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B.Will the tenant income verification be based on: <br />Income verified by a survey of tenants? (HRA has a sample survey form available for applicant use) <br />Special Needs populations presumed to be principally low and moderate income? <br />Residents are currently part of a complex where income has been previously verified as part of other financing <br />which used Federal Housing & Urban Development (HUD) funds? <br />Other, please explain <br />DEVELOPMENT INFORMATION <br />Property Address (Street, City, State, Zip): <br /> # of Bldgs: # Stories: <br />Year Built: <br /> Units subject to rent/income restrictions: <br /># of Total Units: <br />IS THE PROPERTY IN COMPLIANCE WITH CURRENT LAND USE REQUIREMENTS? YES NO <br />IS HOUSING DESIGNED EXCLUSIVELY FOR THE ELDERLY OR PEOPLE WITH DISABILITIES? YES NO <br />Current Indebtedness on the Property/Building: <br />DATE PROPERTY PURCHASED:__________________ MORTGAGE HOLDER____________________________ <br />MONTHLY MORTGAGE PAYMENT:_______________ PRESENT BALANCE_____________________________ <br />INSURANCE AGENT FOR RENTAL PROPERTY:____________________________________________________ <br />RELOCATION INFORMATION <br />Will the rehabilitation result in permanent displacement of any current residents? Yes No <br />Will the rehabilitation require any temporary relocation of current residents? Yes No <br />ADDITION FUNDING REQUESTS <br />Have you applied for other county, state or foundation funding for the proposed improvements? Yes No <br />If yes, please list funding request and status: <br />Funding Agency Status <br />If no, please explain why: <br />3 <br /> <br />