Participant Affidavit and Certification for ADU Grant
Last revised: 05-24-2022
Participant Affidavit and Certification for CalHFA Accessory Dwelling Unit Grant
The following entity, _________________________________________________, a
(“Participant”) has received and reviewed all required documents submitted by
____________________________________________________, ____________________________________________________,
____________________________________________________, and ____________________________________________________
(collectively, “Applicant”) for the purposes of supporting the application for a grant to construct an accessor dwelling unit (“ADU”) on the
below property (“Property”) with funds made available by the California Housing Finance Agency (“CalHFA”) pursuant to its ADU Grant
Program (“Program”) under the terms and conditions of the Program, do hereby represent and warrant as follows:
Property Address
Street:
City:
County:
Zip:
ADU Construction Requirements
Participant certifies the construction of the ADU will follow Fannie Mae/FHA ADU feature requirements. ADU construction
requirements can be found in Fannie Mae’s Selling Guide and FHA’s Single-Family Housing Policy Handbook.
ADU Permits, Fees and Costs
Participant certifies that any “Eligible Costs” under the terms and conditions of the Program (including locality permit and/or impact
fees) related to the ADU construction on the Property have been paid in full.
Certificate of Occupancy
Participant will provide CalHFA a Certificate of Occupancy issued by the local jurisdiction upon completion of the ADU.
Program Income Limits
Participant certifies that the Applicant’s current income meets CalHFA Program
requirements.
Annual Income of all individuals used
for credit qualifying purposes
$_____________________________
Participant Certification
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE
FOREGOING IS TRUE AND CORRECT. I AGREE THAT THE AGENCY (I.E., CALHFA) TO WHICH
EVERY ONE) IS APPLYING MAY, DIRECTLY OR THROUGH ITS CONTRACTORS, AGENTS, GRANTEES OR DESIGNEES, TAKE
SUCH ACTIONS AS IT DEEMS NECESSARY TO VERIFY THE ACCURACY OF THIS CERTIFICATION
UNDERSTAND AND AGREE THAT ANY PERSON OR ENTITY CONTACTED BY THE AGENCY AND/OR ITS CONTRACTORS,
AGENTS, GRANTEES OR DESIGNEES, IN THE COURSE OF SUCH VERIFICATION, MAY RELEASE SUCH PERTINENT
INFORMATION TO THE AGENCY AND/OR ITS CONTRACTORS, AGENTS, GRANTEES OR DESIGNEES.
___________________________________________________________ ____________________
Signature of Authorized Participant Representative Date
______________________________________________________
Print Name and Title of Authorized Participant Representative
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