COMMUNITY DEVELOPMENT & HOUSING
CERTIFICATION/AFFIDAVIT BY APPLICANT (S) Application Page 2
I/We, the applicant(s), certify that all information in this application and information furnished in
support of this application is true and
complete to the b
est of my/our knowledge and belief. Should it be found that I/we willfully falsified any information upon which eligibility
was determined, I/we will be considered in breach and I/we shall be required to return any sums expended by the City of High Point on
my/our behalf, including any legal fees incurred during the verification process and administrative costs.
If Seeking Homebuyer Assistance/Incentive:
I/We certify that I am/we are the homebuyer(s) and will reside in the property as my/our primary residence. I am/we are fully aware of and
agree to invest a minimum of $500 into the property from my/our income and will provide verification of these monies on deposit prior to
closing. I am/we are aware that I/we are not allowed to receive any money back at closing as this will result in disqualification of any and
all assistance/incentive. I am/we are aware that as a first-time homebuyer, I will be required to attend an 8-hour pre-purchase Homebuyer
Education Class prior to loan closing. I/We understand and agree that by receipt of assistance from the City of High Point for down payment
and closing costs for the purchase of a property, a lien will be placed against the property. At the end of the affordability period, if I am/we
are not in default, a Satisfaction of Lien for the cost of down payment assistance will be issued by the City of High Point. I also understand
that I may be required to execute a Resale/Recapture Agreement. I/we understand if my application is approved, the City of High Point will
use photographs of my home for advertisement and on other public displays regarding the Homebuyer Assistance/Incentive Programs.
PENALTY FOR FALSE OR FRAUDULENT STATEMENT:
I/We certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this
application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in
this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both and liability
for monetary damages to the Lender, agents, successors and assigns, insurers and any other person who may suffer any loss due to
reliance upon any misrepresentation which I/we have made on this application.
Applicant(s) expressly authorize you to make inquiries of others concerning the foregoing information. Including, but not limited to
procuring consumer reports from consumer reporting agencies and to provide information arising out of applicant(s) transaction with you to
others. Any person named herein is expressly authorized to furnish you with information in connection with his application.
City of High Point, P.O. 230, 211 South Hamilton Street, High Point, NC 27261 USA
Office: 336.883.3349 Fax: 336.883.3355 TDD 336.883.8517
pplican Sigtn aure
Applican Sigtn ature
State of North Carolina
County of _____________________
This instrument was acknowledged before me on the _______day of _______________________________, by_________________________________
______________________________________________________________________________________ Sworn to and subscribed before me on this day.
____________________________________________________________________My Commission Expires: ___________________________________________