I/We certify that all the information provided is complete, correct and true to the best of my knowledge. I understand that false or misleading information my result in the rejection of my intake packet. I understand that there may be other requirements depending on my progress and/or the type of financing option pursued. I also understand that the completion of this intake packet in no way guarantees me repairs to my home or the loans/funds to purchase such repairs. Although employees of Clinch-Powell will package my application to the best of their abilities, Clinch-Powell does not have any control or influence over Rural Development’s, Federal Home Loan Bank, TN Housing Development Agency, or any other funder/provider’s decision to approve or deny my loan/grant application.
I understand that one of the purposes of this intake packet is for the purpose of having Clinch-Powell package my 504 loan application and submit the completed application to USDA Rural Development, in addition to submitting applications for any other available community repair programs. I realize that I have the option to apply to a Rural Development office directly, but I am choosing to have someone from Clinch-Powell work on my behalf to help gather documents and complete forms in order to “package” my loan application, and that there is a monetary fee associated with this packaging service.
I understand that it is my responsibility to schedule meetings with my packager and provide the requested information/ documentation either promptly before or at the meeting. If I wish to cancel my scheduled meeting, I will do so by contacting Clinch-Powell no later than 24 hours prior to the scheduled meeting time.
I/We authorize Clinch-Powell to check any and all information and/or references contained herein, including but not limited to creditors, employers, and landlords. Clinch-Powell may also ask to see and/or photocopy my Driver’s License, Identification Card, and/or Social Security Card for the purpose of confirming my identification or as specific programs require. I authorize Clinch-Powell to use my Social Security number for the purpose of obtaining my credit report for the purpose of evaluating my credit history. I also authorize the release of my credit report to Clinch-Powell by those credit reporting agencies from which Clinch-Powell may request my credit report. I understand that the information on my credit report will be used by Clinch-Powell, its affiliates, lenders, USDA Rural Development, Federal Home Loan Bank, or Tennessee Housing Development Agency only for the purpose of determining my potential eligibility for a home repair loan/program. This information will not be disclosed to outside, unrelated third parties without my knowledge.
I authorize Clinch-Powell to contact me by any method I have provided. I understand Clinch-Powell has no control over the security of communication methods outside of its internally owned communication portals, and is therefore not responsible for external security breaches. I/we hereby authorize Clinch-Powell, when appropriate, to share information with USDA Rural Development, TN Housing Development Agency, Federation of Appalachian Housing Enterprises, Department of Housing & Urban Development, or another relevant third party or partnering agency for the purposes of program monitoring, reporting, compliance, and evaluation.
By signing below, I/we are verifying that I have read and understand the terms set forth within this authorization, as well as, the disclosures and privacy policy that accompany this authorization. I understand that this form is an authorization to collect specific information and assess my situation, and it is not, in and of itself, a loan or credit application. This authorization will expire five (5) years from the dates below.