who are experiencing homelessness. The goal of this program is renewed financial stability

for participants, as well as behavior change.

REVERSE MORTGAGE COUNSELING is designed to provide elderly clients with the education required

to obtain a Home Equity Conversion Mortgage (HECM). This education provides clients with the

knowledge needed to make an informed assessment in determining if a HECM is right for them as well as

answer any questions they may have as it relates to this loan type. Non-refundable fee of $125.00.

The H.E.L.P. CDC offer referrals to licensed agents and lending institutions with which we have formed a

partnership. These professionals have been thoroughly screened by H.E.L.P. CDC. As a member of H.E.L.P.

CDC’s Homebuyers Club, you are free to choose other agents lending institutions to provide these services

to you.

YOU ARE UNDER NO OBLIGATION TO RECEIVE, PURCHASE, OR UTILIZE ANY OTHER SERVICES OFFERED

BY H.E.L.P. CDC, OR IT’S PARTNERS, IN ORDER TO RECEIVE HOUSING COUNSELING SERVICES.

********************************************************************************************************************************************

Acknowledgement

I have read this disclosure and understand that H.E.L.P. Community Development

Corporation may in the future refer me to licensed professionals with which the program

has developed a partnership.

I understand that I am under no obligation to accept the referral(s).

I also understand that H.E.L.P. Community Development Corporation Homebuyers Club

charge a non-refundable membership fee as stated above.

MEMBER SIGNATURE DATE

MEMBER SIGNATURE DATE

COUNSELOR SIGNATURE DATE

HOMEBUYER NAME_________________________________________

SOCIAL SECURITY CARD

DRIVER'S LICENSE OR OTHER PICTURE ID

NAME, ADDRESS, PHONE NUMBER, AND FAX NUMBER OF EVERY EMPLOYER YOU HAVE HAD IN

THE LAST TWO YEARS

MOST RECENT 90 DAYS PAY STUBS

SIGNED, COMPLETED INCOME TAX RETURNS FOR THE LAST TWO YEARS INCLUDING W-2s

SIGNED, COMPLETED INCOME TAX RETURNS FOR THE LAST TWO YEARS, INCLUDING PERSONAL,

PARTNERSHIP, AND CORPORATE, IF APPLICABLE, AND ALL SCHEDULES

YEAR-TO-DATE BUSINESS PROFIT AND LOSS STATEMENT FOR CURRENT YEAR, IF MORE THAN

THREE MONTHS HAVE PASSED SINCE THE END OF THE TAX YEAR.

CURRENT BALANCE SHEET

CHILD SUPPORT/ALIMONY - "FRIEND OF THE COURT" PRINTOUT OR 12 MONTHS CANCELLED

CHECKS*

AWARDS LETTER FOR SOCIAL SECURITY AND 1099 FOR DISABILITY INCOME

PENSION PAYMENTS

SEASONAL EMPLOYMENT INCOME

GOVERNMENT ASSISTANCE

STATEMENTS OF STOCK DIVIDENDS

FOR GIFT FUNDS - A GIFT LETTER, EVIDENCE OF TRANSFER, AND SOMETIMES EVIDENCE OF

WITHDRAWAL

Use this column to check off your documents as you gather them. Please keep in mind that the lender requires

that the documents come from the same time span. For example, if the pay stubs span January, February, and

March--your bank statements must cover the same months. Your Housing Counselor will use this column to

verify your documents.

IF YOU ARE SELF-EMPLOYED

OTHER SOURCES OF INCOME

Congratulations! You are one step closer to purchasing your new home. To complete the loan application process in a timely manner, you must

gather the documents listed below. While this list may seem extensive, every document is important and must be submitted.

HOMEBUYERS CLUB LOAN DOCUMENTATION CHECKLIST

GENERAL DOCUMENTS

HOUSEHOLD INCOME

INCOME VERIFICATION

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