Fillable Program Eligibility Application and Checklist

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Program Eligibility Application – Rev200324
Housing Trust Silicon Valley
Homebuyer Programs
Program Eligibility Application and Checklist
Thank you for your interest in Housing Trust Silicon Valley (Housing Trust) Homebuyer
Programs. To determine program eligibility, interested applicants must complete the
Program Eligibility Application and provide the required documents. Please review
Program Eligibility Application Checklist and Tips provided in this application.
A complete Program Eligibility Application package is required for program eligibility
determination. Review of a complete application package by Housing Trust staff may
require up to 14 business days. It is highly recommended that applicants do not enter into
a purchase agreement contract prior to receiving a Program Eligibility Determination letter
from Housing Trust. An incomplete application may not be accepted.
Application and all required documents must be hard copies. We will not accept any
original documents. Do not email the application or documents unless otherwise
requested. Application and required documents must be submitted in person and by
appointment only to the Homebuyer Programs Department at:
Housing Trust Silicon Valley
75 East Santa Clara Street, Suite1350
San Jose, CA 95113
All documents accepted become the property of Housing Trust Silicon Valley. You must keep
your own copies for reference. We cannot provide additional copies of an applicant’s
documentation.
For questions or to schedule an appointment, please email:
homebuyer@housingtrustsv.org or contact Homebuyer staff at (408) 703-3837 ext. 301
For additional information about Housing Trust’s Homebuyer Programs,
visit www.housingtrustsv.org/programs/homebuyer-assistance
This is not a loan application or commitment to lend housing funds. This application is for
determination of program eligibility only. Any misrepresentations or falsifications on this
application will result in disqualification from this and future Housing Trust Silicon Valley
Homebuyer Programs.
Program Eligibility Application – Rev200324
Special Instructions for the Acceptance of
Online Eligibility Applications
March 24, 2020
Out of an abundance of caution and for the health of our staff
and clients, we are not accepting applications in person at our
office.
We are offering applicants who have received a lender pre-
approval letter a pre-purchase review with our Homebuyer
Education Specialist.
Applicants meeting the pre-purchase review requirements
can submit an Eligibility application and the required
documents through a secured portal. The Homebuyer
Education Specialist and the Homebuyer Programs team will
provide email instructions on the process and the access for
the secured portal.
We thank you for your patience and understanding during this
time.
Program Eligibility Application – Rev200324
Housing Trust Homebuyer Programs
Eligibility Application and Documentation Checklist
Program Eligibility Application – signed/dated by all applicants and co-applicants over the age of 18.
INCOME Documentation – REQUIRED FOR ALL ADULT HOUSEHOLD MEMBERS OVER THE AGE OF 18.
See Sections 2 & 3 of the Program Eligibility Application Tips for more details.
Copies of FOUR (4) most recent and consecutive paystubs for ALL employed adult household members.
Copies of last
THREE (3)
years Federal and State Tax returns with all W-2s, 1099s and Schedules (signed/dated)
for all adult household members.
Copies of the last THREE (3) years tax transcripts from the IRS for each adult Household member.
If Self-Employed: Year-to-date Profit and Loss statement prepared and signed by a CPA/Tax Preparer on their
letterhead and/or by Applicant (at the discretion of Housing Trust).
If receiving Social Security/Disability/Unemployment /Contributions/Spousal/Child Support - Provide verifiable
documentation.
ASSETS – REQUIRED FOR ALL ADULT HOUSEHOLD MEMBERS OVER THE AGE OF 18
See Section 4 of the Program Eligibility Application Tips for more details.
Checking/Savings – Copies of THREE (3) most recent monthly statements from all checking/savings accounts
Money Market Funds, Mutual Funds, or Certificates of Deposit (CD) and any other asset account – Copies of
THREE (3) most recent monthly statements.
Stocks & Bonds – Copies of THREE (3) most recent monthly account statements. For Bonds, need a list of
Bonds with Amount and Serial Numbers.
Retirement accounts (401K, CalPERS, CalSTRS, 403B, TSP, IRA, or Profit-Sharing Plan) – Copies of the
THREE (3)
most recent statements or most recent quarterly statement.
PARTICIPATING LENDER REQUIRED DOCUMENTATION
Pre-Approval letter from the Participating and Approved Lender.
Lender Credit Report (Housing Trust will request from the Participating Lender).
Gift Letter (If receiving gift funds) – Provide letter signed and dated along with proof of funds from each donor.
OTHER REQUIRED DOCUMENTATION APPLICANTS MUST BRING
Copy of Current Lease OR Rental Agreement (All pages) must be signed by landlord and all adult household
members.
Documentation of six (6) months of rental payments (e.g. cancelled checks) – Cash payment or receipts are not
acceptable.
Last six (6) months of paid utility bills (e.g. PG&E, San Jose Water, Santa Clara Electric).
Certificate(s) of completion for the HUD certified 8-Hour Homebuyer Education Class from an approved designated
agency for all borrowers and co-borrowers including non-borrowing spouse.
CITIZENSHIP
–
Bring proof of citizenship or legal residency for EACH household member
Bring Valid U.S. Passport, Naturalization Certificate, Certified copy of U.S. Birth Certificate or U.S. Permanent
Resident Card (Green Card) USCIS Form I-551 or I-151 (Required).
Valid California issued Driver’s License or Identification Card for ALL adult household members (Required).
Certified copy of U.S. Birth Certificate for children 18 years and younger (Required).
Program Eligibility Application – Rev200324
Program Eligibility Application Tips
INSTRUCTIONS: Tips are provided to help applicants with questions regarding the required documentation. It is not meant to replace or
limit the documentation that is required and listed in the Program Eligibility Application and Documentation Checklist. Start gathering your
documents as soon as possible. Any delays could result in an incomplete application. No screenshots or pictures of documents are
allowed.
Save this Eligibility Application and Documentation Checklist to your computer after you have completed it, so that it is ready
for uploading to a secured online portal that Housing Trust will share with you. Housing Trust will email you separate
instructions on the process. You do not need to digitally sign this application at this time. How to save this PDF: after you have
opened and filled-it out the application, click on the File button (on the upper left), select Save As, and choose a location on your
computer to save to, such as your Desktop.
1. Program Eligibility Application and Documentation Checklist – Fill out the application completely and review the
checklist of ALL required documents.
• The Borrower is the primary Applicant and Co-borrower is Co-applicant #1.
• ALL adult household members (18 years of age or older) are listed on the application.
• ALL adult household members provide their income, tax and asset documentation, regardless if they are
not co-borrowers on the loan.
2. Tax Returns – ALL adult household members provide copies of the last three (3) calendar years (signed and dated)
complete Federal and State Income Tax Returns with ALL Schedules (A, B, C, D, E, etc.), W2s, 1099s including 1099-
INT, 1098, etc.
• Household member receiving several W2s, 1099s, 1098s from different employers for the requested tax years
provides copies of ALL those forms.
• Household members who are dependents are listed on the tax returns of the Borrower(s)
• For any non-filing adult household member, the following must be provided:
- Verification of non-filing for each tax year requested.
- Wage and income transcript for each tax year requested – Last three (3) calendar years.
***Please note the Internal Revenue Service (IRS) may take 10 business days or more to provide the
documents***
• For Amended Tax Returns – Provide copy of the Amended Tax Return and Tax Return originally submitted to the
Internal Revenue Service.
3. Income – Documentation to be provided by ALL adult household members
For W-2 hourly or salaried employees – Most recent and consecutive four (4) paystubs. Paystubs must be legible and
clear.
• Verification of Employment (VOE) – ALL working adult household members will provide the contact information of
the HR/payroll person at the application appointment.
o Housing Trust sends the VOE directly to the employer.
o Your employer may use a third-party provider for verification. A check from the applicant will be required to
cover the cost of the service fee. Employer’s ID number and employee salary key is required.
o If you recently changed jobs, you must provide contact information for the HR/payroll person of the
previous employer.
• Applicants receiving Restricted Stock Units (RSUs) from their employer must provide current vesting schedule.
• Any job changes are disclosed immediately to Housing Trust and the lender. Failure to do so could invalidate the
application and program eligibility determination (pre-approval letter from Housing Trust).
For Self-employed, independent contractor, or any side business that provides a source of income – Applicant
must provide the following:
• Year-to-Date Profit and Loss Statement.
• Last three (3) calendar years of Federal and State tax returns (personal & business) with all schedules,
1099s, etc.
• Business asset accounts – Copies of the three (3) most recent monthly statements for all business accounts
• Copy of business license (if applicable).
• Additional documents – Depending on types of self-employment, partnership, corporation, LLCs, etc. or business.
For other income – Provide most recent statements showing income from social security, annuities, insurance policies,
retirement funds, pensions, disability, death benefits, child support or alimony (see #12 and #13 on next page), public
assistance, or any other source.
Contact Housing Trust for additional documentation requirements.
Program Eligibility Application – Rev200324
4. Assets – ALL adult household members complies by providing third-party documentation (bank, credit union,
etc.)
• Applicant must show funds are currently available for borrower’s down payment and closing costs.
• Statements for the last three consecutive monthly statement periods are required for ALL Asset
Accounts.
o This includes all liquid and non-liquid account such as Checking, Savings, Money Market, Stocks,
Stock Options, Bonds, Mutual Funds, Certificate of Deposits, etc. and from all adult household
members.
o Statements from ALL retirement accounts are also required (see below).
• All statements must be clear, legible, and must include ALL pages, including blank pages.
• Identify the purpose of any non-direct payroll and/or non-electronic deposits over $500 including ATM deposits
that appear on your statements.
• Provide copies of the deposit slips, documents of funds deposited and written explanations for the
deposits.
Retirement Accounts (401K, CalSTRS, CalPERS, 403b, Pension, IRA, Roth IRA, TSP, Profit Sharing Plan, etc.) –
Can be accessed through your plan provider’s portal through its website.
o 401K or 403B withdrawal used for down payment or reserves - provide the terms and conditions of the
withdrawal.
- If 401K or 403B withdrawal is a loan - provide documentation from the provider showing the monthly
repayment amount, term of the loan and interest rate.
5. Lender Documentation
• Pre-approval – After obtaining a pre-approval from an approved participating lender, applicant(s) must send a
PDF copy to the Housing Trust. Applicant(s) are required to bring a copy to the appointment as well.
• The pre-approval must be valid for at least 90 days. Contact Housing Trust staff for more
information.
• Credit Report – Housing Trust will contact lender directly and request a copy of credit report. If the lender is
unable to provide, Housing Trust will require the borrower’s authorization to acquire a credit report.
• A credit report for Non-Borrowing spouse (not on the loan or pre-approval) will be required. Housing
Trust will require a check to cover the fee for the credit report from vendor.
6. Proof of Rent
• Copy of Current Lease OR Rental Agreement (ALL pages, must be signed by both tenants and landlord).
• Six (6) months of rental payments (e.g. cancelled checks).
• For rent paid through an online portal, provide a copy of rental account ledger that reflects the last 6
months of rental payments.
• The rental payments must clearly show the landlord or property management company.
• All adult household members on the application must listed as tenants in the rental agreement.
• For all other circumstances, contact Housing Trust staff for information.
• Six (6) months of paid utility bills (e.g. PG&E, San Jose Water, Santa Clara Electric, etc.) ALL pages,
including blank pages.
• Utility Bill must show address and applicant’s name.
7. State Issued Identification, Birth Certificates, Passports, and other forms of acceptable identification – Must be
current (not expired), clear and legible
• All adult household members will present a valid California Driver’s License or Identification Card at the
appointment.
Birth Certificates, Passports, Permanent Resident Alien, or Naturalization Certificate
• ALL household members at the appointment. will present ONE of the following:
• Certified Birth Certificate (birth certificate from the hospital is not valid documentation).
• Valid (unexpired) (unexpired) U.S. Passport.
• Valid Permanent Resident Alien Card.
• Household members without proof of permanent legal residency in the U.S. are not prohibited from occupying
the home as guest of Applicant. If such household members have been residing in Applicant’s household for
more than 30 days at time of application, such household members must also be listed in Applicant’s application,
and must provide all required income and asset documentation for inclusion in Applicant’s Gross Household
Income and Assets.
8. Gift Letter – Gift Letter (Housing Trust Gift Letter form required) must be signed by both donor and applicant.
• At application, a copy of the most recent bank statement from donor is required. The bank statement must show
enough funds to cover the gift amount.
Program Eligibility Application – Rev200324
• Gift funds that have already been deposited to bank account still require gift letter, copy of funds deposited (such
as cashed check) and copy of donor’s bank statement showing the transfer to applicant’s account.
9. Certificate of Completion for a HUD certified 8 Hour Homebuyer Education class from a designated HUD
approved agency – All borrowers and co-borrowers (including non-borrowing spouses) required to attend this class.
• The certificate of completion must be less than two (2) years at the date of application.
• Attendance of Homebuyer Education class or course can be in person or through a designated agency’s online
course.
10. Judgments, Liens and Collections
• Judgment and liens – Are paid prior to conditional Housing Trust loan approval. Applicant provides valid third
party documentation showing payment and debt is cleared.
• Collections – May require repayment terms. Please speak to your lender and Housing Trust staff for clarification.
11. Bankruptcy, Short sale and Foreclosure
• Bankruptcy (Chapter 7 or 13) – The discharge date must be more than four (4) years prior to application date.
• Applicant(s) must provide the following: filed bankruptcy petition, the discharge of debtor from bankruptcy court
and any other related, filed documents.
***Copy of bankruptcy documents can be obtained at PACER (Public Access to Court Electronic Records)
website: www.pacer.gov***
• Short sale – Four (4) years or more prior to application date. Applicant(s) provide address of property, sale date
and close of escrow date and/or any short sale documents (if available) from a mortgage lender and title
company in a letter of explanation. The letter must be signed and dated by the applicant(s).
• Foreclosure – Seven (7) years or more prior to application date. Applicant(s) provide address of property and/or
any foreclosures documents (if available) from the mortgage lender or title company in a letter of explanation. The
letter must be signed and dated by the applicant(s).
12. Final Divorce Decree and Dissolution – Provide filed final divorce decree, filed marital settlement agreement, and any
attached documents including court ordered alimony, payment history and records.
13. Child Custody and Support Agreement – Provide filed court order child custody and support agreement and any
documents including payment history and records.
• If there is no formal child support agreement, Applicant(s) must provide a “Certificate of Clerk” from Santa Clara
County Superior Court stating there is no confidential parentage or child support records on file.
14. Documentation that is not in English – Must be translated to English by a certified Notary service. You must provide
original document, translated document, invoices that reflects the charges for the translation services and notes what
document was translated. For additional requirements, contact Housing Trust.
Make appointment to submit Program Eligibility Application package – Applicant(s)/borrower, co-borrower(s) and all
household members over 18 years old are required to attend the appointment.
Any questions regarding documentation must be directed to Housing Trust prior to the application
submission appointment. Email homebuyer@housingtrustsv.org
.
Program Eligibility Application – Rev200324
I/WE ARE APPLYING FOR: Empower Homebuyers SCC (No application fee required)
(please select ONE program)
HELP ($100 non-refundable program eligibility application fee,
payable to Housing Trust Silicon Valley)
I. HOUSEHOLD COMPOSITION (NUMBER OF MEMBERS IN HOUSEHOLD):
Full name, gender, date of birth of
ALL
other members in the household and relationship to the Applicant
Name Gender Date of Birth
Relationship to Applicant
APPLICANT
Have you or any adult household member ever owned a home as a primary residence? Yes No If Yes,
Address Date Purchased
City/State/Zip Date Sold
Are you or any member of your household a
senior citizen (62 years+)?
Yes No Do Not Wish to Provide Applicant Household Member
Are you or any member of your household
disabled?
Yes No Do Not Wish to Provide Applicant Household Member
Are you or any member of your household a
Veteran?
Yes No Do Not Wish to Provide Applicant Household Member
YOU MUST PROVIDE THE FOLLOWING INFORMATION FOR EACH HOUSEHOLD MEMBER OVER THE AGE OF 18
II. APPLICANT INFORMATION (Borrower/ Head of Household)
NAME: Last, Middle Initial, First Name
MARITAL STATUS
Married
Single
Divorced
If Married, Name of
Spouse:
CONTACT PHONE NUMBER
Home
Cell
Work
(
)
-
EMAIL:
DATE OF BIRTH (mm/dd/yyyy)
/ /
SOCIAL SECURITY NUMBER:
CALIFORNIA DL/ID #
PRESENT ADDRESS:
City
, Zip
Own Rent Years/Months at Present Address:
List Previous Addresses if Residing at Present Address for LESS than THREE (3) Years:
FORMER ADDRESS
RESIDENCY
BEGIN
END
OWN/RENT
Own Rent
Own Rent
1
Program Eligibility Application – Rev200324
APPLICANT EMPLOYMENT INFORMATION: Provide ALL Sources of Income
Name and Address of Employer:
Self Employed Retired Unemployed
Business Phone (include area code): ( )
Position/Title/Type of Business _____________________________________________
______________________________________________________________________
Yrs. on the job
Yrs. employed in this line of
work/profession
Dates (from – to)
Monthly Income
$
Provide additional employment or sources of income you have: (Documentation
Required)
Name and Address of Employer:
Self Employed Retired Unemployed
Business Phone (include area code): ( )
Position/Title/Type of Business _____________________________________________
______________________________________________________________________
Yrs. on the job
Yrs. employed in this line of
work/profession
Dates (from – to)
Monthly Income
$
If not employed, provide source of income: Retired Disability Social Security Other:
Amount received: $ Frequency: Weekly Monthly Annually Other:
CO-APPLICANT #1 INFORMATION
NAME: Last, Middle Initial, First Name
MARITAL STATUS
Married Single Divorced
If Married, Name of
Spouse:
CONTACT PHONE NUMBER Home Cell Work
(
)
-
EMAIL:
DATE OF BIRTH (mm/dd/yyyy)
/ /
SOCIAL
SECURITY NUMBER:
CALIFORNIA DL/ID #
PRESENT ADDRESS:
City
, Zip
Own Rent Years/Months at Present Address:
List Previous Addresses if Residing at Present Address for LESS than THREE (3) Years:
FORMER ADDRESS
RESIDENCY
BEGIN
END
OWN/RENT
Own Rent
Own Rent
2
Program Eligibility Application – Rev200324
CO-APPLICANT #1 EMPLOYMENT INFORMATION: Provide ALL Sources of Income
Name and Address of Employer:
Self Employed Retired Unemployed
Business Phone (include area code): ( )
Position/Title/Type of Business _____________________________________________
______________________________________________________________________
Yrs. on the job
Yrs. employed in this line of
work/profession
Dates (from – to)
Monthly Income
$
Provide additional employment or sources of income you have: (Documentation
Required)
Name and Address of Employer:
Self Employed Retired Unemployed
Business Phone (include area code): ( )
Position/Title/Type of Business _____________________________________________
______________________________________________________________________
Yrs. on the job
Yrs. employed in this line of
work/profession
Dates (from – to)
Monthly Income
$
If not employed, provide source of income: Retired Disability Social Security Other:
Amount received: $ Frequency: Weekly Monthly Annually Other: ______________
CO-APPLICANT #2 INFORMATION
NAME: Last, Middle Initial, First Name
MARITAL STATUS
Married Single Divorced
If Married, Name of
Spouse:
CONTACT PHONE NUMBER
Home Cell Work
(
)
-
EMAIL:
_________________________________________________
DATE OF BIRTH (mm/dd/yyyy)
/ /
SOCIAL
SECURITY NUMBER: CALIFORNIA DL/ID #
City
, Zip
List Previous Addresses if Residing at Present Address for LESS than THREE (3) Years:
FORMER ADDRESS
RESIDENCY
BEGIN
END
OWN/RENT
Own Rent
Own Rent
3
P
RESENT ADDRESS:
Own
Rent Years/Months at Present Address:_______________________________________________________________
Program Eligibility Application – Rev200324
CO-APPLICANT #2 EMPLOYMENT INFORMATION: Provide ALL Sources of Income
Name and Address of Employer:
Self Employed Retired Unemployed
Business Phone (include area code): ( )
Position/Title/Type of Business _____________________________________________
______________________________________________________________________
Yrs. on the job
Yrs. employed in this line of
work/profession
Dates (from – to)
Monthly Income
$
Provide additional employment or sources of income you have: (Documentation
Required)
Name and Address of Employer:
Self Employed Retired Unemployed
Business Phone (include area code): ( )
Position/Title/Type of Business _____________________________________________
______________________________________________________________________
Yrs. on the job
Yrs. employed in this line of
work/profession
Dates (from – to)
Monthly Income
$
If not employed, provide source of income: Retired Disability Social Security Other:
Amount received: $ Frequency: Weekly Monthly Annually Other:
FOR ADDITIONAL CO-APPLICANT(S) INFORMATION, PLEASE DUPLICATE
THESE PAGES TO FILL OUT AND ATTACH TO THIS APPLICATION
4
Program Eligibility Application – Rev200324
III. INCOME- List the GROSS ANNUAL INCOME for ALL Household Members over the age of 18
INCOME SOURCE
APPLICANT
CO-APPLICANT #1
CO-APPLICANT #2
TOTAL
Wages, Salaries, Tips, etc.
$ $ $
$
Business Income
$
$
$
$
Unemployment &
Disability
$ $ $
$
Interest & Dividend
Income
$ $
$
$
Retirement & Insurance
$
$
$
$
Alimony, Child Support
$
$
$
$
Gift Income
$
$
$
$
Welfare Assistance
$
$
$
$
Armed Forces Income
$
$
$
$
Other Income
(such as regular
monthly support from non-
household member)
$ $ $
$
TOTAL $ $ $
$
IV. ASSETS- List the CASH VALUE OF ALL LIQUID AND NON LIQUID ASSETS EXCLUDING RETIREMENT ACCOUNTS
for ALL household members over the age of 18
Applicant/Co-Applicant(s)
Name
Name of Financial
Institution
Describe Type of Account:
Checking, Savings, Money Market,
Stocks, Stock Options, Bonds, Mutual
Funds, Certificate of Deposits
Account #:
(Last FOUR
digits only)
Balance
$
$
$
$
$
$
$
$
$
$
$
TOTAL CASH VALUE OF ALL LIQUID AND NON LIQUIED ASSETS
$
5
Program Eligibility Application – Rev200324
V. ASSETS- List the VALUE OF ALL RETIREMENT ACCOUNTS for ALL household members over the age of 18
Applicant/Co-Applicant(s)
Name
Name of Financial
Institution
Describe Type of Account: 401K,
CalSTRS, CalPERS, 403b, Pension,
IRA, Roth IRA, TSP, Profit Sharing
Plan, etc.
Account #:
(Last FOUR
digits only)
Balance
$
$
$
$
$
$
$
$
$
TOTAL VALUE OF ALL RETIREMENT ACCOUNTS
$
VI. LIABILITIES include all installments and revolving debts including student loans, car lease, etc. for all borrowers
including non-borrowing spouse
Applicant/Co-Applicant(s)
Name
CREDITOR NAME
&
ADDRESS
TYPE OF ACCOUNT
(Revolving or Installment)
MONTHLY
PAYMENT
BALANCE DUE
$
$
# Payments
$
$
# Payments
$
$
# Payments
$
$
# Payments
$
$
# Payments
$
$
# Payments
$
$
# Payments
$
$
# Payments
TOTAL VALUE OF MONTHLY PAYMENTS
$
6
Program Eligibility Application – Rev200324
VII. ADDITIONAL EXPENSES – List any additional liabilities and other regular expenses including but not
limited to alimony, child support, judgments, child care, union dues, rent, personal loans or medical expenses
on behalf of dependents
Applicant/Co-Applicant(s)
Name
TYPE OF EXPENSE
MONTHLY
PAYMENT
BALANCE DUE
$ $
$ $
$ $
$ $
$ $
TOTAL VALUE OF ALL MONTHLY ADDITIONAL EXPENSES
$
VIII. PURCHASE PRICE AND DOWN PAYMENT
PRE-APPROVED MORTGAGE LOAN AMOUNT PER LENDER $
(from the Lender Pre-Approval letter)
HOUSING TRUST- DOWN PAYMENT ASSISTANCE REQUEST
$
YOUR DOWN PAYMENT CONTRIBUTION $
__________________________________________________
PRE-APPROVED PURCHASE PRICE PER LENDER $
(from the Lender Pre-Approval letter)
WHAT AMOUNT OF GIFT FUNDS (IF ANY) ARE INCLUDED $ _____________________________________
IN YOUR DOWN PAYMENT CONTRIBUTION ABOVE?
X. MEDIA RELEASE AND CONSENT
Publicity for our homebuyer programs helps the Housing Trust Silicon Valley to solicit voluntary donations from local governments,
employers and citizens. To assist us with our fundraising efforts, we wish to identify those Homebuyer Program recipients who are
willing to share their home buying experience with others. I (we) am (are) willing to be contacted by Housing Trust staff and/or members
of the media, to talk about how the Housing Trust’s Homebuyer Program helped me (us) purchase my (our) home: (check one)
Yes No
Where did you hear about the Housing Trust’s Homebuyer Program? (Check all that apply):
Lender
Real Estate Agent
Newspaper Other, please specify ______________________
County
Workshop/Class
Housing Trust website
Radio/ TV
IX. PLEASE ANSWER THE FOLLOWING QUESTIONS
Have you or any member of the household ever filed for bankruptcy (Chapter 7 or Chapter 13)?
If YES, please state the date of discharge: ___________________________________________________
Yes No
Are there any outstanding judgments against you or any member of the household?
Yes No
Have you or any member of your household had a past foreclosure, short sale, or deed in lieu of foreclosure?
Yes No
Have you or any member of your household owned real property at any time within the last three (3) years?
Yes No
7
Program Eligibility Application – Rev200324
You are not required to furnish the following information, but are encouraged to do so. For race, you may check more than one
designation.
1. Ethnicity
2. Race
Hispanic or Latino
Not Hispanic or Latino
American Indian & Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander White
XI. STATEMENT OF NON-DISCRIMATION – Signature on page 9
Housing Trust Silicon Valley (Housing Trust) is an equal opportunity lender. In accordance with applicable law, Housing Trust prohibits
discrimination based on race, color, religion, creed, gender, sex, marital status, age, national origin or ancestry, physical or mental
disability, medical condition, veteran status, sexual orientation, or the presence of children or any other consideration protected by federal,
state or local laws. All such discrimination is unlawful. Housing Trust’s commitment to equal opportunity applies to all persons involved in
our operations and prohibits unlawful discrimination by any of Housing Trust’s employees, including supervisors and coworkers
.
I/WE UNDERSTAND THAT:
• Any and all information provided will be used to determine eligibility for the requested Homebuyer Program. All information
contained in the records kept by Housing Trust Silicon Valley can and will be used for monitoring, auditing and establishing
my/our program eligibility for the requested Homebuyer Program; otherwise this information is confidential.
• In order to determine my/our household’s eligibility, I/we are required to provide all missing and additional documents that
the Housing Trust may request following the Eligibility Application Appointment. All documents must be submitted within 30
days of the appointment. Failure to do so can result in determining my/our application as Incomplete, and therefore, my/our
household will be determined Program Ineligible. If my/our household wishes to reapply in the future, a new eligibility
application package will need to be submitted.
• All documents submitted will become the property of Housing Trust, and that I/we must keep my/our own copies for
reference. Housing Trust will not make copies of submitted documents, such as income, tax, asset documentation, etc.
• Applicant(s) understand that if the application contains false statements, false or falsified documentation, or
misrepresentations, the applicant will be ineligible for all Homebuyer Programs for up to one year or more.
• Housing Trust Silicon Valley reserves the right to decline a Homebuyer Program Eligibility Application any time if the agency
obtains information contradictory to that of the application or documentation provided by the applicant(s).
• The Applicant(s) are responsible in keeping all documentation for program eligibility current. Any changes to employment,
income, credit, assets, status, household size and/or compositions whether or not it affects program eligibility must be
disclosed immediately to the Housing Trust.
• Any job changes must be disclosed immediately to the Housing Trust and the Lender. Failure to do so could invalidate the
application and pre-approval.
• Borrower(s) will sign a Promissory Note and a Deed of Trust with the Housing Trust. The Deed of Trust will be recorded as
a second lien on the property being purchased in conjunction with this loan and the Promissory Note must be executed by
the borrower(s)
• The Homebuyer program is a loan secured by the Deed of Trust, which must be paid back either when the home is sold,
upon expiration of the term, upon default of any terms or conditions, or any specific program requirements of the Housing
Trust loan.
• If the Applicant(s) obtain assistance through a Homebuyer Program, the Applicant(s) will comply with annual certification.
The Housing Trust will be continuously auditing and monitoring compliance with the program requirements.
• If the Applicant(s) obtain assistance through a Homebuyer Program, the Applicant(s) understand they will be required to
maintain a Hazard Insurance Policy on the home and will name Housing Trust as additional insured.
I/WE CERTIFY THE FOLLOWING:
• That I/We have not entered into a purchase sale agreement for a property. I/We understand that I/We must wait until a
program eligibility determination is made and we are in receipt of the program eligibility determination letter before we
can extend an offer for a property.
• That I/We have provided true, accurate and verifiable documentation to support the statements made herein prior to receive
assistance from Housing Trust Silicon Valley for the purchase of a home. I/We further certify to immediately contact Housing
Trust Silicon Valley if there are any changes to my/our household including and not limited to employment, income, assets,
status, residence, credit, household size and/or compositions, etc.
XII. CERTIFICATION – Signature on page 9
8
Program Eligibility Application – Rev200324
• That there is no additional income or assets or persons living in or contributing to the household other than those described
here.
• That the combined household income and assets are below the required maximum household income and assets for the
eligible program.
•
That I/We HAVE NOT owned a home or had ownership in a home or any vested interest in home within the last consecutive
36 months from the date of application.
•
That, regardless of the requested assistance, I/We have funds required for down payment contribution and for closing costs.
•
That owner occupancy is required for the duration of the Program term. The property will not be used as an investment
property, vacation home, or recreational home. Any changes in occupancy requires immediate written notification to the
Housing Trust. Also, I/We will notify the Housing Trust in writing if the residence ceases to be my/our primary residence.
•
That I/We understand ALL the program requirements and restrictions.
• That I/We understand that there are consequences for failure to comply with program requirements before, during, and after
purchasing a unit with assistance from Housing Trust Silicon Valley and I/We have been informed about those consequences.
PLEASE READ BEFORE SIGNING – ALL ADULT HOUSEHOLD MEMBERS MUST SIGN BELOW
I/We certify that the information given on this form is true and accurate to the best of my (our) knowledge. I/We am/are
aware that there are penalties for willfully and knowingly giving false information on an application for Federal, state
or local funds. I/We understand that the information on this form is subject to verification. Penalties for falsifying
information may include denial to participate in the Housing Trust’s Homebuyer Programs, or if made evident after
loan funding, immediate repayment of all funds received, sale of home and/or prosecution under the law.
I/We declare under penalty of perjury of the laws of the State of California that the foregoing is true and correct and was executed
in
(City), California.
APPLICANT
DATE
CO-APPLICANT #1 DATE
CO-APPLICANT #2 DATE
CO-APPLICANT #3 DATE
CO-APPLICANT #4 DATE
Disclaimer
This is not a commitment to lend. Guidelines and minimum requirements are subject to change without notice. Subject to
review of credit and/or collateral; not all applicants will qualify for financing. Equal Housing Opportunity. Housing Trust is a
California Community Lender licensed by the Department of Business Oversight. State of California CFL Lender License
#6053356. NMLS License #287840.
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9
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Program Eligibility Application and Checklist

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Completed 10 August 2021

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