Part II: Uniform Housing Programs Application

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PART III

Attachment II

Uniform Housing Programs

Application

UNIFORM HOUSING PROGRAMS APPLICATION FOR SINGLE FAMILY ACTIVITIES
Texas Department of Housing and Community Affairs (TDHCA)
Mailing Address: P.O. Box 13941, Austin, Texas 78711-3941
Physical Address: 221 E. 11th Street, Austin, TX 78701

Table of Contents

1. APPLICANT INFORMATION 3

A. APPLICANT CONTACT INFORMATION 3

B. APPLICANT LEGAL DESCRIPTION 3

C. APPLICANT DISCLOSURES 3

D. APPLICATION TECHNICAL ASSISTANCE AND CAPACITY BUILDING 4

E. CONSULTANT OR ADMINISTERING AGENT 4

2. LOCATION & JURISDICTION INFORMATION of the APPLICATION ACTIVITY 4

3. FUNDING REQUEST 5

A. PROGRAM FUNDS 5

B. PROGRAM ELIGIBLE ACTIVITIES 5

C. FUNDING REQUEST 5

D. PREVIOUSLY AWARDED STATE AND FEDERAL FUNDING 5

4. POPULATIONS SERVED 6

A. PROPOSED LOW INCOME LEVELS TO BE SERVED 6

B. RELOCATION 6

C. SPECIAL NEEDS & PERSONS WITH DISABILITIES 6

Part A. Certification of Applicant 7

Part B. Previous Participation and Background Certification Form (also referred to as the “Previous Participation Certification in the HTC QAP) 9

Part C. Evidence Of Nonprofit Organization 13

Special Notation Symbols Used in the Application:

2 Attachment may be required. ÑSection does not apply to all Applicants ! Significant Issue

The undersigned hereby makes application to TDHCA for financial assistance, has read and understands the application instructions, and certifies that all information herein is true and correct to the best of their knowledge and belief.

! Submitted Application must have the original signature from a representative with authority to execute documents on the Applicant’s behalf.

Applicant’s Authorized Representative’s Signature / Representative’s Printed Name, Title / Date
1. APPLICANT INFORMATION

Provide the contact data for the Applicant’s staff person who is responsible for application and contract administration. This contact will not be the consultant or the end service provider.

A. APPLICANT CONTACT INFORMATION

Applicant Legal Name: / Phone:
Applicant Contact Name: / Fax:
Applicant Mailing Address:
City, State, ZIP: / Email:
If Applicant’s “Physical Address” is different from the “Mailing Address,” provide the physical address below:
Applicant Physical Address:
City, State, ZIP:

B. APPLICANT LEGAL DESCRIPTION

Applicant is legally formed? No Yes If yes, the Federal Taxpayer Identification # (TIN) is: ______
Legal Form of Applicant (check only one):
For-profit Corporation Non-profit Corporation General Partnership Limited Partnership
Limited Liability Company Unit of Local Government Individual/D.B.A. Housing Authority

Other Designations (Mark all that apply.): Historically Underutilized Business CHDO COG Federal Tax Exemption

Applicant is in good standing with the Secretary of State? No Yes The State Filing # is:

Applicant’s Fiscal Year Ends: Month Day: Applicant’s Data Universal Numbering System (DUNS) Number

Is Applicant registered in the Central Contractor Registration ( CCR)? NO Yes

C. APPLICANT DISCLOSURES

2 If “Yes” is answered for any of items “1” through “5” below, please provide a thorough explanation of the circumstances and copies of correspondence regarding the status of ruling from the authority that made the determination, and place behind Tab 2.

Has the Applicant:

1) been delinquent on filing of any federal or state tax returns? No Yes

2) received federal or state findings? No Yes

3) been delinquent on federal or state debt? No Yes

4) been debarred from HUD [1] or other federal programs? No Yes

5) filed bankruptcy in the last 10 years? No Yes

D. APPLICATION TECHNICAL ASSISTANCE AND CAPACITY BUILDING

Has the Applicant received technical assistance or capacity building training for their organization for completing this application or for the Activity for which this application is being made? No Yes

If “Yes”, it was sponsored by: TDHCA Other (Sponsor Name):

The Activity was: Workshop Field Office Assistance Capacity Building Funds Predevelopment Funds

Other (describe Activity):

E. CONSULTANT OR ADMINISTERING AGENT

ÑIf a Consultant or Administering Agent was used to complete the application, then provide the following information:

Consultant Name: / Phone:
Contact Name: / Fax:
Mailing Address: / Email:
City, State, ZIP: / Proposed Fee: / $
Taxpayer ID # (TIN):

Does the Consultant/Administering Agent qualify as a HUB? No Yes

Is there a direct or indirect, financial, guarantor or other interest with Applicant or other team members? No Yes

If “Yes,” describe relationship(s):

2. LOCATION & JURISDICTION INFORMATION of the APPLICATION ACTIVITY
Local Jurisdiction Name: / TDHCA Uniform State Service Region:
Local Official with Jurisdiction over the Activity site is the: Mayor County Judge Other:
Local Official Name: / Phone:
Mailing Address: / Fax:
City, State, ZIP:
State Senator: / District #:
State Representative: / District #:
U.S. Representative: / District #:
2 Attachment may be required. Attach additional jurisdiction information to behind this page.
List the County or Counties in which the award will be used / Check the box below which best describes the area within the county that will be served.
(Make additional copies of this form as required for additional counties.)
1. / Rural Areas of the County, or
Urban Areas of the County
List Specific City(ies) or Colonia(s) that will be served:
2. / Rural Areas of the County, or
Urban Areas of the County
List Specific City(ies) or Colonia(s) that will be served:
3. / Rural Areas of the County, or
Urban Areas of the County
List Specific City(ies) or Colonia(s) that will be served:
4. / Rural Areas of the County, or
Urban Areas of the County
List Specific City(ies) or Colonia(s) that will be served:
3. FUNDING REQUEST

A. PROGRAM FUNDS

Next to the program name, check the box to indicate under which type of funds this application will be made.

TDHCA funds for which this Application will be used: / General / Contract For Deed / CHDO / Disaster Relief
HOME
Housing Trust Fund (HTF)

B. PROGRAM ELIGIBLE ACTIVITIES

Check the boxes next to the program name to indicate the activities this application will fund.

TDHCA Activities for which this Application will be used: / Administration Funds / CHDO Operating Expenses / Homebuyer Assistance (General, HBA, or CFD) / Homebuyer Assistance with Rehabilitation (CFD only) / Owner Occupied Housing Assistance / Tenant Based Rental Assistance / Single Family Development
HOME
Housing Trust Fund

C. FUNDING REQUEST

Complete the table below to describe this application’s funding request. / Requested Funds are in the form of a: / If the award will be in the form of a loan, the requested terms are:
TDHCA Programs for which this Application will be used: / Requested Amount / Grant / Loan / Interest Rate (%) / Amortization (Yrs.) / Term (Yrs.)
HOME Project Funds / $
Administration Funds (2%,4% or 6% of Project Funds ) * / $
Housing Trust Fund / $

* Depends on activity and award type

D. PREVIOUSLY AWARDED STATE AND FEDERAL FUNDING

Has this Applicant previously received TDHCA funds? No Yes

Has this Applicant previously received non-TDHCA federal funding? No Yes

Will this Applicant receive non-TDHCA federal funding for costs described in this application? No Yes

2 If the answer to any of the above questions is “Yes,” then include a funding description behind Tab 3 that at a minimum includes the source, amount, term and any associated rental restrictions. If the award was from TDHCA, then the TDHCA contract number should also be provided.

4. POPULATIONS SERVED

! Unless modified by TDHCA, the unit, income, and rent levels to be served as represented by the Applicant in this section shall be a condition of the funding award. If applicable, appropriate restrictions shall be incorporated into the funding contract/commitment and land use restriction agreement.

Attachment II, Page 3 of 15

A. PROPOSED LOW INCOME LEVELS TO BE SERVED

Enter the proposed number of Low Income Households to be served at each Maximum Allowable Household Income Level.

INCOME LEVEL OF PROPOSED HOUSEHOLDS / Number of Assisted Units
≤ 30% AMFI1
> 30% and ≤ 50% AMFI
> 50% and ≤ 60% AMFI
> 60% and ≤ 80% AMFI
Total assisted units by program

Notes:

(1) TDHCA is committed to targeting funds towards households earning less than 30 percent of the area median family income. Applicants are encouraged to income target households that earn 30% or less of the AMFI in an effort meet the Department’s obligation.

B. RELOCATION

Is temporary relocation of a current tenant(s) anticipated during the rehabilitation period? No Yes

Is permanent relocation of a current tenant(s) anticipated during or after the rehabilitation period? No Yes

2 If the answer to either of the previous two questions is “Yes,” then a relocation plan must be provided behind Tab 3.

C. SPECIAL NEEDS & PERSONS WITH DISABILITIES

Ò Only Applicants proposing to serve Special Needs populations must complete this section.

TDHCA has a goal of allocating 20 percent of the annual HOME allocation to Applicants serving persons with special needs. Eligible activities include owner occupied housing assistance, homebuyer assistance, and tenant based rental assistance. Unless approval by the Department is granted, this application will serve only persons that qualify under the following HUD special needs or persons with disabilities designations. If applicable, please indicate the number of households proposed to serve:

persons with drug and alcohol addictions
colonia residents
persons with disabilities
victims of domestic violence
elderly persons
persons with HIV/AIDs
homeless populations
migrant farm workers

An Applicant may serve 100% Special Needs populations, or a percentage of Special Needs populations. The proposed numbers must be indicated above.

Attachment II, Page 3 of 15

EXHIBIT 1. PARTICIPANTS IN THE APPLICATION INFORMATION
Part A. Certification of Applicant

This certification must be signed and filed by persons who are authorized to execute the HOME contract.

I hereby apply to the Texas Department of Housing and Community Affairs for approval to participate in this Application Activity as the Applicant. I certify that all statements made by me in the “Participants in the Application Information” section of the Application and related exhibits are true, complete, and correct and are made in good faith. I further certify that:

(1) The Participants in the Application Information, Previous Participation Certification, herein after referred to as the “Previous Participation Certification” contains a listing of every development activity that received TDHCA funding, which I have been or am now an Applicant.

(2) For the period beginning ten years prior to the date of this certification:

(a) I have not been arrested, indicted, convicted, or imprisoned for a felony during the last ten years, and am not presently the subject of a complaint or indictment charging for a crime of moral turpitude.

(b) I have not been suspended, debarred, or been subject to enforcement action under state or federal securities law, or otherwise restricted by any department or agency of federal or state government from doing business with such department or agency.

(c) I have not defaulted on an obligation covered by a surety or performance bond and have not been the subject of a claim under an employee fidelity bond.

(3) For the period beginning ten years prior to the date of this certification, during my participation in the developments shown by me in the Previous Participation Certification, there has not been:

(a) a mortgage in default, assigned or foreclosed, nor has mortgage relief by the lender been given;

(b) to the best of my knowledge, unresolved findings raised as a result of Departmental or HUD audits, management reviews or other governmental investigation concerning me or my developments, or contracts;

(c) any breach by the owner of any agreements relating to the construction or rehabilitation, use, operation, management, or disposition; or

(d) a suspension or termination of payments under any state or federal assistance contract.

(4) To the best of my knowledge, the Applicant has demonstrated fiscal, programmatic, and contractual compliance on previously awarded Department contracts or loan agreements and resolution of any previous audit findings and outstanding monetary obligation with the Department per 10 TAC Section 53052 (c) (2) and (3).

(5) As required by Section 2306.257 of the Texas Government Code, as added by SB 322, 77th Session of the Texas Legislature, an Applicant may not receive funds or other assistance from the Department unless the Applicant certifies that it is in compliance with the housing laws described in subparagraph (a) through (d) of this paragraph. To satisfy that requirement, I hereby certify that the developments listed in the Previous Participation Certification, in which I am currently participating, are in compliance with:

(a) state and federal fair housing laws, including Chapter 301, Property Code, the Texas Fair Housing Act; Title IV of the Civil Rights Act of 1968 (42 U.S.C. Section 3601 et seq.); and the Fair Housing Amendments of 1988 (42 U.S.C. Section 3601 et seq.),

(b) the Civil Rights Act of 1964 (42 U.S.C. Section 2000a et seq.),

(d) the Rehabilitation Act of 1973 (29 U.S.C. Section 701 et seq.).

(6) The Applicant also certifies that the Applicant, or a branch, division, or department of said Applicant does not and will not knowingly employ an undocumented worker, where "undocumented worker" means an individual who, at the time of employment, is not lawfully admitted for permanent residence to the United States or authorized under law to be employed in that manner in the United States. If, after receiving a public subsidy, the Applicant, or a branch, division, or department of the Applicant is convicted of a violation under 8 U.S.C Section 1324a(f), the Applicant shall repay the amount of the public subsidy with interest, at the rate and according to the other terms provided by an agreement under Tex. Gov't Code Section 2264.053, not later than the 120th day after the date TDHCA notifies the Applicant of the violation."

Once staff recommends that an Applicant receive an award and before the award is granted by the Board, the Department and the Applicant must enter into an agreement that says, at least:

“The Applicant agrees that if the Applicant, or a branch, division, or department of the Applicant is convicted of a violation under 8 U.S.C Section 1324a(f), the Applicant shall repay the amount of the public subsidy with interest, at the rate of (TBD) % per annum, not later than the 120th day after the date TDHCA notifies the Applicant of the violation."