NORTH LAUDERDALE COMMUNITY DEVELOPMENT DEPARTMENT

Preferred Mortgage Lenders

1. SunTrust Bank, 954-838-4622, located at 14050 NW 14^th Street Suite #100 Sunrise, Florida 33323.

2. Bank of America Mortgage, 954-489-7542, located at 888 West Cypress Creek Road Fort Lauderdale, Florida 33309.

3. Bank Atlantic, CRA Lending, 800-330-3711, located at 2100 West Cypress Creek Road Fort Lauderdale, Florida 33309.

4. City National Bank of Florida, 305-577-7263, located at 25 West Flagler Street Miami, Florida 33130.

5. Northern Trust Bank of Florida, 954-527-3939 extension 253, located at 1100 East Las Olas Blvd., Fort Lauderdale, Florida 33301

6. Republic Bank, 954-474-8549, located at 300 South Pine Island Road Plantation, Florida 33324.

7. SunTrust Bank, 954-623-1252, located at 225 North Federal Highway Suite 700 Pompano Beach, Florida 33062

8. Washington Mutual Bank, 954-635-6006, located at 200 South Pine Island Road #102, Plantation, Florida 33324

9. Bank United, 954-296-3761, located at 2895 University Drive Coral Springs, Florida 33065

10. Gibraltar Bank, 954-768-5345, located at 450 East Las Olas Blvd #180 Fort Lauderdale, Florida 33301

11. Mortgage Solutions Inc. of South Florida, 305-653-2791, located at 17121 NE 6^th Avenue North Miami Beach, Florida 33162

12. Colonial Bank N.A., 954-839-1078, located at 1580 Sawgrass Corporate Parkway Sunrise, Florida 33323

13. Windsor Capital Mortgage Corporation, 754-366-0885, located at 8005 SW 5 Street North Lauderdale, Florida 33068

IMPORTANT:

IF YOU ARE INTERESTED IN USING ANY OF THE ABOVE LENDERS, PLEASE CALL FIRST TO MAKE ARRANGEMENTS TO MEET WITH A REPRESENTATIVE.

CITY OF NORTH LAUDERDALE

Homeownership Opportunities Program

BORROWER APPLICATION

*Information contained herein shall be kept and disclosed in conformance with Section 119.07, Florida Statutes, and shall be used only for the purpose of determining eligibility in the City of North Lauderdale’s Homeownership Opportunities Program. All information supplied will be verified at a later date through supporting documentation, including income tax returns and bank statements. PLEASE PRINT CLEARLY.

IMPORTANT: IF YOU HAVE OWNED RESIDENTIAL PROPERTY OR COMMERCIAL PROPERTY WITHIN THE LAST TWO (2) YEARS, YOU ARE NOT ELIGIBLE FOR THIS PROGRAM.

THE APPLICANT IS THE PERSON WHO WILL OWN THE HOUSE AND BE RESPONSIBLE FOR THE MORTGAGE PAYMENT. IF YOU INTEND TO OWN THE HOUSE WITH SOMEONE ELSE, CO-APPLICANT INFORMATION MUST BE PROVIDED.

-------------------------------------

PERSONAL INFORMATION

APPLICANT	CO-APPLICANT
MARITAL STATUS:	MARITAL STATUS:
Married ( ) Single ( ) Divorced ( )	Married ( ) Single ( ) Divorced ( )
Widower ( ) Separated ( )	Widower ( ) Separated ( )
Relationship to Co Applicant_______________	Relationship to Co Applicant_______________
Race___________________________________	Race___________________________________
US Citizen? Yes ____ No____	US Citizen? Yes ____ No____
If no, Alien Registration # __________________	If no, Alien Registration # __________________

LIST DEPENDENTS OR MEMBERS OF HOUSEHOLD WHO WILL RESIDE IN PROPERTY WITH YOU AND CO-APPLICANT:

Full Name Relationship Age S.S.# Occupation

1.________________________________________________________________________________

2.________________________________________________________________________________

3.________________________________________________________________________________

4.________________________________________________________________________________

5.________________________________________________________________________________

6.________________________________________________________________________________

FINANCIAL INFORMATION

Note: Be sure to include ALL SOURCES OF INCOME RECEIVED within the last 24 months.

APPLICANT	CO-APPLICANT
EMPLOYER NAME: _______________________ _______________________________________	EMPLOYER NAME: _______________________ _______________________________________
EMPLOYER ADDRESS:_____________________ _______________________________________ _______________________________________	EMPLOYER ADDRESS:_____________________ _______________________________________ _______________________________________

POSITION HELD:_________________________	POSITION HELD:_________________________
LENGTH OF EMPLOYMENT:_________________	LENGTH OF EMPLOYMENT:_________________
GROSS MONTHLY SALARY:_________________	GROSS MONTHLY SALARY:_________________

PREVIOUS EMPLOYER’S NAME & ADDRESS: ________________________________________ ________________________________________ ________________________________________	PREVIOUS EMPLOYER’S NAME & ADDRESS: ________________________________________ ________________________________________ ________________________________________

POSITION HELD:_________________________	POSITION HELD:_________________________
LENGTH OF EMPLOYMENT:_________________	LENGTH OF EMPLOYMENT:_________________
GROSS MONTHLY SALARY:_________________	GROSS MONTHLY SALARY:_________________

LIST ANY OTHER HOUSEHOLD INCOME (If any, include Child Support, Alimony, Interest, Dividends)

NAME EMPLOYER/SOURCE GROSS MONTHLY INCOME

1.________________________________________________________________________________

2.________________________________________________________________________________

3.________________________________________________________________________________

4.________________________________________________________________________________

OTHER INCOME NOT SHOWN ABOVE __________________________________________

(social security, child support, alimony, etc.) __________________________________________

__________________________________________

WHAT IS YOUR HOUSEHOLD’S TOTAL GROSS MONTHLY INCOME: $_____________

(Attach copy of latest Income Tax Returns.)

TOTAL ANNUAL INCOME $__________________

ASSETS

Checking or Savings Accounts

Bank Name Account No. Type Balance

____________________________ ________________ __________ _________

OUTSTANDING LOANS OR OTHER DEBTS (Including all charge cards):

Lender/Creditor Account No. Monthly Pmt Balance

____________________________ ________________ __________ _________

LIST ANY ADDITIONAL NAMES UNDER WHICH CREDIT HAS PREVIOUSLY BEEN RECEIVED:

APPLICANT:______________________

CO-APPLICANT:___________________

THESE QUESTIONS APPLY TO BOTH APPLICANT AND CO-APPLICANT. IF YOU ANSWER YES TO ANY OF THESE QUESTIONS, PLEASE EXPLAIN ON SEPARATE SHEET.

APPLICANT	YES	NO	CO-APPLICANT	YES	NO

Are there any outstanding judgments against you?	( )	( )	Are there any outstanding judgments against you?	( )	( )
Have you declared bankruptcy within the past seven years?	( )	( )	Have you declared bankruptcy within the past seven years?	( )	( )
Been party to a lawsuit?	( )	( )	Been party to a lawsuit?	( )	( )
Are you obligated to pay alimony, child support, or separate maintenance?	( )	( )	Are you obligated to pay alimony, child support, or separate maintenance?	( )	( )
Are you a co-maker or endorser on a note?	( )	( )	Are you a co-maker or endorser on a note?	( )	( )

AGREEMENT

AFFIDAVIT AND RELEASE

The undersigned applies to participate in the Homeownership Program indicated in this application, which requires a loan to be secured as a second mortgage on the property received through this program. The undersigned further understands that he/she must own and live in the unit for a least a period of 5 years and the City of North Lauderdale is not responsible for any damage, and I the undersigned release and hold harmless the City from any and all liabilities to myself and personal property. The undersigned further understands that all statements made in this application are true and made for the purposes of participating in this homeownership opportunities program. The undersigned warrants that all income from every person in the household is accurately listed on this application. Verifications may be obtained from any source named in the application. The undersigned fully understands that it is a federal crime punishable by fine or imprisonment or both, to knowingly make any false statements concerning any of the above facts, as applicable under the provisions of Title 18, U.S. Code, Sections 1001 and 1014.

_________________________________________ ____________________

Applicant’ Signature Date

_________________________________________ ____________________

Co-Applicant’ Signature Date

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AUTHORIZATION FORM REQUIRED BY FEDERAL PRIVACY ACT

IMPORTANT – APPLICANT(S) READ BEFORE SIGNING: Under the Privacy Act of 1974, it will be necessary for the Program/Lender to supply the appropriate agencies you listed on your Application with written approval from you to allow them to release information from your files to verify the information you provided on your application. Please sign the appropriate space below to authorize these verifications if required.

This authorizes the Program/Lender to have free access to my information and records relative to my employment, sources of other income, creditors and mortgage verifications as may be required to process my Homeownership Opportunity Application.

____________________________________ ________________________ _______________

SIGNATURE OF APPLICANT SOCIAL SECURITY # DATE

____________________________________ ________________________ _______________

SIGNATURE OF CO-APPLICANT SOCIAL SECURITY # DATE

CITY OF NORTH LAUDERDALE

COMMUNITY DEVELOPMENT DEPARTMENT

_____________________________________________________________________

NOTE: This form must be filled out, witnessed and notarized in its entirety to be valid.

***WARNING*** Florida Statutes 817 provide that false statements or misrepresentations concerning income, assets or liabilities relating to a financial condition is a misdemeanor of the first degree and is punishable by fines and/or imprisonment as provided under FS 775.082 and 775.83.

AFFIDAVIT OF ALTERNATIVE INCOME SOURCES

I_____________________________ do solemnly swear that I_____ do or____ do not receive ANY form of alternative income at the present time nor in the past 12 months other than which is reported on my application and this form. I understand that the term “alternative income applies to ANY form of funds that I may have received whether taxable or non-taxable.

______ My alternative income sources are as follows:

1. Source___________________________________ Amount__________

2. Source___________________________________ Amount__________

3. Source___________________________________ Amount__________

4. Source___________________________________ Amount__________

5. Source___________________________________ Amount__________

______ I do not receive, nor have received, in the past 12 months, ANY source of alternative income.

Applicant Name Printed_____________________________________________

Applicant Address Printed___________________________________________

Applicant Telephone Number: Home_______________ Work_____________

Applicant Signature________________________________________________

Signed and sworn to before me this_____ day of __________, _______.

Notary

Date

APPLICANT AUTHORIZATION TO RELEASE INFORMATION

***IMPORTANT, READ BEFORE SIGNING***

FINANCIAL RECORDS RELEASE

_____________________________________________________________________

NOTE: This form must be filled out, witnessed and notarized in its entirety to be valid.

I hereby grant permission and authorize any: bank, employer, insurance agency, lender, creditor and Governmental Agency to release information that is requested by the City of North Lauderdale or its authorized representative. I understand this information shall only be used to determine my financial status to qualify for a City of North Lauderdale sponsored program.

I understand this information is required to process my application. Refusal to provide this form in a properly completed manner will be grounds for disqualification. I understand that incorrect or misleading statements of material fac

1	2	3	4	5	6	7	8
$39,850	$45,550	$51,250	$56,950	$61,500	$66,050	$70,600	$75,150

FACT SHEET

Household-Size Income Eligibility

APPLICANT	CO-APPLICANT
NAME: ________________________________	NAME: ________________________________
DATE OF BIRTH:________________________	DATE OF BIRTH: ________________________
SOCIAL SECURITY NUMBER:_____________	SOCIAL SECURITY NUMBER:______________
ADDRESS:______________________________ _______________________________________ _______________________________________	ADDRESS:______________________________ _______________________________________ _______________________________________
PHONE (HOME):_________________________	PHONE (HOME):_________________________
PHONE (WORK):_________________________	PHONE (WORK):_________________________
How long at present address:_______________	How long at present address:_______________
Landlord Name:__________________________	Landlord Name:__________________________
Landlord Address:________________________ _______________________________________	Landlord Address:________________________ _______________________________________
Landlord Phone:__________________________	Landlord Phone:__________________________
Monthly Rent:____________________________	Monthly Rent:____________________________
Utilities Included: Yes ( ) No ( )	Utilities Included: Yes ( ) No ( )
Previous Address:________________________ _______________________________________ _______________________________________	Previous Address:________________________ _______________________________________ _______________________________________
How long at previous address:_______________	How long at previous address:_______________