please do not mail or fax the...

1

CITY OF DEERFIELD BEACH First Time Homebuyer Program

(Purchase Assistance)

The City of Deerfield Beach, through the use of Community Development Block Grant (CDBG), State Housing

Initiatives Partnership (SHIP) and Home Investment Partnerships Program (HOME) funds, is pleased to

provide first time homebuyer purchase assistance for low to middle-income households for the purchase of

foreclosed and vacant properties in Deerfield Beach to occupy as their primary residence. Assistance is in the form

of a 0% interest deferred second loan that reverts to a grant if all program conditions are met. This program is

administered by the City of Deerfield Beach in conjunction with the City’s consultant, Deerfield Beach Housing

Authority (DBHA). Should you have any questions pertaining to this application please contact:

Deerfield Beach Housing Authority

533 South Dixie Highway, Suite 201 Deerfield Beach, FL 33441

954-425-8449 Extension 113

33

PURCHASE ASSISTANCE

1. A first-time homebuyer is defined as a person who has never owned a home before, or one who has not owned a home as a primary residence within the past three (3) years.

2. Maximum assistance for home purchase is up to $50,000 for persons who qualify at the 50% and 80%

AMI per income chart adjusted for household size and up to $30,000 for persons who qualify at the

Moderate Income (MI) 120% of AMI per income chart adjusted for family size. The determination

is based on income and need. See income chart below and assistance levels attached (Policies and

Procedures).

3. Applicants will be able to find their own property within the City’s target area. Please see page 3 for the

target area map.

4. All applicants must be pre-approved by a lender before an application will be accepted.

5. Applicant has to be a first time homebuyer at the time of completing this application and prior to receiving any assistance from the City.

5. Applicant must have an executed real estate contract at the time of application submittal.

6. Properties for purchase include single-family detached homes, condos, town homes and villas, and

must meet the HUD and SHIP funding guidelines.

7. All applicants will be selected on a first-come, first qualified basis within the stated income groups when funding is available.

8. Eligible applicants will be selected in the order in which they have been Income Certified and have a

PLEASE DO NOT MAIL OR FAX THE APPLICATION CALL TO SCHEDULE AN

APPOINTMENT

954-425-8449 EXT. 113

2

mortgage pre-approval letter by mortgage providers. Funds will only be reserved after an executed purchase

contract is received.

9. Should your income change after you were determined income eligible and assistance has not been provided, your program eligibility will have to be recertified.

10. You may use any licensed real estate professional of your choice. We also recommend you seek competent legal advice.

3

2015 FIRST TIME HOMEBUYER PROGRAM (PURCHASE ASSISTANCE)

Household Size

Extremely Low 30% AMI & Lower

Very Low 31% to 50% AMI

Low 51% to 80% I

Moderate 81% to 120% AMI

1 $14,550 $24,200 $38,750 $58,082

2 $16,600 $27,650 $44,250 $ 66,360

3 $20,090 $31,100 $49,800 $ 74,640

4 $24,250 $34,550 $55,300 $ 82,922

5 $28,410 $37,350 $59,750 $ 89,640

6 $32,570 $41,100 $64,152 $ 96,240

7 $36,730 $42,850 $68,602 $ 102,840

8 $40,890 $45,650 $73,000 $ 109,560

*Income Limits Effective March 6, 2015 The map on the following page indicates the target areas and census tracts in the City of Deerfield Beach where CDBG, SHIP, and HOME funds will be used. All properties purchased with CDBG, SHIP, and HOME funds must meet

HUD and SHIP guidelines in order to be considered eligible. The terms of the City’s purchase assistance program are outlined on the following pages.

2015 FIRST TIME HOMEBUYER PROGRAM (PURCHASE ASSISTANCE)

Household

Size

Extremely Low

30% AMI & Lower

Very Low

31% to 50% AMI

Low

51% to 80%

I

Moderate

81% to 120%

AMI 1 $14,550 $24,200 $38,750 $58,082

2 $16,600 $27,650 $44,250 $ 66,360

3 $20,090 $31,100 $49,800 $ 74,640

4 $24,250 $34,550 $55,300 $ 82,922

5 $28,410 $37,350 $59,750 $ 89,640

6 $32,570 $41,100 $64,152 $ 96,240

7 $36,730 $42,850 $68,602 $ 102,840

8 $40,890 $45,650 $73,000 $ 109,560

*Income Limits Effective March 6, 2015

The map on the following page indicates the target areas and census tracts in the City of Deerfield Beach where

CDBG, SHIP, and HOME funds will be used. All properties purchased with CDBG, SHIP, and HOME funds

must meet HUD and SHIP guidelines in order to be considered eligible. The terms of the City’s purchase

assistance program are outlined on the following pages.

4

The map on the following page indicates the target areas and census tracts in the City of Deerfield Beach where

CDBG, SHIP, and HOME funds will be used. All properties purchased with CDBG, SHIP, and HOME funds

must meet HUD and SHIP guidelines in order to be considered eligible. The terms of the City’s purchase

assistance program are outlined on the following pages.

2 V E V

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NW 38 CT 2000 Census Tract Streets

W SAMPLE RD

NE 35TH ST

NE 35TH ST

NE 33RD CT

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Not To Scale

Created by the City of Deerfield Beach GIS. Published 2-26-13

NW 29TH MNR

NW 19TH TER

NE 30TH CT

NE 32ND ST

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DISCLAIMER

This map and all information contained on it is used by the City of Deerfield Beach for City planning purposes only. The City of Deerfield

Beach makes no representation as to the accuracy of any information contained therein. The burden for determining the accuracy,

completeness, and general reliability of the information contained herein rests solely with the person who uses same. The City of

Deerfield Beach makes no warranties, expressed or implied as to the accuracy of the information contained herein, there are no implied

warranties or merchantability or fitness for a particular purpose, and any person who has a copy of this map, by virtue of their possession

of same, does hereby acknowledge and accept the limitations as set forth herein and acknowledges the lack of any warranties,

expressed or implied, as to the accuracy of the information contained thereon. In no event shall the City of Deerfield Beach be liable

to the person possessing or using this map or any party for damages of any type, including but not limited to incidental, consequential

or exemplary damages arising out of the use or inability to use this map or the material information contained thereon.

LA VIDA TER

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SW 19TH ST SW 18 ST

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Date Saved: Tuesday, February 26, 2013 4:33:30 PM

G:\Data\DeerfieldBeach\SeniorServices\CommunityDevelopment\Census2010_130103\CommDevCensusTract2000_8x11_130226.mxd

NE 27TH ST

City of Deerfield Beach First Time Homebuyer (Purchase Assistance) Program

3

CITY OF DEERFIELD BEACH PURCHASE ASSISTANCE PROGRAM DISCLOSURES

City of Deerfield Beach First Time Homebuyer (Purchase Assistance) Process

1. Read, understand and sign program application disclosures. Signed disclosures must accompany application. 2. Be preapproved by a participating lender. 3. Have a signed real estate contract to submit with your completed application.

4. Schedule an appointment with Deerfield Beach Housing Authority (DBHA) to submit your completed application and real estate contract.

5. Your application will receive an initial review from DBHA and you will receive a pre-award letter acknowledging receipt of your application. This does not reserve funding for you and all

information presented will be verified. A final approval is based on the verification of income and

p rope r t y eligibility.

6. All purchase contracts must contain the program’s required addendum which outlines program conditions and disclosures. Program requirements must be acknowledged by both buyer and seller.

7. Once your offer for purchase is accepted on the property of your choice, The City of Deerfield Beach will order an appraisal and property inspection.

8. Executed contracts must be forwarded to DBHA at the time of application submittal to review property eligibility and reserve funding. DBHA will stop accepting applications once CDBG, SHIP and

HOME funds are committed. Funds are on a first come, first qualified basis.

9. Your lender will need your executed purchase contract to finish processing your loan. 10. You will be required to attend and satisfactorily complete a HUD Approved 8 Hour Homebuyer’s Education

Class. We advise you do this as early as possible to help you understand the home buying process. It is valid

for 12 months. This must be on file before your scheduled closing.


4

Mortgage Pre-Approval Required

Deerfield Beach Housing Authority will not be able to accept an application without a pre-approval letter from a

qualified lender. The lender will require you to complete a loan application and will review your credit, income and

other standard loan information to determine if you qualify for a mortgage and how much you are able to afford. Interest

rates, loan amounts and terms of any loan are subject to negotiation between lender and borrower. Throughout the

process, the lender who pre-approved you may request additional information from you to complete the loan application.

You must be determined to be both income eligible for the purchase assistance program and able to secure a loan to

receive assistance from the City.

Income Certification Process

The DBHA will verify all household income information. The verification is required to determine your eligibility for

assistance under HUD and SHIP program guidelines. If you qualify for assistance, your income will be certified

and you will receive a notice of eligibility. Should your income change after you were determined income eligible and

assistance has not yet been provided, your program eligibility will have to be recertified.

Finding an Eligible Property

All properties must have an appraisal that is no older than 60 days, a roof inspection, termite inspection and other

inspections that may be determined under the program. Once your contract to purchase has been accepted, you will

need to work with your lender to finalize your mortgage process.

DBHA reviews all final loan packages and inspection reports to determine program eligibility. All loan

documentation, sales contracts and property inspections will be forwarded to DBHA by your lender. Once you have

received a mortgage commitment from your lender, you must be sure that DBHA receives a copy of your HUD 1

closing statement at least 3 days prior to closing to enable final compliance review with HUD/ SHIP program rules.

Deerfield Beach Housing Authority and the City of Deerfield Beach are not acting in any capacity relating to

mortgage or real estate transaction. You agree to hold harmless Deerfield Beach Housing Authority and the

City of Deerfield Beach, any governmental agency, its officers, employees, stockholders, agents, successors

and assigns from any and all liability that may arise due to you applying for any grant or mortgage or your

purchase of any real estate. Applicants should always seek competent, professional legal advice when engaging

in any real estate related transaction.

Applicant’s Signature Date

Co-Applicant’s Signature Date


5

CITY OF DEERFIELD BEACH FIRST TIME HOMEBUYER (PURCHASE ASSISTANCE)

PROGRAM DISCLOSURES

FALSE STATEMENTS DISCLOSURE AND ACKNOWLEDGMENT

By completing and submitting this application, you acknowledge that the intent of the SHIP, HOME and

CDBG programs are to assist households who would like to purchase a property as an owner occupied

residence. You must be a first-time homebuyer to receive assistance under the City’s First Time Homebuyer

(Purchase Assistance) Program.

By signing this disclosure and completing this application, you attest to the fact that you do not currently own any

other residential real estate and that you intend to purchase a property as your primary residence as stipulated in

the terms of your agreement with the City. You will be required to maintain a homestead exemption status and

maintain flood and hazard/homeowners insurance, where applicable, for the duration of the term stipulated in

your agreement with the City.

FEDERAL WARNING: There are fines and imprisonment—$10,000/5years—for anyone who makes false, fictitious,

or fraudulent statements or entries in any matter within the jurisdiction of the Federal Government (18 U.S.C 1001).

STATE WARNING: Florida Statute 817 provides that willful false statements or misrepresentation concerning income and

assets or liabilities relating to financial condition is a misdemeanor of the first degree and is punishable by fines and

imprisonment provided under S775.082 o 775.83.

LOCAL WARNING: The local government overseeing the administration of this program, may also impose fines and/or

imprisonment for anyone who makes false, fictitious or fraudulent statements regarding, income assets, liabilities,

household size, occupancy and any other information necessary to determine eligibility for this program.

I/We have read, understand and acknowledge the above disclosure.




6

PUBLIC RECORDS DISCLOSURE AND ACKNOWLEDGMENT

Information provided by the applicant may be subject to Chapter 119, Florida Statutes regarding Open Records.

Information provided by you that is not protected by Florida Statutes can be requested by any individual for their

review and/or use. This is without regard as to whether or not you qualify for funding under the program(s) for

which you are applying.

Having been advised of this fact prior to making application for assistance or supplying any information, I/We

agree to hold harmless and indemnify Deerfield Beach Housing Authority, and the City of Deerfield Beach,

any governmental agency, its officers, employees, stockholders, agents, successors and assigns from any and all

liability and costs that may arise due to compliance with the provisions of Chapter 119, Florida Statues.

I/We agree that neither Deerfield Beach Housing Authority nor the City of Deerfield Beach, have any duty or

obligation to assert any defense, exception, or exemption to prevent any or all information given to Deerfield

Beach Housing Authority or the City of Deerfield Beach in connection with this application, or obtained by

them in connection with this application, from being disclosed pursuant to a public records law request.

Furthermore, by signing below, I/we agree that neither Deerfield Beach Housing Authority nor the City of

Deerfield Beach have any obligation or duty to provide me/us with notice that a public records law request

has been made.

I/We agree to hold harmless Deerfield Beach Housing Authority, and the City of Deerfield Beach or any

governmental agency, its officers, employees, stock holders, agents, successors and assigns from any and all

liability that may arise due to my/our applying for any grant or mortgage or my/our purchase of any real estate,

or any matter arising out of any housing rehabilitation project funded by the City of Deerfield Beach.




7

NOTICE OF COLLECTING SOCIAL SECURITY NUMBER FOR

GOVERNMENT PURPOSE

The City collects your social security number for a number of different purposes. The Florida Public Records

Law (specifically, section 119.071(5), Florida Statutes (2007), requires the City to give you this written statement

explaining the purpose and authority for collecting your social security number.

Your social security number is being collected for the purposes of income certifying you for the City’s housing

assistance program, which requires third-party verification of assets, employment and income. In addition, this

information may be collected to verify unemployment benefits, social security/disability benefits and other

related information necessary to determine income and assets and your eligibility for the program that is funded

by local, Federal and/or State program dollars.

Authorization to Collect Social Security Number

24 CFR 5.609, referred to as "Part 5 Annual Income” - Code of Federal Regulations.

City of Deerfield Beach CDBG, HOME and SHIP Implementation Procedures.

Your social security number will not be used for any other purpose other than verifying your eligibility for the

City’s program.

I/We have read and understand this information.




8

CONFLICT OF INTEREST DISCLOSURE

In accordance with 24 CFR 570.611 applicants can be denied participation in the City’s Purchase

Assistance/Residential Repair Program if a conflict of interest exists. A conflict of interest exists if an applicant is

an employee, agent, consultant, officer, and elected official, an appointed official of the City of Deerfield

Beach or its sub-recipients and if within the past 12 months, any of the following three statements applies

to any of the applicants:

1. Exercises or has exercised any functions or responsibilities with respect to funds for this program.

2. Participates or has participated in the decision making process related to funds for this program. 3. Is or was in a position to gain inside information with regard to program activities.

A conflict of interest may also arise if an applicant for assistance is related by family or has business ties to any

employee, officer, elected or appointed official or agent of a unit of local government who exercises any functions

or responsibilities with respect to the City’s program. When a conflict of interest or perceived conflict of interest

exists, the applicant must acknowledge and disclose that conflict. Please note if a conflict of interest exists, we are

required to seek a legal opinion to make it known to the public that you are applying for this program either

by newspaper or at through the City Commission public hearing process and then request an exception

from the U.S. Department of HUD. This process is mandatory for all City of Deerfield Beach employees and

any time a conflict exists.

Please read statement #1 and #2 and check the statement that applies to you.

1. I/We DO NOT have a conflict of interest as it relates to applying for assistance from the City

2. I/We HAVE a conflict of interest as it relates to applying for assistance from the City.

If you placed a checkmark by statement #2, please explain the Conflict of Interest:

I/We have read and understand what a Conflict of Interest is as it pertains to this application for assistance.




9

CITY OF DEERFIELD BEACH

PURCHASE ASSISTANCE PROGRAM TERMS AND CONDITIONS

Minimum Contribution from Borrowers Own Funds: 1% (one percent) or up to half of the lender’s required

down payment.

First Mortgage Maximum LTV (Loan to Value): 95% LTV and 95% (For FHA). Applicant must be pre- qualified based on ability to pay without consideration of assistance from the City.

Maximum Combined LTV (Loan to Value): 105% CLTV

Second Mortgage Purpose:

Soft Second Mortgages - Zero percent (0%) interest deferred second mortgage that does not require payment by the Program recipient as long as terms of agreement between the City and

owner are maintained for duration of the affordability period. Interest rate and principal buy

down may be permitted.

Maximum Amount of Assistance:

Extremely Low: 30% AMI or Lower – Up to $40,000 Very Low: 50% AMI or Lower - Up to $40,000 Low Income: 51% AMI to 80% AMI - Up to $40,000 Middle Income: 81% up to 120% AMI- Up to $30,000

(Based on Area Median Income – AMI, See income chart)

Second Mortgage Interest Rate: 0% interest for the term of the loan – 10 Years or 15 years

Zero percent interest, deferred payment loan secured by a mortgage and note. The loan is forgivable in its entirety

at the end of the term. The term begins the date of the closing, provided the title remains under the ownership of

the original purchaser.

Borrower Income Limitations: 120% of the area median income (AMI) adjusted for household size.

Property Eligibility: Single-family detached homes, condominiums, townhomes, and villas.

Purchase checks are issued by the City of Deerfield Beach. DBHA is not responsible for issuance of checks.

Prospective homebuyers must have their title company coordinate the closing with DBHA of Florida. Federal

and State statutes, regulations and programs governing this application are subject to change at any time

I/We understand and agree with the terms mentioned above.

Applicant’s Signature: Date:

Co-Applicant’s Signature: Date:


10


HOME REPAIR PROGRAM TERMS AND CONDITIONS

The City’s First Time Homebuyer (Purchase Assistance) program has set aside funds to address minor

repairs that may be needed for the property you have purchased with CDBG, SHIP and HOME funds. If

the City of Deerfield Beach provides additional assistance to repair your home, the following terms and

conditions will apply for home repair assistance.

Average Amount of Assistance: Very Low and Low Income: 50% AMI or Lower - $15,000* Moderate to Middle Income: 51%-120% AMI- $10,000* (Based on Area Median Income – AMI, See income chart)

Second Mortgage Interest Rate: 0% Interest Deferred Loan - 15 Years

Zero percent interest, deferred payment loan secured by a mortgage and note. The loan is forgivable in its entirety at the end

of the term. The term begins the date of the closing, provided the title remains under the ownership of the original purchaser.

Property Eligibility: Housing units that have been purchased with CDBG, SHIP and HOME funds

Standard Repairs Permitted (Subject to availability of funds): The City maintains a list of standard repairs

that it will complete in a program assisted unit. These repairs address code issues, health, safety, welfare, and

other non-cosmetic type repairs. If a home needs repair assistance, purchasers should take into consideration

the maximum amount of funding available for repairs.

Federal and State statutes, regulations and programs governing this application are subject to change at any

time.

I/We understand and agree to the terms and conditions outlined above.



(END OF DISCLOSURES)


11


FIRST TIME HOMEBUYER

(PURCHASE ASSISTANCE)

PROGRAM

APPLICATION


12

CITY OF DEERFIELD BEACH FIRST TIME

HOMEBUYER (PURCHASE ASSISTANCE) PROGRAM

Please provide (2) two photocopies of the below documents that apply to you. WE DO NOT MAKE COPIES.

1. Three (3) most recent pay stubs or earnings statements showing the employee’s name, gross pay per pay period, deductions, and frequency of pay for every household member over 18 years old.

2. Last six (6) months bank statements for every household member. We need every page of the bank statements – including any “blank” pages.

3. Federal income tax returns filed with the IRS for the last two (2) years AND W-2s for the last two

(2) Years. We will accept: a. A copy of the original signed federal tax return with W-2s or b. A transcript of your federal return from the IRS with W-2s. You can request a transcript by

filling out IRS form 4506-T and sending to the IRS. The form can be obtained from the IRS

website www.irs.gov, by calling the IRS at 1-800-829-3676, or by going to the IRS office.

4. Proof of number of dependents claimed (Dependents must be listed on your federal tax return).

a. Birth Certificate on which the parent/applicant’s name is listed or

b. School records which give the parent’s names and address or

c. Court-ordered letters of guardianship or

d. Divorce decree or e. Letters of adoption

f. If a dependent over 18 is a full time student please submit a copy of their class schedule in addition to the above documents.

5. Signed Social Security Cards for all household members.

6. Proof of citizenship or legal immigrant status documents. a. United States of America birth certificate or b. U.S. Passport or

c. Acceptable forms of verifying immigration status

7. If you are divorced, we need a copy of your divorce decree or certified court documents.

8. If you are separated, we need 5 years tax returns showing single filing AND spouse’s driver’s license or a utility bill that shows a different address.

9. Self-Employment Income. Schedule C, E, or F must be included with your federal income tax return AND

a. Accountant or bookkeeper’s statement of net income expected for the next 12 months printed on the accountant/book keeper’s company letterhead or

b. A notarized sworn statement from the self-employed individual of net income expected for the

next 12 months

http://www.irs.gov/


13

10. Social Security, Supplemental Security Income (SSI), and Disability benefits - An award or benefit notification letter prepared and signed by the authorizing agency.

11. Unearned Income. Please provide documents for all that apply.

a. Unemployment Compensation - Unemployment benefit award notice with three (3) copies of

unemployment check stubs.

b. Disability Compensation - Notice of eligibility from employer or authorizing agency and three (3)

copies of check stubs.

c. Worker’s Compensation - Notice of eligibility with amount awarded and three (3) check stubs.

d. Severance Pay - Notice of employer stating the amount received in severance pay.

e. Welfare of other needs based payments given to any household members.

12. Unemployed household member not receiving unemployment benefits or income. Please provide a

notarized, sworn statement from the household member stating that unemployment benefits are not

received and he/or she is not receiving any income.

13. For Alimony or Child Support Payments

a. A printout from the court or governmental agency through which payments are being made or

b. An original notarized letter from the non-custodial parent stating the amount given weekly, bi- weekly,

or monthly or

c. An original notarized statement from custodial parent stating that child support is not received for each

child.

For Scholarships, Grants, and Veteran’s Administration Benefits - Benefactor’s written confirmation

of amount of assistance and educational institution’s written confirmation of expected cost of the student’s

tuition, fees, books, and equipment for the next 12 months.

14. Assets - Please bring current statements for the assets mentioned below for each household member if

applicable. We need all pages of each statements submitted and listed on your application form.

a. 401(K) account statement

b. Retirement statement

c. Pension statement

d. IRA statement

e. Certificate of deposit (CD) statement

f. Annuities

15. Life Insurance policy with current cash value and the type (term or whole). We need all pages of the

most current policy statement.

16. Recurring Contributions and Gifts. Example: non-household member paying all or part of bills, mortgages

or contributing money on a regular basis.

a. Notarized statement or affidavit signed by the person providing the assistance, giving the purpose, dates

and value of the gifts or

b. A letter from a bank, attorney, or a trustee providing required verification.

17. Executed Real Estate Contract.


14


FIRST TIME HOMEBUYER (PURCHASE ASSISTANCE)

PROGRAM

GENERAL APPLICANT INFORMATION

APPLICATION DUE DATE:

Name of Applicant:

Name of Co-Applicant:

Address:

Home Phone: Work Phone: Cell Phone:

Household Size: Anticipated Gross Annual Household Income:

Marital Status of Applicant:

Additional Comments:



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

For Office Use ONLY

Assigned to Program Specialist: Date:


15


FIRST TIME HOMEBUYER (PURCHASE ASSISTANCE) PROGRAM

APPLICANT’S INFORMATION

APPLICANT’S NAME: SS#:

CO-APPLICANT’S NAME: SS#

STREET ADDRESS: PHONE

CITY: STATE: ZIP:

MAILING ADDRESS:

ANNUAL GROSS INCOME: Attach additional sheet(s) if necessary.

SOURCE APPLICANT CO-APPLICANT OTHER MEMBER 18

OR OVER

TOTAL

Gross Salary

Overtime, Tips, Bonuses, etc.

Interest/Dividends

Business Net Income

Rental Net Income

Social Security, Pensions, Etc.

Unemployment, Workers Comp.

Alimony, Child Support

Welfare Payments

Other (List)


16



APPLICANT/CO-APPLICANT, EMPLOYER(S) and all household members over 18:

Attach additional sheet if necessary.

Name of Employee (Applicant):

Name of Employer:

Address:

Phone:

Years Employed:

Position: Supervisor:

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

Name of Employee (Co-Applicant):

Name of Employer:

Address:

Phone:

Years Employed:


Please use the space below to list the employment information for other household members over the age

of 18 or to provide information on additional employment of applicant and/or co-applicant. Use additional

sheets if necessary.

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

Name of Employee:

Name of Employer: Address:

Phone: Years Employed:


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

Name of Employee:

Name of Employer:

Address:

Phone:

Years Employed:


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

Name of Employee:

Name of Employer:

Address:

Phone:

Years Employed:



17



Please complete the following for ALL members of the household. Attach an additional sheet, if needed.

FULL NAME

First Middle Last

DATE OF

BIRTH

RELATIONSHIP SOCIAL SECURITY #

ASSETS:

Name:

TYPE CASH VALUE ANNUAL INCOME

FROM ASSETS

BANK NAME ACCOUNT NO.

Checking Accounts:

Savings Accounts:

Credit Union

Account:

Stock, Life

Insurance :

Other:

Other:


18



ASSETS:

Name:


FROM ASSETS


Checking Accounts:

Savings Accounts:

Credit Union

Account:

Stock, Life

Insurance :

Other:

Other:

ASSETS:

Name:


FROM ASSETS


Checking Accounts:

Savings Accounts:

Credit Union

Account:

Stock, Life

Insurance :

Other:

Other:


19



LIABILITIES:

List debts including auto loans, credit cards, charge accounts, real estate & mortgage loans, etc.

TYPE CREDITOR’S NAME MONTHLY PAYMENT BALANCE

Mortgage

Rent/Lease Payment

Do you have any outstanding unpaid collections or judgments? Yes No Amount $

Have you declared Bankruptcy in the last 7 years? Yes No

Are you a party in a lawsuit? Yes No

IMPORTANT - APPLICANT READ BEFORE SIGNING

The information provided is true and complete to the best of my/our knowledge and belief. I/We consent to the

disclosure of such information of purposes of income verification related to my/our application for financial

assistance. I/We understand that any willful misstatement of material fact will be grounds for disqualification.

Applicant(s) understand(s) that the information provided is needed to determine assistance eligibility and in no

way assures qualification for assistance. The applicant(s) also agrees to provide any other documentation needed

to verify eligibility.

WARNING: Florida Statute 817 provides that willful false statements or misrepresentation concerning income

and assets or liabilities relating to financial condition is a misdemeanor of the first degree and is punishable by

fines and imprisonment provided under S775.082 o 775.83.

Applicant Signature Date

Co-Applicant Signature Date


20



Statement of Household Size

This is to certify that person(s) will be residing in the property that I/We intend to purchase.

Applicant Signature Date

Co-Applicant Signature Date


21


FIRST TIME HOMEBUYER

(PURCHASEASSISTANCE) PROGRAM

AUTHORIZATION FOR THE RELEASE OF INFORMATION

I/We , the undersigned, hereby authorize the release without liability,

information regarding my/our employment income, and/or assets to Deerfield Beach Housing Authority for

the purposes of verifying information provided, as part of determining eligibility for assistance under the First

Time Homebuyer (Purchase Assistance) Program. I/We understand that only information necessary for

determining eligibility can be requested.

Types of information to be verified:

I/We understand that previous or current information regarding me/us may be required. Verifications that may be

requested are, but not limited to: personal identify; employment history, hours worked, salary and payment

frequency, commissions, raises, bonuses, and tips; cash held in checking/savings accounts, stocks, bonds,

certificate of deposits (CD), Individual Retirement Accounts (IRA), interest, dividends, etc.; payments from

Social Security, annuities, insurance policies, retirement funds, pensions disability or death benefits;

unemployment, disability and/or worker’s compensation; welfare assistance; net income from the operation of a

business; and, alimony or child support payments, etc.

Organizations/Individuals that may be asked to provide written/oral verification are, but not limited to:

Past/Present Employers Alimony/Child/Other Support Providers

Banks, Financial or Retirement Institutions Social Security Administration

State Unemployment Agency Veteran’s Administration

Welfare Agency Other:

Agreement to Conditions:

I/We agree that a photocopy of this authorization may be used for the purposes stated above. I/We understand

that I/We have the right to review this file and correct any information found to be incorrect.

Signature of Applicant Print Name Date

Signature of Co-Applicant Print Name Date

NOTE: This general consent may not be used to request a copy of a tax return. If one is needed, contact your local IRS office for Form

4506. Request for Copy of Tax Return will need to be signed separately.


22

DEERFIELD BEACH HOUSING AUTHORITY PROGRAM ADMINISTRATOR FOR THE CITY OF DEERFIELD BEACH FIRST TIME

HOMEBUYER (PURCHASE ASSISTANCE) PROGRAM

PURCHASE ASSISTANCE/RESIDENTIAL HOME REPAIR PROGRAM

Credit Bureau Services, Inc. REPOSITORY REPORT ORDER FORM

Date: Requested by:

Client Code:

APPLICANT INFORMATION:

BORROWER:

A.K.A./FKA:

SS#: DATE OF BIRTH

CO-APPLICANT INFORMATION:

CO-BORROWER

A.K.A./FKA

SS #: DATE OF BIRTH

ADDRESS:

PREVIOUS ADDRESS:

I (We) authorize Credit Bureau Services, Inc. to access repository information from a credit reporting agency

of its choice and provide this information to Deerfield Beach Housing Authority

Borrower’s Signature Co- Borrower’s Signature Date


23

Real Estate Contract Addendum

First Time Homebuyer (Purchase

Assistance) Program City of

Deerfield Beach

This addendum (“Florida Addendum”) is made a part of Real Estate Sales Contract dated between the Seller(s)

_______________________________________, and the Purchaser(s) ____________________________________, (Contract) for the

Property located at: ______________________________________, Florida.

The Seller and Purchaser agree and acknowledge the following:

a. Property is intended to be purchased as an owner occupied property by the Buyer who must maintain homestead on the property throughout the affordability period set in the award agreement with the

city.

b. The property must not be currently under contract with any other party and the property must not be made available for purchase to any other party for the duration of this contract.

At any time prior to completion of transaction, if any of the conditions above are not met, this property will not be

eligible for purchase by the City.

Buyer Date Seller Date

Buyer Date Seller Date

Listing Agent Date Selling Agent Date

please do not mail or fax the...

Documents