Thank you for showing interest in the Oakland County Homeownership Program.

The Oakland County HOME Program is geared toward people who are interested in

owning a home but may not think they have the credit score or income to

accomplish that goal. This program is federally funded and administered through

the county which is designed exclusively to create affordable housing for low to

moderate income households. The Oakland County HOME Program, all homes

undergo extensive rehab to ensure the home is maintenance-free for at least five

years. This rehab work can consist, but not limited to: new roof, doors, flooring,

kitchen appliances, updated plumbing and electrical, cabinetry, etc. In addition,

Oakland County grants each approved applicant homebuyer’s assistance which

helps fill the financial gap between their mortgage loan and home purchase price.

Application documents include:

Flyer describing the Home Ownership Program

Application Form A and Form B

Self-employment Affidavit

Eligibility Screening Form

Credit Check and Privacy Disclosure Form

OC Home Additional Information

Business For-Self Affidavit

Income Verification Affidavit

U.S. Citizen/ Permanent Resident Alien Form

Program Qualifications

All approved applicants must meet the following requirements:

1. Pre-approval letter from a lender of your choice.

a. It is recommended that you have a tri-merge credit score of at least

620.

b. If you are finding it difficult to secure a pre-approval, we can connect

you with financial institutions that we have previously worked with.

2. Maximum household income is no greater that 80% area median income

(see flyer for chart)

3. Must provided a minimum of 1% of personal funds at closing.

4. NO bankruptcies or foreclosure within the last two years.

5. Complete the MSHDA Homebuyer Education Class (offered at Community

Housing Network Inc.).

Application

Print out ALL application forms and complete with the appropriate information.

Provide ALL requested and applicable documentation.

Homebuyer Education Class

As a nonprofit agency we provide MSHDA Homebuyer Education classes at a

small registration fee of $10 per person. As a part of the Oakland County

Homeownership (HOME) Program it is required that you take this homebuyer

education class. Please contact Maddie Jaks, Housing Counseling Supervisor, to

sign up for one of the classes. Her contact information is mjaks@chninc.net or

(248) 824-7392. You can sign up for this class before or after you submit your

application. Please note, Oakland County cannot make a final decision on your

application until the class has been completed.

The reviewing proces can be very complex, we ask that you please fill out the

application completely and gather all of the documents together before

you submit your application . Please email, postal mail, fax, or hand-deliver all

required materials. If you are mailing your application, please send to our Troy

office:

Community Housing Network

Attn: Anita Davis

570 Kirts, Suite 231

Troy, MI 48084.

Fax number – (248) 928-0122; please include cover page with attention

the to Anita Davis, and the number of pages.

Please contact Anita Davis if you have questions about the forms or program

requirements. Email is the easiest way to get a hold of Mrs. Davis, at

ADavis@chninc.net, but feel free to call 248-824-7315.

HOMEBUYERS ASSISTANCE PROGRAM

APPLICATION Form A

CURRENT ADDRESS

Street

City/State/Zip Code

PHONE NUMBERS: HOME ( ) CELL ( ) MESSAGE ( )

WORK – Applicant ( ) WORK Co-Applicant ( ) APPLICANT

CO-APPLICANT

Male NAME Female

Male NAME Female

BIRTH DATE

BIRTH DATE

SOCIAL SECURITY NUMBER

SOCIAL SECURITY NUMBER

MARRIED SEPARATED UNMARRIED incl.single,divorced,widowed

MARRIED SEPARATED UNMARRIED incl.single,divorced,widowed

EMPLOYMENT INFORMATION EMPLOYMENT INFORMATION EMPLOYER ______________________________________ Address __________________________________________ _________________________________________ Occupation Date Hired _______ I am Paid: Weekly Bi-Weekly Twice Monthly I Work: Full Time Part Time Hours Worked/ Pay Gross Wages/Pay $___________

EMPLOYER __________________________________________ Address _____________________________________________ Occupation Date Hired _______ I am Paid: Weekly Bi-Weekly Twice Monthly I Work: Full Time Part Time Hours Worked/ Pay Gross Wages/ Pay $ _________

2

nd EMPLOYER ______________________________________

Address __________________________________________ _________________________________________ Occupation Date Hired _______ I am Paid: Weekly Bi-Weekly Twice Monthly I Work: Full Time Part Time Hours Worked/ Pay Gross Wages/ Pay $_____ ______

2

nd EMPLOYER ______________________________________

Address____________________________________________ ___________________________________________________ Occupation Date Hired ___________

I am Paid: Weekly Bi-Weekly Twice Monthly

I Work: Full Time Part Time Hours Worked/Pay Gross Wages/ Pay $___________

Total number in Household (including applicant &

Co-applicant) ______ List ages of all persons residing in household:

Are any individuals 18 and over, (excluding applicant and Co-applicant) Full-time students? Yes No If yes, submit proof of enrollment. Employed? Yes No If yes, submit a copy of their most recent check

stub.

Income from all sources for all household members, including unrelated persons

Social Security $ per month Child Support $ per month Pension $ per month Spousal Support $ per month Rental $ per month Parsonage Allowance $ per month Land Contract $ per month Other, describe $ per month

List your Existing Debts

Current Balance

Monthly Payment

Company : Address :

$

$

Company : Address:

$

$

Company: Address:

$

$

Have you declared Bankruptcy in the last 7 years? Yes No If yes, indicated the type: Chapter 7 Chapter 13 Open Date Closed

THE FOLLOWING INFORMATION IS OBTAINED FOR STATISTICAL REPORTING ONLY

IMPORTANT, READ THIS BEFORE SIGNING FINANCIAL PRIVACY NOTICE: By the Right to Financial Privacy Act of 1978, Oakland County Community & Home Improvement has a right to access financial records held by any financial institution in connection with the consideration or administration of the Home Improvement Loan Program for which you have applied. Financial records involving your transactions will be available without further notice or authorization but will not be disclosed or released to another government agency or department without your consent except as required or permitted by law. APPLICANTS CERTIFICATION: The applicant certifies that all information in this application, and all information furnished in support of this application is for the purpose of income qualifying for the HOME Program-Homebuyer Assistance Progaram, and that these statements are true to the applicants knowledge and belief. PENALTY FOR FALSE OR FRAUDULENT STATEMENT: U.S.C. Title 18, Sec. 1001, provides: Whoever, in any matter within the jurisdiction of any department or agency of the United Sates knowingly and willfully falsifies...or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing, or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years, or both."

Applicants Signature:

Date: Co-Applicant’s Signature: Date:

SINGLE RACE Complete for Head of Household only White Black/African American Asian American Indian/Alaskan Native Hawaiian/Other Pacific Islander

MULTI-RACE Complete for Head of Household only Black/African American & White Asian & White American Indian/Alaskan Native & White American Indian/Alaskan Native & Black/African American Other Multi-racial

Number of HANDICAPPED PERSON/S in household? _______ Number of UNRELATED PERSON/S living in household? _______

HISPANIC Complete for Head of Household Only

Yes No

HOMEBUYERS ASSISTANCE PROGRAM

DOCUMENTATION REQUIRED

Form B

YOU MUST SUBMIT COPIES OF THE FOLLOWING DOCUMENTATION. DO NOT MAIL ORIGINAL DOCUMENTS

INCOME TAX FORMS

FEDERAL INCOME TAX FORMS ,a complete copy (all pages) of your most recently filed, signed and dated including W2 forms, 1099 forms and STATE OF MICHIGAN INCOME TAX FORMS, most recently filed, signed and dated, W2 forms, 1099 forms and schedules

If you are self employed, please submit 2 years tax forms. Both Federal and State.

CURRENT HOUSEHOLD INCOME

SUBMIT COPIES OF THE DOCUMENTATION THAT APPLIES TO YOUR HOUSEHOLD. WE ARE REQUIRED TO CONSIDER THE

INCOME FROM ALL SOURCES FOR ALL HOUSEHOLD MEMBERS, INCLUDING UNRELATED PERSONS.

EMPLOYMENT If you or any adult (18 years of age or older) living in the household is employed, submit a copy of their last 3 months of

payroll check stub/s

UNEMPLOYMENT If you or any adult (18 years of age or older) living in the household is unemployed , submit documentation of

Unemployment Benefits Payments. The information is available at www.Michigan.gov/uia, (select) Online applications available.

(select) UIA Online Services for Unemployed Workers; or a copy of your unemployment Benefit Award Letter. SOCIAL SECURITY BENEFITS, submit a copy of the following:

Annual Social Security award letter

If you do not have any of the above items you can phone the social security office at (800) 772-1213 and ask them

to send you documentation of your benefits.

NOTE: You must document the Social Security Benefits for all household members receiving Social Security Benefits

PENSION or DISABILITY, submit a copy of the most recent check stub

CHILD SUPPORT, submit a copy of a child support payment history for the last 6 months, known as court

Order Information Report, which can be obtained in person at the Oakland County Friend of the Court, Banking Dept.,

230 Elizabeth Lake Rd, Pontiac, MI or request by phone toll free at 888-350-0900 ext. 81565.

FULL-TIME STUDENT, any household member 18 or older, excluding borrower and co-borrower,

submit proof of enrollment ex: current report card, current student registration form. If employed, submit copies of their last

3 check stubs. PUBLIC ASSISTANCE, submit a copy of most recent Budget Letter or Family Independence Agency Quarterly Statement.

Foster care payments are excludable.

SOLE PROPRIETOR BUSINESS submit a Profit and Loss Statement, for the current year PARTNERSHIP OR S CORPORATION INCOME, submit a copy of your Schedule K-1, for the current year

MAIL YOUR APPLICATION AND SUPPORTING DOCUMENTATION TO:

CHDO-PreCon Homebuyer

10/2015

Oakland County Community & Home Improvement Division

HOME Program Certification

“U.S. Citizen/ Permanent Resident Alien”

§

I, __________________________________ certify, under penalty of perjury, 1 that, to the best of my knowledge, I am lawfully within the United States because (please check the appropriate box): [ ] I am a citizen by birth, a naturalized citizen or national of the United States; or [ ] I have eligible immigration status as checked below. Attach INS document(s) evidencing eligible immigration status and signed verification consent form. [ ] Immigrant status under ¶¶101(a)(15) or 101(a)(20) of the INA3; or

[ ] Permanent residence under ¶249 of the INA4; or [ ] Refugee, asylum, or conditional entry status under ¶¶207, 208 or 203 of the INA 5; or [ ] Parole status under ¶212(d)(f) of the INA 6; or [ ] Threat to life or freedom under ¶243(h) of the INA 7; or [ ] Amnesty under ¶245 of the INA 8;

_________________________________ ______________ Signature of Family Member Date

[ ] Check box on left if signature is of adult residing in the unit who is responsible for child named on

statement above.

Notice to Applicants In order to be eligible to receive assistance under the Homebuyer Program through the Oakland County Community & Home Improvement Division (OCCHI), each family member must be lawfully within the United States. Please read the Declaration statement carefully. Please feel free to consult with an immigration lawyer or other immigration expert of your choosing. Instructions to complete form: Print or type first name, middle initial(s) and last name. Place an “X” in the appropriate boxes. Sign and date at bottom of page.

OCCHI: Enter INS/SAVE Primary Verification # ; _____________________ Date: _____________ ______________

CHDO-PreCon Homebuyer

10/2015

(1) PENALTY FOR FALSE OR FRAUDULENT STATEMENT: U.S.C. Title 18, Sec. 1001, provides:

“Whoever, in any matter within the jurisdiction of any department or agency of the United Sates knowingly and willfully falsifies...or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing, or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years, or both.

The following footnotes pertain to noncitizens that declare eligible immigration status in one of the following categories: (2) Eligible immigration status and 62 years of age or older. For noncitizens who are 62 years of age

or older or who will be 62 years of age or older and receiving assistance under a Section 214 covered program on June 19, 1995. If you are eligible and elect to select this category, you must include a document providing evidence or proof of age. No further documentation of eligible immigration status is required.

(3) Immigrant status under ¶¶101(a)(15) or 101(a)(20) of INA. A non citizen lawfully admitted for permanent residence as defined by ¶101(a)(20) of the Immigration and Nationality Act (INA), as an immigrant as defined by ¶101(a)(15) of the INA (§ U.S.C. 1101 (a)(20) and 1101(a)(15) respectively[immigrant status]. This category includes a noncitizen admitted under ¶¶210 or 210A of the INA (§ U.S.C. 1160 or 1161), [special agricultural worker status] who has been granted lawful temporary resident status.

(4) Permanent residence under ¶249 of INA. A noncitizen who entered the U.S. before January 1,

1972, or such later date as enacted by law, and has continuously maintained residence in the U.S. since then and who is not ineligible for citizenship, but who is deemed to be lawfully admitted for permanent residence as a result of an exercise of discretion by the Attorney General under ¶249 of the INA (§ U.S.C. 1259) [amnesty granted under INA 249].

(5) Refugee, asylum or conditional entry status under ¶¶ 207, 208, or 203 of INA. A non citizen who

is lawfully present in the U.S. pursuant to an admission under ¶207 of the INA (§ U.S.C. 1157) [refugee status]: pursuant to the granting of asylum (which has not been "terminated" under ¶208 of the INA (§ U.S.C. 1158) [asylum status]: or as a result of being granted conditional entry under ¶203(a)(7) of the INA (§U.S.C. 1153(a)(7)) before April 1, 1980, because of persecution or fear of persecution on account of race, religion, or political opinion or because of being uprooted by catastrophic national calamity [conditional entry status].

(6) Parole status under ¶212(d)(5) of INA. A noncitizen who is lawfully present in the U.S. as a result of

an exercise of discretion by the Attorney General for emergent reasons or reasons deemed strictly in the public interest under ¶212(d)(5) of the INA (§ U.S.C. 1182(d)(5)) [parole status].

(7) Threat to life or freedom under ¶243(h) of INA. A non citizen who is lawfully present in the U.S. as

a result of the Attorney General's withholding deportation under ¶243(h) of the INA (§ U.S.C. 1253(h) [threat to life or freedom].

(8) Amnesty under ¶245A of INA. A non citizen lawfully admitted for temporary or permanent residence

under ¶245A of the INA (§ U.S.C. 1255a) [amnesty granted under INA 245A].

CREDIT REPORT AUTHORIZATION AND PRIVACY DISCLOSURE FORM

I hereby authorize and instruct Community Housing Network, Inc. (CHN) to obtain and review my credit report. My credit report will be obtained from a credit-reporting agency chosen by CHN. I understand and agree that CHN intends to use the credit report for the sole purposes of evaluating my financial readiness to purchase a home, and assisting me to complete the purchase of a home. CHN is not acting as agent to any lending institution or representing an agent of any lending institution. CHN will not make any determination of credit worthiness as it relates to approval or denial of any loan I apply for. In addition, in connection with determining my ability to obtain a loan;

I authorize I do not authorize CHN to share my credit report, and any information that I have provided, with certified nonprofit housing counselors at CHN, for the purpose of providing housing and credit counseling services in connection with my potential home purchase, and to Oakland County Community and Home Improvement Department as part of the documentation submission required to generate a homebuyer assistance note, should I enter into a purchase agreement for a home. I understand that I may revoke my consent to these disclosures by notifying CHN in writing. _____________________________ _______________________________ Client’s Name (Print) Client’s Name (Print) _____________________________ _______________________________ Client’s Signature Client’s Signature _____________________________ _______________________________ Client’s Social Security Number Client’s Social Security Number Date: ________________________ Date: ___________________________ Current Address: Current Address: _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________

Please Fax or email to Anita Davis

Fax: 248-928-0122 or adavis@chninc.net

Community Housing Network Inc. Oakland County HOME Program

Income Verification Affidavit

Date: ____________________ Applicant: ________________________________________ To determine eligibility for the Oakland County Home Program, Federal Guidelines require we consider the income of all household members 18 years and older. VERIFICATION OF INCOME FOR: ____________________________ 1. Are you employed? Yes____ No____

If yes, submit a copy of last three (3) months payroll check stubs.

2. Do you receive Unemployment Benefits? Yes____ No____

If yes, submit a copy of your Benefit Award letter which has the amount you receive each week. If no, Date you received your last unemployment check (if applicable) ____________ Date you became unemployed _________________.

3. Are you self-employed? Yes____ No____

If yes, complete and return the attached Business-For-Self Affidavit.

4. Are you receiving financial assistance (ex: Social Security, Disability, Pension, etc.,)

Yes____ No ____ If yes, submit documentation of assistance you receive.

5. List other sources of income; _____________________________________________________ CERTIFICATION: This statement is true to the best of my knowledge and belief. PENALTY FOR FALSE OR FRAUDULENT STATEMENT: U.S.C. Title 18, Sec. 1001 provides: “Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies…or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing, or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years, or both”. ___________________________________ ____________________ Household Member’s Signature Date ___________________________________ ____________________ Applicant’s Signature Date

0AKLAND COUNTY COMMUNITY & HOME IMPROVEMENT

BUSINESS – FOR - SELF

AFFIDAVIT

Name: Address:

Case No.

Business Name: Business Address:

Type of Business:

INCOME FROM BUSINESS TRANSACTED

This business has been closed. I no longer have self-employment income.

From January 1, 2013 through ___ _______. (Current Date)

Year-to-date Gross Income $ ______________ Business related expenses (1) Company car and truck expenses $__________ (2) Office expenses $__________ (3) Cost of Materials and Supplies $__________ (4) Business property (a) Rent or Mortgage for business property $__________ NOTE: We do not deduct for depreciation and we do not deduct for the household expenses for running your business from your home (ex: mortgage, utilities, etc.

(b) Utilities for the business property $__________ (c) Machinery, and equipment $__________ (5) Employee Wages/salaries $ __________ (Do not include owner salary) (a) Employee Benefits $__________ (b) Federal Withholding Tax $__________ (c) State Withholding Tax $__________ (d) FICA $__________ (6) Taxes and Licenses $__________ (7) Other ___________________________ $__________ ___________________________ $__________ TOTAL EXPENSES $ ( _________) Year-to-date estimated profit (Net Income) $ __________ Do you receive a salary from this Business YES No Amount $ __________ CERTIFICATION: This statement is true to the best of my knowledge and belief.

PENALTY FOR FALSE OR FRAUDULENT STATEMENT: U.S.C. Title 18, Sec. 1001, provides: Whoever, in any matter within the jurisdiction of any department or agency of the United Sates knowingly and willfully falsifies...or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing, or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years, or both."

__________________________________________ _________________________ Signature: Date Signed

Policy – Intake – Sole Proprietor (BFS) Estimated Annual Income During January, February and March most companies have not completed a Profit/Loss Statement as many of the bills for their expenditures have not been received and/or paid and they may not have received payment for the work they performed. Therefore, to determine the Estimated Annual Business-for-Self Income during the first quarter each calendar year (January through March) we will use the current years Federal Income Tax Profit and Loss Statement, to determine their business-for-self earnings. The applicant must complete the enclosed Business-for-Self affidavit, If the applicant has self employment earnings from April through December during the current calendar year. Policy – Intake – Business-for-Self revised 10-31-13

OC HOME Initial Eligibility Screening

Name(s):

Address:

Daytime Phone:

Evening Phone:

Email Address:

Notes/Explanations

How many members are there in your

household?

List names and ages (including

yourself):

Do you intend to own and reside in the home

for at least 5 years? Y N

What is your middle credit score?

How much do you have saved for a down

payment?

How much on average do you and all co-

applicants pay each month toward debt (car

loans, student loans, credit card payments,

medical bills, etc.)

Student loan deferred Yes or No

Have you and all co-applicants been steadily

employed for the last 2 years? Y N

If No please explain:

Have you or any co-applicants filed for

bankruptcy in the last 2 years? Y N

If Yes, discharge date:

Have you or any co-applicants been

foreclosed in the last 3 years? Y N

If Yes, date of Sheriff’s Sale:

Do you or any co-applicants have any federal

or state income tax liens? Y N

Do you or any co-applicants have any past

due child support obligations? Y N

How did you find out about this opportunity?

MC HOME Additional Information

Please include this document with your application. 1. Please check whether you rent or own your current place of residence: □ Rent □ Own 2. If you chose rent please include a Rental Reference: this would be the name and contact information of someone from whom you’ve rented from.

Name of landlord: _____________________________ Phone Number: ______________________________ E-mail Address: _______________________________

3. Below provide the highest level of education you have completed: 4. Please attach a photo copy of your social security card so we can verify your SSN on your application.