CUMBERLAND COUNTY AFFORDABLE HOUSING TRUST FUND

DOWN PAYMENT/ CLOSING COST ASSISTANCE PROGRAM

 

PROGRAM APPLICATION CHECK LIST:  Your application for down payment and closing cost assistance will only be considered if documentation for all of the following 7 categories is included with this application; the application must be completed in full; and signed by all adult household members.  Please return this application to:  The Redevelopment Authority of Cumberland County, Attention Housing Programs Manager, 114 North Hanover Street, Suite 104, Carlisle, PA 17013.

 

1.      Employment verification forms (pages 6 & 7) for all adult household members and for all current employment.  (You may make additional copies if your household has more than 2 current employers).  Complete and sign only the top section and return the entire form with this application.  This office will contact your employer in order for the employer to complete the rest of the form.  If your employer uses The Work Number, please provide the employer’s code, your social security number, and your salary key on the form and please sign the form.

 

2.      Copies of documentation of all sources of income coming to all members of the household such as social security, disability, pensions, dividends, child support, alimony, etc.

 

3.      A copy of the most recent income tax return and W2 form for each adult household member.

 

4.      A copy of the most recent pay stub of all employment for all adult household members.

 

5.      A copy of the most recent account statement for all bank accounts (savings, checking, money market) for each adult household member.

 

6.      A copy of the most recent account statement for all assets including stocks and bonds (excluding retirement accounts from which you are not currently receiving income).

 

7.      A mortgage pre-approval letter from a lender.

 

If you have already attended a certified homebuyer’s workshop, please provide a copy of the letter of completion or the certificate with this application.  If you have not attended a workshop, please register for one as soon as possible.  If you already have an Agreement of Sale, please provide this office with a copy of the Agreement.

 

 

APPLICANT’S GENERAL INFORMATION:

 

 

1.  NAME:  ____________________________________________________________________________

                                                FIRST                          MIDDLE                     LAST               (MAIDEN)

 

2.  TELEPHONE:

                                                                        DAY                                                    EVENING

 

3.  SOCIAL SECURITY NUMBER:

 

4.  DATE OF BIRTH:

 

5.  PRESENT ADDRESS:

           

6.  How long at this address?          ______________

 

7.  Currently, I:  __ rent; ___ live with family or friends; ___ own my own home

 

8.  Have you ever been an owner or co-owner of real estate?  ___________

                          If yes, when did ownership cease?  __________________   

                    Did you own the real estate with a spouse from a previous marriage? ______

 

      9.  Marital status:  ____ married; ____ separated; ___ divorced; ___ single

 

    10.  Are you a U.S. citizen?  _____ Yes; ____ No

           (If no, you must provide documentation regarding your immigration status with this application.)

 

    11.  Employer:  Name: ________________________________________________________________

                                            Address: _______________________________________________________

                                            Your job title: ____________________________________________________

                                            How long employed? ______________________________________________

 

     12.  Additional / part time employer: Name: _________________________________________________

                                           Address: ________________________________________________________

                                           Your job title: _____________________________________________________

                                           How long employed? _______________________________________________

 

    13.  List dependents that will live in the household at least 50% of the time:

 

NAME:                                                            DATE OF BIRTH:                               RELATIONSHIP:

 

 

 

 

 

ADDITIONAL APPLICANT’S GENERAL INFORMATION:

 

 

1.  NAME:  ____________________________________________________________________________

                                                FIRST                          MIDDLE                     LAST               (MAIDEN)

 

2.  TELEPHONE:

                                                                        DAY                                                    EVENING

 

3.  SOCIAL SECURITY NUMBER:

 

4.  DATE OF BIRTH:

 

5.  PRESENT ADDRESS:

           

6.  How long at this address?    ______________

 

7.  Currently, I:  __ rent; ___ live with family or friends; ___ own my own home

 

8.  Have you ever been an owner or co-owner of real estate?  ___________

                          If yes, when did ownership cease?  __________________   

                    Did you own the real estate with a spouse from a previous marriage? ______

 

      9.  Marital status:  ____ married; ____ separated; ___ divorced; ___ single

 

    10.  Are you a U.S. citizen?  _____ Yes; ____ No

           (If no, you must provide documentation regarding your immigration status with this application.)

 

    11.  Employer:  Name: ________________________________________________________________

                                            Address: ____________________________________________________________

                                            Your job title: ____________________________________________________

                                            How long employed? _____________________________________________

 

     12.  Additional / part time employer: Name: ______________________________________

                                                                        Address: ________________________________________

                                                                        Your job title: _________________________________

                                                                        How long employed? __________________________

 

    13.  List dependents that will live in the household at least 50% of the time and not listed on page 2:

 

NAME:                                                            DATE OF BIRTH:                               RELATIONSHIP:

 

 

 

 

GROSS MONTHLY INCOME:                                              1ST APPLICANT                                                  2ND APPLICANT

 

SALARY/ WAGES FROM

FULL TIME EMPLOYMENT                                             _________________                                        ________________

 

SALARY/WAGES FROM

PART TIME EMPLOYMENT                                            _________________                                        ________________

               

BONUSES                                                                             _________________                                        _________________

 

PENSIONS                                                                            _________________                                        _________________

 

SOCIAL SECURITY                                                            _________________                                        _________________

 

ALIMONY                                                                            _________________                                        _________________

 

CHILD SUPPORT                                                                _________________                                        _________________

 

DIVIDENDS                                                                           _________________                                       _________________

 

INTEREST                                                                             _________________                                        _________________

 

OTHER INCOME:

SPECIFY                                                                                __________________                                      __________________                                                                                                     

                                                                                                __________________                                      __________________

               

TOTAL:                                                                                 __________________                                      __________________

                               

LIST ASSETS:

 

Checking Account(s)                                                          Saving Account(s)                                              Money Market Account(s)

                Total Balance: ___________________         Total Balance: ___________________         Total Balance: ___________________

 

Stocks and Bonds (non-retirement): Description ____________________________________________________________________

                Total Balance: ___________________________________________________________________________________________

 

 

     Copies of most recent statements from all assets, accounts, pay stubs, documentation of all sources of income including but not limited to pensions, SSI, child support, and alimony payments must be provided with this application in order for this application to be considered.

 

     I/We verify that the information provided above is true and correct.  I/We understand that false statements herein are made subject to the penalties of 18 Pa CSA 4904 relating to unsworn falsification to authorities.

 

_______________________________________________________________                                            

Signature                                                                                                               date       

 

_______________________________________________________________

Signature                                                                                                               date                                         


 

FIRST TIME HOMEBUYER STATUS CERTIFICATION

 

I/ We hereby certify that I/we am/are first-time homebuyer(s)* or that I/we have not owned a home within the last three years.

 

 

______________________________________________                ____________

Applicant's signature                                                                                          date

 

_______________________________________________              ____________

Co-applicant's signature                                                                                     date

 

·         A first-time homebuyer is defined as someone who has never before owned a home, has owned a mobile home but not the land the mobile home was located on, or someone who has lost their home due to a divorce settlement and has not owned a home since (displaced homemaker).

 

 

 

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

 

The following information is requested by the Federal Government for certain types of home ownership and housing rehabilitation programs.  You are not required to furnish this information, but are encouraged to do so.  However, if you choose not to furnish it, under Federal regulations this Authority is required to note race and ethnicity and gender on the basis of visual observation or surname. 

Applicant #1                         

Ethnicity:  Are you Hispanic or Latino?               __ Yes     __No

Race:                       __ American Indian or Alaskan native

                                                 __ Black/African American

                                                 __ Asian

                                                 __ Native Hawaiian/other Pacific Islander

                                                 __ White

                Gender:  __ Female                                __ Male

__ I do not wish to furnish this information.

Applicant #2                         

Ethnicity:  Are you Hispanic or Latino?               __ Yes     __No

Race:                       __ American Indian or Alaskan native

                                                 __ Black/African American

                                                 __ Asian

                                                 __ Native Hawaiian/other Pacific Islander

                                                 __ White

                Gender:  __ Female                __ Male

__ I do not wish to furnish this information.

 

                                Please list ethnicity, race, and gender of all other household members.

NUMBER OF ADDITIONAL MEMBERS IN HOUSEHOLD:  ___________

Please identify each household member by:  ethnicity: Hispanic or Latino or NOT Hispanic or Latino; race: (use 1 of 5 categories shown above); and gender.

1.        _____________________________________________________________________

2.        ____________________________________________________________________

3.        _____________________________________________________________________

4.        _____________________________________________________________________

5.        _____________________________________________________________________

6.        _____________________________________________________________________

 

__ I do not wish to furnish this information.

 

 

EMPLOYMENT VERIFICATION

 

Applicant must complete the top section only of this verification.  Please return this entire form with your application.  Please provide the appropriate contact information (payroll dept., human resource dept.) so this office can verify your employment and income.  This office will then send it to this contact.  If your company uses The Work Number, please provide the employer’s code and your salary key.

____________________________________________________________________________________

                Applicant’s Name (please print)                                                               Social Security No.

Applicant's Address: _______________________________________________________

Name of Employer:                                                                                                                                             

Address of Employer:                                                                                                                                         

Phone Number of Employer:                                                                                                                             

Fax Number of Employer:  _________________________________________________

To Whom It May Concern:

                I would like the requested information regarding my wages furnished to the Redevelopment Authority of the County of Cumberland as soon as possible.

 

                                                                                                                                                                                               

                Signature of Applicant                                                                                                       Date

 

FOLLOWING INFORMATION IS TO BE COMPLETED BY AN EMPLOYER ONLY

 

Employment Data

Pay Data

Applicant’s Date of Employment

 

Base Pay

$ __________________  Annual           $  ________________  Weekly      $ __________________  Other (Specify)

$ __________________  Monthly          $  ________________  Hourly  

Applicant’s Present Position Title:

____________________

Type

Year to Date as

of _______________

Past Year

Is continuance of overtime likely? ___yes   ___ no

Anticipated overtime in the next 12 months

_________________

Base Pay

$

$

Is continuance of bonus likely?  ___yes  ___no

Anticipated bonus next 12 months:

$________________

Overtime

$

$

Number of hours worked per week ______________

Commissions

$

$

Anticipated increase or decrease in salary in the next year_________________

Bonus

$

$

Signature:

 

Please print name and phone number:

 

Title of Employer

Date

 

Thank you for your cooperation in supplying this information.  Please return to Attn. Pat Mrkobrad, Housing Programs Manager, Redevelopment Authority of Cumberland County, 114 N. Hanover St., Suite 104, Carlisle, PA 17013 or by fax: 717-249-4071.  Call 717-249-0789 x 136 if you have any questions.

 

EMPLOYMENT VERIFICATION

 

Applicant must complete the top section only of this verification.  Please return this entire form with your application.  Please provide the appropriate contact information (payroll dept., human resource dept.) so this office can verify your employment and income.  This office will then send it to this contact.  If your company uses The Work Number, please provide the employer’s code and your salary key.

__________________________________________________________________________________

                Applicant’s Name (please print)                                                       Social Security No.

Applicant's Address: _______________________________________________________

Name of Employer:                                                                                                                                             

Address of Employer:                                                                                                                                         

Phone Number of Employer:                                                                                                                             

Fax Number of Employer:  _________________________________________________

To Whom It May Concern:

                I would like the requested information regarding my wages furnished to the Redevelopment Authority of the County of Cumberland as soon as possible.

 

                                                                                                                                                                                               

                Signature of Applicant                                                                                                         Date

 

FOLLOWING INFORMATION IS TO BE COMPLETED BY AN EMPLOYER ONLY

 

Employment Data

Pay Data

Applicant’s Date of Employment

 

Base Pay

$ __________________  Annual           $  ________________  Weekly      $ __________________  Other (Specify)

$ __________________  Monthly          $  ________________  Hourly  

Applicant’s Present Position Title:

____________________

Type

Year to Date as

of _______________

Past Year

Is continuance of overtime likely? ___yes   ___ no

Anticipated overtime in the next 12 months

_________________

Base Pay

$

$

Is continuance of bonus likely?  ___yes  ___no

Anticipated bonus next 12 months:

$________________

Overtime

$

$

Number of hours worked per week ______________

Commissions

$

$

Anticipated increase or decrease in salary in the next year_________________

Bonus

$

$

Signature:

 

Please print name and phone number:

 

Title of Employer

Date

 

Thank you for your cooperation in supplying this information.  Please return to Attn. Pat Mrkobrad, Housing Programs Manager, Redevelopment Authority of Cumberland County, 114 N. Hanover St., Suite 104, Carlisle, PA 17013 or by fax: 717-249-4071.  Call 717-249-0789 x 136 if you have any questions.