606 Bloomingdale Trail Homeowners Forgivable Loan Program

606 Bloomingdale Trail Homeowners Forgivable Loan Program

Reservation of Funds Form

Borrower’s Last Name First M.I. Social Security NumberDate of Birth

Borrower’s Home Address:ZIP

Borrower’s Marital Status ______Number of persons in your household

Daytime Phone ( ) ______Evening Phone ( ) ______

Borrower’s Driver’s License Number Borrower’s Auto License Plate Number .

Co-Borrower’s Last Name First M.I. Social Security NumberDate of Birth

Co-Borrower’s Home Address:ZIP

Co-Borrower’s Marital Status ______Daytime Phone ( ) ______

Evening Phone ( )______

Co-Borrower’s Driver’s License Number Co-Borrower’s Auto License Plate Number .

List below the Name, Date of Birth, and Social Security Number of all persons in your household, other than Borrower & Co-Borrower

In order to receive a Reservation for a 606 Target BlocksForgivable Loan, you must meet the following conditions:

Borrower(s) must complete and return this signed Application to Neighborhood LendingServices, Inc. (NLS) together with the items listed below;
Property must be a 1 to 4 unit Residential property located in the 606 Bloomingdale Trail Homeowners Forgivable Loandesignated by the City of Chicago delegate agency;
Borrower(s) must have a gross annual household income that is less than or equal to the Program guidelines (see below);
Borrower(s) must agree to rehabilitate the property purchased according to the Scope of Work/Specifications developed by NLS, and that the work will be performed by licensed and insured Contractors with all appropriate permits;
Borrowers must be current on all mortgages related to the property and have no liens other than said mortgage(s);
Borrower(s) must have or be able to acquire property insurance for the project while it is under construction;
Borrower(s) must pay all City of Chicago parking tickets, and be current on City water bills.
Borrower(s) or Household members who are City Employees do not qualify under this program

To Apply for a RESERVATION of funds, complete this Application entirely and mail or deliverthis Application together with the items listed belowto Destiny Edmonds at Neighborhood LendingServices, Inc.,1279 N. Milwaukee Ave., 4th Floor, Chicago, IL 60622. You can also send a secure E-FAXof this Application toDestiny Edmonds at (773) 329-4039.

Proof of household income for all members of household–Three most recent consecutive pay stubs (showing year-to-date earnings) AND copy of most recent two (2) years’ of Federal Income Tax return & all schedules; copy of Social Security award letter; copy of IRS 1099 form for Social Security or pension benefits; or public assistance award letter (if applicable).
Proof of residency (Copy of either your Illinois driver’s license or copy of State of Illinois photo identification card)
Ownership status – Provide your most recent mortgage statements for all mortgages and home equity loans on the home along with proof of ownership if there are no mortgages.
Proof of homeowners/property insurance in effect (Copy of insurance declaration page)
Rental Income – If property has a rental unit, copies of all current leases are required.

Type of Home (Circle one): Single-family home 2-Flat 3-Flat 4-flat

Monthly Household Income:

Borrower Salary/Wages: $ (gross pay before deductions)

Employer’s Name/Address:

Co-Borrower (or other Household member) Salary/Wages $ (gross pay before deductions)

Employer’s Name/Address:

Pension/Social Security/SSI$ per month (for Borrower)

Pension/Social Security/SSI$ per month (for Co-Borrower)

Pension/Social Security/SSI$ per month (for other Household members)

Part time work$ per month (Kind of Work) .

Public Assistance$ per month (source) .

Rental Income$per month (include lease(s))

Income from other $ per month (source) .

Household members$ per month (source) .

$ per month (source) .

Is any member of the household a City of Chicago employee? Yes No

If Yes, please list name(s) and City Department(s)______

To be eligible for a 606 Target BlocksForgivable Loan your annual gross Household Income

must be less than the following amounts:

Household of 1 person:$ 42,600 per yearHousehold of 6:$70,550 per year

Household of 2:$ 48,650per yearHousehold of 7:$75,400 per year

Household of 3:$ 51,750 per yearHousehold of 8:$80,300 per year

Household of 4:$ 60,800 per yearHousehold of 9:$85,120 per year

Household of 5:$ 65,700 per yearHousehold of 10:$89,984 per year

Certification

I/we hereby apply for a Reservation of Funds for a606 Target Block Forgivable Loan. I/we certify that the information provided in this Application is true and complete as of the date set forth at my/our signature below.
I/we further declare and certify that, as a condition of this Reservation of Funds, I/we will occupy the property that I acquire as my/our principal place of residence and that I/we will be the owner of record of the property acquired.
I/we understand that any intentional or negligent misrepresentation of the information contained in this Application may result in my/our Application being deemed ineligible for the Forgivable Loan.
I/we have not been declared in arrearage in any child support obligation by the Circuit Court of Cook County or by another Illinois court of competent jurisdiction, or have entered into and am in compliance with a court-approved agreement for the payment of all such child support. I/we am not in default or in arrearage on any outstanding loans, water charges, sewer charges, property taxes, sales taxes or other fines (including but not limited to parking violation complaints), fees, taxes, assessments or charges owed to the City of Chicago, personally or by any partnership, corporation, joint venture or land trust in which I/we have at least a 5% beneficial interest.
I/we understand that City of Chicago Employees and their household members do not qualify under this program.
I understand that the City of Chicago Dept. of Revenue will verify the status of water bills and parking tickets and that my/our eligibility for a forgivable loan under this program is dependent on those items being paid.
I understand that this Reservation of Funds is not a guarantee that I will be able to obtain the funds as funding is limited and will be granted based upon the order that completed applications are received.
I/we hereby authorize Neighborhood Lending Services, Inc. to verify information and declarations contained in this Application. Further, under penalties of perjury, I/we state that the information contained in this application is true, correct, and complete.

Date Date

Signature of Borrower Signature of Co-Borrower, if applicable

Email Address______

Return your completed Application with the additional information required, to:

Destiny Edmonds at Neighborhood Housing Services of Chicago, Inc.

1279 N. Milwaukee Ave., 4TH Floor, Chicago, IL 60622;

or by secure E-Fax to (773) 329-4039

Target BlocksReservation of Funds Form606 Program