Sample "Declaration of Eligibility - P2p Down Payment Assistance" - Arizona

Declaration of Eligibility - P2p Down Payment Assistance is a legal document that was released by the Arizona Department of Housing - a government authority operating within Arizona.

Form Details:

  • Released on August 24, 2018;
  • The latest edition currently provided by the Arizona Department of Housing;
  • Ready to use and print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

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Download Sample "Declaration of Eligibility - P2p Down Payment Assistance" - Arizona

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1090003988
Arizona Department of Housing
P2P DOWN PAYMENT ASSISTANCE
DECLARATION OF ELIGIBILITY
Read Declaration of Eligibility carefully before completing and signing these forms.
Applicant Information
Subject Property (
must be primary residence)
5150 S MISSION RD
CAROL ANNA MARQUEZ
Applicant
Address
ROBERTO MARQUEZ
Tucson, AZ 85706
Co-Applicant
City/State/Zip
If the County does not populate with
5205551234
Phone
County
your 3.2 file; you will have to edit the
luciaxxxxxxx@xmail.com
2
property TAB in the system and select
Email
Number of Household Members
the county
$3,594.50
Household Monthly Gross Income
Estimated Assistance Calculation:
Property Purchase Price:
$120,000.00
$12,000.00
Estimated Assistance Amount:
(10 % of purchase price up to $20,000)
Declaration Statements:
1. The Subject Property will be my Primary Residence.
2. The Subject property is in an eligible city according to program information.
3. My Annual Gross Income is NOT greater than $92,984.00.
Required Documents for Declaration of Eligibility: (all forms must be fully executed)
1. Declaration of Eligibility
2. Household Composition Declaration
3. Dodd-Frank Certification
4. Third Party Authorization
I (We) have
have not
previously received Save Our Home AZ Assistance.
I (We) acknowledge and understand that this request and Principal Reduction Assistance if approved is based upon the
truthfulness and accuracy of the documentation I (we) provide in support of this Request. I (We) acknowledge that a material
misstatement negligently made by me (us) in connection with this request for Program assistance will constitute a federal
violation punishable by a fine; and a material misstatement fraudulently made in support of this Request; will constitute a
federal violation punishable by up to a $10,000 fine which may be in addition to any criminal penalty imposed by law. In
addition, any material misstatement or false statement which affects my (our) eligibility for Program Assistance will result in a
denial of my (our) Request for Program Assistance or, if Program Assistance has been made prior to discovery of the false
statement, will constitute a default on the Program Assistance. In addition, I (we) hereby acknowledge and understand that any
false pretense, including any false statement or representation; or the fraudulent use of any instrument, facility, article or other
valuable thing or service pursuant to my (our) participation in the Program, may be punishable by imprisonment or by a fine.
Signature of Applicant:
Date:
Signature of Co‐ Applicant:
Date:
rev. 11/22/2016
8/24/2018
1090003988
Arizona Department of Housing
P2P DOWN PAYMENT ASSISTANCE
DECLARATION OF ELIGIBILITY
Read Declaration of Eligibility carefully before completing and signing these forms.
Applicant Information
Subject Property (
must be primary residence)
5150 S MISSION RD
CAROL ANNA MARQUEZ
Applicant
Address
ROBERTO MARQUEZ
Tucson, AZ 85706
Co-Applicant
City/State/Zip
If the County does not populate with
5205551234
Phone
County
your 3.2 file; you will have to edit the
luciaxxxxxxx@xmail.com
2
property TAB in the system and select
Email
Number of Household Members
the county
$3,594.50
Household Monthly Gross Income
Estimated Assistance Calculation:
Property Purchase Price:
$120,000.00
$12,000.00
Estimated Assistance Amount:
(10 % of purchase price up to $20,000)
Declaration Statements:
1. The Subject Property will be my Primary Residence.
2. The Subject property is in an eligible city according to program information.
3. My Annual Gross Income is NOT greater than $92,984.00.
Required Documents for Declaration of Eligibility: (all forms must be fully executed)
1. Declaration of Eligibility
2. Household Composition Declaration
3. Dodd-Frank Certification
4. Third Party Authorization
I (We) have
have not
previously received Save Our Home AZ Assistance.
I (We) acknowledge and understand that this request and Principal Reduction Assistance if approved is based upon the
truthfulness and accuracy of the documentation I (we) provide in support of this Request. I (We) acknowledge that a material
misstatement negligently made by me (us) in connection with this request for Program assistance will constitute a federal
violation punishable by a fine; and a material misstatement fraudulently made in support of this Request; will constitute a
federal violation punishable by up to a $10,000 fine which may be in addition to any criminal penalty imposed by law. In
addition, any material misstatement or false statement which affects my (our) eligibility for Program Assistance will result in a
denial of my (our) Request for Program Assistance or, if Program Assistance has been made prior to discovery of the false
statement, will constitute a default on the Program Assistance. In addition, I (we) hereby acknowledge and understand that any
false pretense, including any false statement or representation; or the fraudulent use of any instrument, facility, article or other
valuable thing or service pursuant to my (our) participation in the Program, may be punishable by imprisonment or by a fine.
Signature of Applicant:
Date:
Signature of Co‐ Applicant:
Date:
rev. 11/22/2016
8/24/2018
1090003988
Arizona Department of Housing
P2P DOWN PAYMENT ASSISTANCE
Household Composition Declaration
18 &
OWN OTHER
ANNUAL
PROPERTY
OVER
WORKING
FULL NAME
INCOME
RELATIONSHIP
(YES/NO)
(YES/NO)
(YES/NO)
Borrower
$
1
CAROL ANNA MARQUEZ
2
$
ROBERTO MARQUEZ
Co-Borrower
Additional household members should be written in on
3
$
the additional lines of the household composition form
4
$
even if they are not on th mortgage.
5
$
6
$
7
$
8
$
I (We) have
have not
previously received Save Our Home AZ Assistance.
I (We) acknowledge and understand that this request and Principal Reduction Assistance if approved is based
upon the truthfulness and accuracy of the documentation I (we) provide in support of this Request. I (We)
acknowledge that a material misstatement negligently made by me (us) in connection with this request for
Program assistance will constitute a federal violation punishable by a fine; and a material misstatement
fraudulently made in support of this Request; will constitute a federal violation punishable by up to a $10,000 fine
which may be in addition to any criminal penalty imposed by law. In addition, any material misstatement or false
statement which affects my (our) eligibility for Program Assistance will result in a denial of my (our) Request for
Program Assistance or, if Program Assistance has been made prior to discovery of the false statement, will
constitute a default on the Program Assistance. In addition, I (we) hereby acknowledge and understand that any
false pretense, including any false statement or representation; or the fraudulent use of any instrument, facility,
article or other valuable thing or service pursuant to my (our) participation in the Program, may be punishable by
imprisonment or by a fine.
Signature of Applicant:
Date:
Signature of Co‐ Applicant:
Date:
rev. 03/17/2016
8/24/2018
1090003988
Save Our Home Arizona Program (SOHAZ)
Arizona Home Foreclosure Funding Corporation
Lender:
1110 West Washington Street, Suite 310, Phoenix, AZ 85007
CAROL ANNA MARQUEZ,ROBERTO MARQUEZ
Borrower(s):
FEDERAL TRUTH IN LENDING DISCLOSURE STATEMENT
Initial
ANNUAL
FINANCE CHARGE
Amount Financed
Total of Payments
The
The dollar amount the credit will
The amount of credit provided to you
amount you will have Paid
PERCENTAGE
cost you
or on your behalf
after you have made all
RATE
Payments as scheduled
The cost of your credit as a
yearly rate
12,000.00
0.0%
$0
$0
$
PAYMENT SCHEDULE:
N/A
Final Balloon Payment due
: $0.
SECURITY: You are giving a security interest in the property located at
5150 S MISSION RD, Tucson, AZ 85706
ASSUMPTION: Someone buying your home cannot assume the mortgage on the original terms.
NO GUARANTEE TO REFINANCE: There is no guarantee that you will be able to refinance to lower your
rate and payments.
See your Mortgage and Note for any additional information about nonpayment, default, and any required
repayment in full before the scheduled date.
12,000.00
ITEMIZATION OF AMOUNT FINANCED of $
.
Amounts paid to others on your behalf
25.00
$
to public officials for recording fees.
11,975.00
Title Company
$
to
for down payment assistance and closing costs.
Borrower(s) hereby acknowledge(s) on the date set forth below receipt of the disclosure before
consummation of the transaction.
08/24/2018
08/24/2018
CAROL ANNA MARQUEZ
ROBERTO MARQUEZ
Borrower
Date
Borrower
Date
TCO 361587204v2
rev. 03/17/2016
8/24/2018
Dodd-Frank Certification
The following information is requested by the federal government in accordance with the Dodd-
Frank Wall Street Reform and
Consumer Protection Act (Pub. L. 111-203).
You are
required to furnish this information. The law provides that no person shall be eligible to begin
receiving assistance from the Making Home Affordable Program, authorized under the
Emergency Economic Stabilization Act of 2008 (12 U.S.C. 5201 et seq.), or any other mortgage
assistance program authorized or funded by that Act, if such person, in connection with a
mortgage or real estate transaction, has been convicted, within the last 10 years, of any one of
the following: (A) felony larceny, theft, fraud, or forgery, (B) money laundering or (C) tax evasion.
Borrower
Co-Borrower
 I have not been convicted within the last
 I have not been convicted within the last
10 years of any one of the following in
10 years of any one of the following in
connection with a mortgage or real estate
connection with a mortgage or real estate
transaction:
transaction:
(a) felony larceny, theft, fraud, or forgery,
(a) felony larceny, theft, fraud, or forgery,
(b) money laundering or
(b) money laundering or
(c) tax evasion
(c) tax evasion
In making this certification, I/we understand that the servicer, the U.S. Department of the Treasury,
or their agents may investigate the accuracy of my statements by performing routine background
checks, including automated searches of federal, state and county databases, to confirm that I/we
have not been convicted of such crimes. I/we also understand that knowingly submitting false
information may violate Federal law.
______________________________________
____________________
Borrower Signature
Date
______________________________________
____________________
Co-Borrower Signature
Date
*************
If there is a 3rd or 4th borrower on the transaction you will have to
print an additional Dodd-Frank Certification and have the additional
borrowers sign and check the appropriate boxes.
*************
8/24/2018
Third-Party Authorization Form
Arizona Department of Housing
1090003988
______________________________________
________________________________________
Mortgage Lender/Servicer Name (“Servicer”)
[Account][Loan] Number
5150 S MISSION RD Tucson AZ 85706
___________________________________________________________________________________________
Property Address
The undersigned Borrower and Co-Borrower (if any) (individually and collectively, “Borrower” or “I”), authorize the above
Servicer and it’s successors and assigns (individually and collectively, “Servicer”) and the following third parties
______________________________________
_________________________________________
[Counseling Agency]
[Agency Contact Name and Phone Number]
602-771-1000
Arizona Home Foreclosure Prevention Funding Corporation
______________________________________
_________________________________________
[Eligible Entity]
[Eligible Entity Contact Name and Phone Number]
______________________________________
_________________________________________
[Other Third Party]
[Third Party Contact Name and Phone Number]
__________________________________________________________________________________________
[Relationship of Other Third Party to Borrower and Co-Borrower]
(individually and collectively, “Third Party”) to share, release, discuss, and otherwise provide to and with each other public
and non-public personal information contained in or related to the mortgage loan of the Borrower. This information may
include (but is not limited to) the name, address, telephone number, social security number, credit score, credit report,
income, government monitoring information, loss mitigation application status, account balances, program eligibility, and
payment activity of the Borrower. I also understand and consent to the disclosure of my personal information and the terms
of any agreements under the Making Home Affordable or Hardest Hit Fund Programs by servicer or Eligible Entity to the
U.S. Department of the Treasury or their agents in connection with their responsibilities under the Emergency Economic
Stabilization Act.
The Servicer will take reasonable steps to verify the identity of a Third Party, but has no responsibility or liability to verify the
identity of such Third Party. The Servicer also has no responsibility or liability for what a Third Party does with such
information.
Before signing this Third-Party Authorization, beware of foreclosure rescue scams!
It is expected that a HUD-approved housing counselor, HFA representative or authorized
third party will work directly with your lender/mortgage servicer.
Please visit http://makinghomeaffordable.gov/counselor.html to verify you are working with a
HUD-approved housing counseling agency.
Beware of anyone who asks you to pay a fee in exchange for a counseling service or
modification of a delinquent loan.
This Third-Party Authorization is valid when signed and until Servicer receives a written revocation signed by any borrower
or co-borrower.
I UNDERSTAND AND AGREE WITH THE TERMS OF THIS THIRD-PARTY AUTHORIZATION:
Borrower
Co-Borrower
ROBERTO MARQUEZ
CAROL ANNA MARQUEZ
_______________________________
_________________________________
Printed Name
Printed Name
_______________________________
_________________________________
SIGN
SIGN
Signature
Signature
HERE
HERE
_______________________________
_________________________________
Date
Date
8/24/2018
8/24/2018
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