Homebuyer_Pre-App

Dear Homeowner:

Thank you for choosing Clinch-Powell to help you work through this difficult time. This program is provided to you free of charge because of funding received from government programs. In order to keep this service free, Clinch-Powell must follow certain program guidelines which often include specific forms and documentation.

The following information is needed in order for us to begin working with you to help resolve your mortgage issue. Please fill forms out as completely and accurately as possible, making sure to include signatures for each borrower.

Returning the packet without necessary signatures and supporting documents will delay the process.

Please complete the following forms in detail to the best of your knowledge:

Foreclosure Prevention Intake Form, ALL pages, Signed and COMPLETED (pg 1 & 2)
Write a brief letter of hardship to your lender, explaining the reason you have fallen behind on your mortgage-this must signed & dated!
*Supporting documentation of your situation as listed below:

*REQUIRED-- Copies (no originals) of the following documents in order to properly evaluate your circumstances and recommend appropriate options. (Across the board, any lender or program will also require these items.)

Proof of income for each member in household (most recent award letters and/or 3 consecutive pay stubs)
- Proof of receipt of public benefits (ex: transaction history print out for Food Stamps)
Most recent tax return with W-2’s,(* sign the second page of 1040!)
Last two (2) months of bank statements (ALL pages; must be bank-issued or stamped, i.e. not internet print out)
Most recent monthly Mortgage STATEMENT,
Current Homeowner’s INSURANCE Statement and City/County TAX Statement(s)
Any/all recent letters from your mortgage company (especially if one is a Notice of Sale Date)
Supporting documentation of YOUR particular hardship
- Laid-Off from job:
  - Separation notice from employer (w/ dates of employment),
  - last pay stub
- Death or divorce:
  - Death Certificate
  - Divorce decree
- Long-term medical condition:
  - Documentation of disability (w/ effective date)
  - Covid-19

*Additional documents that MAY BE REQUESTED during this process:

Current electric bill (this is to verify you are living in the residence)
Mortgage NOTE or Promissory Note
Copy of divorce decree and/or child-support order
Official documentation relating to your bankruptcy (if it occurred within the last 10 years)

First Name *

First Name

Last Name *

Last Name

Phone Number *

Area Code Phone Number

E-mail *

By providing an email address, you attest it is secure and you can and will check it regularly.

Birthdate *

Month Day Year

Social Security Number *

Gender:

Male Female Prefer not to answer

Race:

Native-American or Alaskan Native Black or African American Asian Native Hawaiian or Pacific Islander White Prefer not to answer

Ethnicity:

Hispanic Non-Hispanic

Disabled

No Yes

Veteran:

No Yes Active duty

Currently enrolled in school or training program:

No Yes

Do you need to add a Co-Applicant? *

No Yes

Co-Applicant First Name

First Name

Co-Applicant Last Name

Last Name

Phone Number

Area Code Phone Number

E-mail

By providing an email address, you attest it is secure and you can and will check it regularly.

Birthdate

Month Day Year

Social Security Number

Gender:

Male Female Prefer not to answer

Race:

Native-American or Alaskan Native Black or African American Asian Native Hawaiian or Pacific Islander White Prefer not to answer

Ethnicity:

Hispanic Non-Hispanic

Disabled

No Yes

Veteran:

No Yes Active duty

Are you a Veteran or Active Duty Military?

No Yes

Currently enrolled in school or training program:

No Yes

Address *

Street Address

Street Address Line 2

City State

Zip Code

County *

EX: Grainger County

How long have you lived at current address? *

Is this a rental property? *

Yes No

Current rent amount

Household Size *

# of people living in house

List the NAMES and BIRTHDAYS of EVERYONE who will be living in the home. *

Are you currently employed? *

Yes No

APPLICANT Employer Information

Company Name or Self-Employed

Street Address

City State

Zip Code

Employer Phone Number

Area Code Phone Number

Start Date

Month Day Year

Gross Monthly Income

Gross Monthly Before Taxes

APPLICANT Previous Employer Information

Company Name or Self-Employed

Street Address

City State

Zip Code

Applicant Previous Employer Phone Number

Area Code Phone Number

Applicant Previous Employer Start Date

Month Day Year

Applicant Previous Employer End Date

Month Day Year

Applicant Previous Gross Monthly Income

Gross Monthly Before Taxes

Select ALL OTHER types of income you receive. *

Child Support / Alimony Social Security / Disability Retirement / Pension I only receive Employment Income Self - Employed

List the MONTHLY AMOUNTS of all types of income you receive.

Is the Co-Applicant currently employed?

Yes No

CO-APPLICANT Employer Information

Company Name or Self-Employed

Street Address

City State

Zip Code

Phone Number

Area Code Phone Number

Start Date

Month Day Year

Gross Monthly Income

Gross Monthly Before Taxes

Co-Applicant Previous Employer Information

Company Name or Self-Employed

Street Address

City State

Zip Code

Co-Applicant Previous Employer Phone Number

Area Code Phone Number

Co-Applicant Previous Employer Start Date

Month Day Year

Co-Applicant Previous Employer End Date

Month Day Year

Co-Applicant Previous Gross Monthly Income

Gross Monthly Before Taxes

Select ALL OTHER types of income you receive.

Child Support / Alimony Social Security / Disability Retirement / Pension I only receive Employment Income Self - Employed

List the MONTHLY AMOUNTS of all types of income you receive.

Does anyone else in the household receive any income? (We need to know, even if they are not going to be on the loan.) *

Yes No

If so, list all TYPES and AMOUNTS of EVERYONE ELSE receiving income in the household.

List all other household ASSETS Ex: IRA, Pension, Savings, Investment Income, Property, etc.

List all debts below (Credit cards, Loans, etc.). Please give Company Name, Type of Debt, Balance Owed, and Monthly Payment Amount using the table below. EX: Wells Fargo; Car Loan; $12,000; $300 - If no debts, put "0" in all blanks.

Have either applicant or co-applicant filed bankruptcy in the past 3 years? *

No Yes

In the past 10 years, have either the applicant or co-applicant been convicted of: A) felony larceny, theft, fraud, or forgery; B) money laundering; or C) tax evasion? *

No Yes

If you answered "Yes" to either of the above questions, please explain:

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Have the applicant or co-applicant owned a home in the past 3 years? *

No Yes

Are you represented by a Realtor? *

No Yes

If Yes, please provide the name & company of your Realtor:

In what city or county would you like to purchase? *

City, TN / County, TN

How did you hear about Clinch-Powell? *

Would you like to receive our Newsletter?

Yes No

Authorization to Verify and Release of Information: I/We authorize Clinch-Powell RC&D Council, Inc. 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 and the Federation of Appalachian Housing Enterprises [Fahe] to use my Social Security, or other federally issued identification 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 and/or Fahe by those credit reporting agencies from which Clinch-Powell or Fahe 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, Fahe/Just Choice Lending, or THDA only for the purpose of determining my potential eligibility for a home loan and/or mortgage program. This information will not be disclosed to outside, unrelated third parties without my knowledge.I/we hereby authorize Clinch-Powell, when appropriate, to share information with USDA Rural Development, THDA, Fahe, HUD, or another relevant third party or partnering agency for the purposes of program monitoring, reporting, compliance, and evaluation. 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 understand that the purpose of this pre-application is to permit Clinch-Powell to assess my current situation and help me determine which mortgage programs I may be eligible to apply for. I understand that Clinch-Powell’s role is to assist me in determining my options and potentially applying for a mortgage loan, but Clinch-Powell may not be my lender. There may be fees associated with the services that Clinch-Powell provides to me, but I will be advised of such a fee in advance of service. If I provide specific account information for electronic payment, I authorize Clinch-Powell to utilize it for my expressed purposes (provided by me either written or verbally). I understand checks must clear before payment will be credited, there is $30 fee for insufficient funds, and that any money previously owed to Clinch-Powell must be reconciled before new services may begin. In the event that, based on the assessment of my completed pre-application and credit history, I am not currently eligible for the loan programs Clinch-Powell works with, I authorize the transfer of this pre-application and the information contained within to one of Clinch-Powell’s housing counseling programs in order to assist me in becoming mortgage loan ready. At the time of file transfer, I will be given the opportunity to discontinue services if I so choose. By signing below, I/we are verifying that I/we 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. I/We have read and fully understand the above Authorization. *

Yes No

Applicant Signature *

Clear

Co-Applicant Signature

Clear

Disclosure and Conflict of Interest

Clinch-Powell RC&D Council is a non-profit Community Housing Development Organization and a HUD-approved counseling agency (82394) that, among other activities, helps families with affordable housing goals. Most services are available in alternative formats and locations upon request.

Clinch-Powell receives funding for its housing programs through grants and loans from a number of sources, including but not limited to: USDA Rural Development, US Dept. of Housing & Urban Development [HUD], Corporation for National and Community Service, Federal Home Loan Bank, the Environmental Protection Agency, Tennessee Housing Development Agency, Fahe/ Just Choice Lending, Citizens Bank & Trust Co. of Grainger County, BB&T Bank, SunTrust Bank, public fundraising, and private donations.

As a housing counseling agency, Clinch-Powell offers the following services: 1) Pre-Purchase Homebuyer Education Workshops--utilizing the Realizing the American Dream curriculum; 2) Pre-Purchase Counseling--financial readiness to purchase/own an affordable home; 3) Post-Purchase Counseling and Workshops--non-delinquency home improvement, energy efficiency; 4) Foreclosure Prevention/ Loss Mitigation Counseling—assisting to resolve mortgage defaults; 5) Rental Counseling--locating safe/decent rental housing; 6) Household Budgeting & Credit Repair Counseling and Workshops--financial literacy and personal money management; 7) High-Cost Mortgage Counseling--requirement of certain mortgage loans to ensure borrower’s understanding of the risk of the loan. Clinch-Powell, along with Clinch-Powell Construction Company develops affordable single-family homes to sell to low- to moderate- income families. In addition to coordinating the packaging and servicing of select loan products, Clinch-Powell itself occasionally offers low-interest loans and grants for various affordable housing activities. Clinch-Powell NMLS #195063; Sara Knight NMLS #920625, Kelsey Cook NMLS #1372118, Andrea Karr NMLS #1553157 Please visit http://mortgage.nationwidelicensingsystem.org/ to find more information regarding history and profile as a mortgage lender. Lastly, Clinch-Powell is a property manager for a multi-family low-income apartment building, as well as, multiple single-family rental housing units which it also owns.

In providing counseling services, Clinch-Powell housing counselors will present to their clients several options in the furtherance of their housing goal/service, possibly including recommendations of some of the above listed services. The Clinch-Powell housing counselor will recommend only services that are in the best interest of the client and will inform the client of any interests the organization has in any particular product or service. Within the agency, individual housing counselors may perform multiple affordable housing activities within the scope of their regular job duties, and as such, will not receive any additional funds or incentives specifically for those activities. Moreover, as per HUD guidelines, housing counselors will not simultaneously participate in specific housing activities.

As the client, you have the right to inquire as to specific relationships Clinch-Powell or its employees have with other entities. You also have the right to choose (or not) the products or services that you feel are right for your household, regardless of any option presented or recommendation made by the housing counselor. YOU ARE UNDER NO OBLIGATION TO UTILIZE/RECEIVE, OR EVEN CONTINUE WITH SERVICES THROUGH YOUR HOUSING COUNSELOR OR CLINCH-POWELL AS A WHOLE. Your decision to utilize or not utilize certain programs and products will not in any way affect your housing counseling service. If you decide to discontinue services with Clinch-Powell, or if your need is beyond the scope of the agency’s capabilities, Clinch-Powell staff will assist you locating a more suitable local agency.

If you/your housing situation meet certain criteria, we may collect personal information directly from you and enter into a computer system call HMIS (Homeless Management Information System). Many agencies that provide assistance use this computer system to gather information about clients that are homeless or at risk of homelessness. We only collect information that we consider to be appropriate. You are not required to provide this information. However, without your information we may not be able to fully assist your needs. All information provided to the HMIS system is safeguarded and held under tightest security.

I/We have read and fully understand the above Disclosure and Conflict of Interest Policy. *

Yes No

I/We have read and fully understand the above Privacy Policy. *

Yes No

Privacy Policy Notice

We may collect non-public personal information about you from the following sources: A) Information that you provide to us orally, written, or digitally such as on applications or other forms; B) Information about your transaction with us or others; and C) Information from others, such as credit bureaus, real estate appraisers, lenders and employers. We do not disclose any non-public personal information about you without your consent to anyone, except: ·information provided to your lender as required to gain approval for a loan or protect your current home, ·to government agencies and grantors in compliance with their respective monitoring and reporting requirements, ·in broader forms to partnering agencies for reporting purposes, joint applications, and/or compilation of statistical data, ·as required by law. To maintain security of customer information, we restrict access to your personal and account information to persons who need to know that information in order to provide you products and services requested with this application. We may disclose certain limited information to relevant third parties as part of a particular service as further described in the specific program authorization. We maintain physical, electronic and procedural safeguards that comply with federal standards to guard your non-public personal information. As a client, you have the right to opt-out and direct us to withhold non-public personal information from third parties, or to specify/limit to whom such information is provided. If you choose to opt-out, we will not be able to answer questions from third parties. To opt-out, you will need to make special note of this on this page, written separately, or explicitly stated to your counselor; not signing this page is not sufficient to opt-out. If at any time, you wish to change your decision with regard to your opt-out, you may call us at 865-828-5927 and do so. If you decide to discontinue services through Clinch-Powell, we will still adhere to the policies and practices as described in this notice. The agency will continue to safely maintain your records for a period of time, of at least three (3) years, after which all digital files will be purged and paper documents will be shredded and destroyed.

Comments or questions:

0/300

By selecting the submit button I/we acknowledge, just as if I/we had signed a written contract, that all of the information stated in this application, to the best of my/our knowledge is true and accurate. *

Yes No

PLEASE READ: Tri-Merge Credit Pull Payment Options: IF YOU PROCEED TO PAY PAL and DO NOT PAY, your form will NOT be submitted. If you do not wish to pay with a credit or debit card through Pay Pal, please select "Pay via Phone" or "Pay via Check or Money Order" *

Pay via Pay Pal portal $ 28.43

Number of Applicants on Homebuyer Pre-Application

Pay via Phone $28.43 Free

Pay via Check or Money Order $27.50 Free

Total $ 0.00

Homebuyer Pre-Application

Applicant Information

Household Information

Household Income

Program Participation Questions

Electronic Signature and Submission