HTFJC Revolving Loan Fund Application
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Date:
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Month
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Day
Year
Date
Project Name
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Type of Project (pick one or more)
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Development of Owner-Occupied Housing
Development of Transitional/Rental Housing
Development of Emergency Shelter
Homeowner Assistance (Downpayment, etc.)
Rehabilitation of Owner-Occupied Housing
Rehabilitation of Transitional/Rental Housing
Rehabilitation of Emergency Shelter
Pilot program
Other
Lead Applicant Information
Name of Person Submitting Application
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First Name
Last Name
Federal Tax ID#
Name of Entity Submitting Application
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Phone Number of Person Submitting Application
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Please enter a valid phone number.
Email Address of Person Submitting Application
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example@example.com
Mailing Address of Entity
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Legal Representative or Authorized Signer CEO/Director
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Title of Legal Representative or Authorized Signer CEO/Director
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Email of Legal Representative or Authorized Signer CEO/Director
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example@example.com
Phone Number of Legal Representative or Authorized Signer CEO/Director
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Please enter a valid phone number.
Organization Type of Lead Applicant (please check one)
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Community Housing Development Organization (CHDO)
Private Non-profit Organization
Private For-profit Organization
Public Organization
Individual or Partnership Applicant (please see next item for providing description)
If Individual or Partnership Applicant, please describe type of partnership and status of partnership.
Funds Requested
Total Amount Requested: $
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Terms Requested
(Must provide sufficient supporting information to comply with said terms)
Proposed repayment terms requested. Please elaborate on any unique circumstances. Grants are only available in limited circumstances when serving those with incomes below 30% AMI:
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Proposed term of affordability in years: Length of time income limits (maximum income levels) will be adhered to and monitored by entity
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Project Address, if known including city
1. APPLICANT
Describe the applicant's mission, programs, and years in existence. Provide a description of experience with other housing projects.
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Identify staff members who will be involved with the project including their past experience and their role in this proposed project. Attach list of Board members and their occupations (see below).
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Board of Directors Attachment - Please attach Board of Directors List
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2. IDENTIFICATION OF PROJECT TEAM
Please provide complete relevant contact information and credentials, as applicable, for members of the overall project team such as the Developer, General Partner, General Contractor, Architect, Property Management, etc. Complete as fully as possible given the project team may not be fully formed.
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3. PROJECT DESCRIPTION
Please describe the major components of the project (location, what will be accomplished, who it will serve, when it will start/finish, total project cost, etc.)
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Describe the neighborhood and surrounding community, if known. Indicate why this site was selected. Attach a Location Map indicating project location (see below).
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Location Map Attachment, if property has been identified
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Describe the Tenant Selection Plan if applicable and as required by HOME, CDBG, NHTF, and LIHTC.
Please attach a Project Development Timetable outlining the stages of the project (i.e. acquisition of site, temporary relocation of residents, financial closing, construction start, construction completion, rent up, etc.)
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4. DEGREE OF NEED
Please describe the need for the specific activity proposed. How does the proposed project meet a need not addressed by a similar program in Johnson County?
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Please explain how the proposed project is not duplicative of other housing available to people with low incomes. Or, if the project duplicates other types of housing provided please share information supporting the need for additional housing. How is this proposed project different from existing housing available?
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Demonstrate the need for the financial assistance requested. Without the requested level of funding at the terms requested, what changes or modifications would be made to the project?
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5. BENEFITS
Please identify the population and income groups to be served and services that will be provided by the proposed project.
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6. CONFLICT OF INTEREST
Please describe any potential conflicts of interest or actual conflicts of interest that may exist between the Applicant and members of the Board of Directors of the Housing Trust Fund of Johnson County. Conflicts can be of a personal nature, related to a business relationship, a situation where the Applicant can receive a personal benefit from the Housing Trust Fund, etc.
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Does Your Entity Have a Conflict of Interest Policy?
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Yes
No
7. PROJECT INFORMATION
Type of Activity (check all that apply)
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Acquisition
Conversion/Adaptive Re-Use
Demolition
Historic Preservation/Renovation
New Construction
Refinance
Rehabilitation
Other
8. BUILDING & SITE INFORMATION
Total Number of Buildings Proposed
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Total Site Area (Acres)
Density (Units/Acres)
Year Built, if applicable
Are Buildings Vacant or Occupied?
Number of Bedrooms Per Unit
Total Number of Units Per Building?
9. SITE CONTROL
Does the Applicant Currently Have Site Control of the Property/Building?
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Please Select
Yes
No
Attach As-Is Appraisal and Attach Evidence of Site Control, if available
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If Owned - Please Enter Date of Purchase and Purchase Price
If Leasing - Please Outline Lease Terms
If Option to Lease or Purchase - Please Outline Terms
If No Site Control, Please Explain Your Plans and Timeline for Obtaining Site Control:
Will The Proposed Project Displace Existing Tenants?
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Yes - if so, please answer question below about existing tenants
No
If the proposed project will displace existing tenants, please describe what, if anything, will be done to help tenants being displaced to secure subsequent housing that is affordable.
Current rent(s), if applicable
If current rents will be increased, please provide rationale, benefits to the tenants, how health and safety will be enhanced, etc.
10. Property Zoning
Is the property in compliance with current zoning/rental permit requirements
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Yes
No (if no, please see question below)
If the property is not in compliance with current zoning/rental permit requirements, please explain changes needed and progress to date.
Are variances, conditional use permits, or special use permits required
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Yes
No
Is the property located in a historic district or designated as a historical building?
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Yes
No
Unusual Site Features (check all that apply)
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30 year Flood Plain
100 year Flood Plain
Slope (please add degree of slope below)
Industrial/Environmental Hazard (please explain below)
Sensitive Areas (please explain below)
Encumbrances/Liens
Other (please explain below)
None
If there is an issue with slope, please provide the degree of slope
If Industrial/Environmental Hazard, Sensitive Area, Encumbrances/Liens or Other unusual site feature checked above, please explain the issue and proposed resolution.
11. CURRENT INDEBTEDNESS OF PROPERTY
Are Property Taxes on the property/building(s) current?
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Yes
No (If no, please include outstanding Property Taxes on 11. Current Indebtedness of Property Spreadsheet as instructed below.)
Please attach 11. Current Indebtedness of Property Spreadsheet related to any current debt on property located that the bottom of Revolving Loan Program webpage - htfjc.org/revolving-loan-program below:
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12. CURRENT DEBTS OWED TO HTFJC
Does your entity have existing loans with HTFJC?
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Yes --If Yes then attach the 12. Existing Debt Spreadsheet located that the bottom of Revolving Loan Program webpage - htfjc.org/revolving-loan-program below
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12. Current Debts Owed to HTFJC - spreadsheet from HTFJC webpage required, if applicable Attachment 12. Existing Debt at htfjc.org/revolving-loan-program
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13. PROPOSED SOURCES OF FUNDING
Spreadsheet required from bottom of HTFJC Revolving Loan webpage - htfjc.org/revolving-loan-program . In addition, attach funding commitments, preliminary loan commitments, etc.
Attach 13. Proposed Sources of Funding Spreadsheet from HTFJC Revolving Loan Fund webpage - htfjc.org/revolving-loan-program
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Documentation of funding commitments, preliminary loan commitments, etc. - attach any available.
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14. Estimated Annual Income and Expenses
Transitional and Rental Projects Only - ATTACH the 10-year Cash Flow Proforma - PROGRAM TEMPLATE IS AVAILABLE AT htfjc.org/revolving-loan-program If mixed use (Housing and Commercial) cash slows should be provided separately.
14 a. Proforma - 10-year Cash Proforma required for rental and transitional housing - from webpage htfjc.org/revolving-loan-program
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14 b. Units, Monthly Rents, Income Limits, etc. Spreadsheet 14b. at htfjc.org/revolving-loan-program required for Transitional and Rental Projects.
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15 Project Budget (Required)
The Project Budget Spreadsheet is located at htfjc.org/revolving-loan-program
15. Project Budget using spreadsheet from htfjc.org/revolving-loan-program
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Please confirm:
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Signature of Person Authorized to Submit Application
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