HOME OF YOUR OWN HCV HOMEOWNERSHIP PROGRAM APPLICATION

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Candace Merritt
6 years ago
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1 HOME OF YOUR OWN HCV HOMEOWNERSHIP PROGRAM APPLICATION NOTE: Please report in writing any change of address immediately at 1122 Broadway, Suite 300, San Diego, CA HEAD OF HOUSEHOLD NAME: Last First MI HEAD OF HOUSEHOLD S SOCIAL SECURITY NUMBER: STREET ADDRESS: MAILING ADDRESS: TELEPHONE NUMBER: Apt City State Apt City State ZIP CODE: ZIP CODE: Home Work/Other Name Please list all household members Relationship to Head of of Birth Sex SSN Household 1. Name and address of current landlord (include city, state, zip and phone number). 2. How long have you resided in the home? a. Applicant s current total contract rent? $ b. Applicant s portion: $ c. PHA s portion: $ 1

2 (If you have resided at this address less than a year you will need to submit a completed Landlord Reference form from each Landlord from the past year.) 3. Would any family member require or benefit from a unit specifically designed for individuals with disabilities? 4. Are you or any member of the household disabled? If yes, who? 5. Are you or any member of the household receiving SSA or SSI? If yes, who? 6. Are you or any member of the household currently participating in the FSS/ASPIRE program? If yes, which program and who? 7. Have you or any member of the household graduated from the FSS/ASPIRE program in the last 12 months? If yes, who and when? 8. Do you or any member of your household currently own a home or have owned a home (USA or anywhere) within the last three (3) years? 9. Do you or any member of your household currently owe money to SDHC or any other Housing Authority? 10. Have you or any member of your household had any program violations during the past twelve (12) months? 2

3 11. Have you or any member of your household been arrested or convicted for drug related or violent criminal activities? 12. Have you or any member of your household taken and completed a First-Time Homebuyers class in the past twelve (12) months? If yes, please attach a copy of the certificate to your application packet. 13. Do you or any member of your household currently have an FSS/ASPIRE escrow account? If yes, please provide account balance: 14. Do you currently have a least $3,000 in savings or personal resources (checking, saving, IDA, etc.) for down payment or other closing costs? A maximum of $1,500 may be used from your FSS/ASPIRE match to meet this requirement. The other $1,500 needs to be verifiable savings accumulated over several months in your savings, IDA, or checking account. Note: Please provide a copy of all household asset statements for the last six consecutive months as verification. 15. Have you or any adult member of the household ever defaulted on a mortgage loan? 16. Do all adult household members who will be included on the loan documents have good credit? If no, please explain: 17. Do you know your current FICO/Credit Score? If yes, what is the score? 18. What is your household s gross annual income? 3

4 Other information 19. Does any family member have any outstanding judgments? Yes 20. Has any family member declared bankruptcy within the past 7 years? No Yes 21. Is any family member financially responsible for child support or alimony? Yes 22. Is any family member receiving child support or alimony? Yes 23. Is any family member a defendant or plaintiff in a lawsuit? No Yes 24. Will any portion of your down payment be borrowed? No Yes If yes, Amount $ From When 25. Is any family member presently delinquent or in default on any debt or loan, mortgage, financial obligation, bond or loan guarantee? Yes 26. Has any family member previously participated in the Housing Choice Voucher (Section 8) Homeownership program? Yes If yes, who and when? 4

5 [FOR NON ELDERLY / NON DISABLED ONLY] 27. Are you or any adult member of your household working full-time? (Full-time is at least 35 hours per week) If yes, who? Yes 28. Has/Have any adult household member (s) listed on the previous question been continuously working fulltime (No gaps in employment for one year) for at least a year? Yes If yes, who? If no, please explain? 29. Has/Have any adult household member (s) listed above been continuously working for at least 2 years? Yes If yes, who? If no, please explain? Please complete the information below for each employed person. Name of person employed Your position Gross Annual Income from employment Hours worked per week Years on job (If less than 2 years list previous employers) 5

6 Name of person employed Your position Annual Income from employment Hours worked per week Years on job (If less than 2 years list previous employers) Name of person employed Your position Annual Income from employment Hours worked per week Years on job (If less than 2 years list previous employers) 6

7 Documentation may be requested from you to verify dates and locations. However, this does not automatically disqualify you from being assisted with any low-income housing program. I acknowledge receipt of a copy of this application. WARNING! TITLE 18, SECTION 1001 OF THE UNITED STATES CODE, STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES. MAKING FALSE STATEMENTS IS ALSO A FELONY UNDER CALIFORNIA STATE LAW (PENAL CODE SECTIONS 115, 118, 487, 532.) I/We hereby certify under penalty of perjury that all of the information contained in this document is true and correct. I/We understand and acknowledge that making false statements on this document is a crime under state and federal law, which may result in termination from the program and criminal prosecution. MUST BE SIGNED BY ALL HOUSEHOLD MEMBERS WHO ARE 18 YEARS AND OLDER. Signature of Head of Household Signature of Spouse or Co-Applicant Signature of Other Adult Signature of Other Adult Signature of Other Adult Translator Certification: I certify that I translated the above information. Signature 7

8 AUTHORIZATION FOR RELEASE OF INFORMATION I/We hereby authorize the San Diego Housing Commission (SDHC), and its staff, to contact any agencies, offices, sources, groups, or organizations to obtain any information or materials including credit checks, DMV reports, police and/or court records, etc., which are deemed necessary to determine my eligibility for participation in the HCV Homeownership Program. I/We hereby authorize any and all agencies, sources, offices, groups, or organizations contacted by the SDHC and its staff to cooperate fully and fully divulge the information requested. In addition, I/we give my permission for involved agencies/lenders to exchange information regarding my involvement in the Home of Your Own Program, ASPIRE Program, FSS Program. This authorization expires 15 months from the date of signature. Copies of the document shall be considered to have the same force as an original. ALL MEMBERS OF THE HOUSEHOLD 18 OR OLDER MUST SIGN THIS FORM Household address: Street Unit/Apartment No. Signature of Head of Household City ZIP State Last four (4) digits of your Social Security Number Signature of Spouse/ Co-head Last four (4) digits of your Social Security Number Signature of Other Adult Last four (4) digits of your Social Security Number Signature of Other Adult Last four (4) digits of your Social Security Number Translator Certification: I certify that I,, translated the above information. Signature

9 VERIFICATION OF DISABILITY The United States Housing Act of 1937, as amended, authorizes special considerations in federally funded housing to a person who is permanently disabled or who is handicapped person. (1) A disabled person is one with an inability to engage in any substantial gainful activity because of any physical or mental impairment that is expected to result in death or has lasted or can be expected to last continuously for at least 12 months; or for a blind person at least 55 years old, inability because of blindness to engage in any substantial gainful activities comparable to those in which the person was previously engaged with some regularity and over a substantial period. (2) A developmentally disabled person is one with a severe chronic disability that: (a) is attributable to a mental and/or physical impairment; (b) as manifested before age 22; (c) is likely to continue indefinitely; (d) results in substantial functional limitations in three or more of the following areas: capacity for independent living, self-care, receptive and expressive language; learning, mobility, self-direction, and economic self-sufficiency AND requires special interdisciplinary or generic care treatment, or other services which are of extended or lifelong duration and are individually planned or coordinated. (3) A disabled person is also one who has a physical, emotional or mental impairment that: (a) is expected to be of long-continued or indefinite duration; (b) substantially impedes the person's ability to live independently; (c) is such that the person's ability to live independently could be improved by more suitable housing conditions. The Housing Commission of the City of San Diego is attempting to provide housing assistance to. In order to determine eligibility, the family status must be verified. Below is a release signed by the applicant authorizing us to obtain the requested information. This information will be held in confidence for use only in determining eligibility for housing assistance. We ask your cooperation in returning this completed form in the enclosed addressed envelope within five days so we can complete eligibility determination. Applicant s Authorization to Release Information CERTIFICATION OF DISABILITY In my opinion, does does not have a disability/handicap as defined above. : Signature Professional Title Physician s License # : Telephone:

10 LANDLORD REFERENCE The San Diego Housing Commission is attempting to provide housing assistance under the Section 8 Program to the applicant below. To finalize our determination, we need to verify residence. The applicant has authorized you to release this information (authorization attached) which will be held in confidence for use by this agency. We re asking for your cooperation by completing and returning this form within 5 days. Thank you for your assistance. Tenant/Applicant Name Street City, State Zip Does the above mentioned person/household pay their rent in full and on time? [ ] Yes [ ] No How many notices (if any) have been issued in the last 12 months? Please list all individuals living in the household How long has the person/household lived in the rental unit? From / To / Would you rent to this person/household again? [ ] Yes [ ] No Are you a relative? [ ] Yes [ ] No If yes, what is the relationship? Print Name and Title Telephone with Area Code Signature and WARNING! Title 18 of the United States Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department or agency of the United States.

Rental Application. Applicant: Name: Current Address: City, State, Zip Code: Work Phone: Marital Status: single married divorced separated widow

Rental Application. Applicant: Name: Current Address: City, State, Zip Code: Work Phone: Marital Status: single married divorced separated widow Rental Application Applicant: Name: Current Address: City, State, Zip Code: Work Phone: Home Phone: Date Of Birth: Social Security # Bedroom Size Requested: Marital Status: single married divorced separated