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Three Oaks Communities

IDD Housing Access Pilot Program (IHAPP)

Accetpance of Deed Restriction and Down Payment Assistance Program

and Preliminary Income and Disability Certification Form

The recent IHAPP grant award will provide important new resources for our Walton Oaks and Auburn Oaks neighborhoods, including funding to help accelerate development and a new Down Payment Assistance program for buyers of IDD-designated units (IDD Units).


Please complete and submit this form no later than TBD.

Acceptance of Deed Restriction and Down Payment Assistance Program Participation


IHAPP Deed Restriction


As a condition of the IHAPP grant, a new deed restriction will be recorded against all IDD Units at Walton Oaks and Auburn Oaks. The deed restriction will remain in effect for a period of ten (10) years following the initial sale of each IDD Unit and will include the following income and certification requirements:


  1. Income Requirements. Across all IDD Units at Walton Oaks and Auburn Oaks, at least 75% of occupants, whether owners or renters, must have annual household income at or below 30% of Area Median Income (AMI), currently $22,020 in Oakland County. All occupants of IDD Units must have annual household income at or below 60% of AMI, currently $44,040.


  2. Income Certification. The Developer (Three Oaks Communities), the homeowners association for each neighborhood once formed and controlled by its Board of Co-owners, or an authorized third party designated to perform this function, will be responsible for certifying the income eligibility of occupants of IDD Units:

    • Upon the initial sale or lease of an IDD Unit; and

    • Whenever the ownership or occupancy of an IDD Unit changes during the applicable ten-year deed restriction period.

    • TOC reserves the right to not enter into a Purchase Agreement with any buyer, or not to approve a lease agreement, for an IDD Unit if doing so would violate the terms of the IHAPP grant.


Click [here...waiting on CHN to provide] to review the legal description of the deed restriction.


New Down Payment Assistance Program


In consideration of the IHAPP deed restriction requirements, and to further improve affordability for IDD residents, the Developer is establishing a new Down Payment Assistance (DPA) Program providing $20,000 of assistance per standard IDD Unit. For IDD condominium units that are combined into a larger unit, the amount of DPA will be adjusted proportionately based on the square footage of the combined unit.


The DPA will be:


  1. Structured as a soft second mortgage. The DPA will bear 0% interest, require no scheduled principal payments, and be applied at closing in addition to or in replacement of any deposits you may have already paid, subject to any financing terms your chosen financial institution may require.


  2. Assumable upon resale. The DPA may be assumed by a subsequent eligible owner upon resale of the IDD Unit, subject to the HOA bylaws, deed restrictions, and other applicable requirements in effect at the time of transfer.

I accept and acknowledge the IHAPP deed restriction and terms of the Developer's new Down Payment Assistance program.
Yes. I accept this as an amendment to my Reservation Agreement or Purchase Agreement, as applicable, and I agree to complete the preliminary income certification in the next section of this form.
No. Please cancel my Reservation Agreement or Purchase Agreement. Any fees or deposits I am eligible for will be refunded to me by the Developer.

Preliminary Income Certification


Acknowledgements


  1. This is a preliminary income certification to measure compliance with IHAPP's requirements at this time. All residents of an IDD Unit will be required to provide a final certification at the time of closing or execution of a lease agreement to occupy their IDD Unit.


  2. Fields marked with an "*" are required. You will not be able to submit this form without completing all required fields.


  3. Completion of this form does not represent approval of an application to reserve, purchase, or lease an IDD Unit or approval to participate in TOC's Down Payment Assistance Program.


  4. TOC has authorized Three Oaks Community Builders (TOCB) to administer this form on its behalf. TOCB may share your responses with TOC, Community Housing Network, and the Michigan State Housing Development Authority, as required under the terms of the IHAPP grant.


  5. TOC and TOCB reserve the right to request additional documentation or verification, as deemed necessary to reasonably validate the information you provide in this form. Click here for a List of Acceptable Forms of Verification.

Applicant Information Section:

Applicant should be the individual who will occupy the IDD Unit

Multi-line address
My Neighborhood:
Auburn Oaks
Walton Oaks
Undecided

Disability Status: For purposes of this Application, an Intellectual or Developmental Disability (IDD) is a disability recognized by the Social Security Administration that began before age 22 and results in significant limitations in intellectual functioning, adaptive functioning, or other major life activities.

Do you have an Intellectual and/or Developmental Disability (IDD)?
Yes
No. You are not eligible to complete this form.

IDD Unit Occupancy and Ownership

I plan to occupy the IDD Unit as my primary residence.
Yes
No. You are not eligible to complete this form.
The IDD Unit that I intend to occupy must be owned at all times by (check which one applies to you).
The Occupant directly,
A Special Needs Trust whose sole beneficiary is the Occupant,
Tenants-in-Common where all co-owners are Individuals with IDD or Special Needs Trusts whose beneficiaries will occupy the IDD Unit, or
One or more Special Needs Trusts or other approved legal entity that is leasing the IDD Unit to one or more Occupants who may not be the beneficiary of the Special Needs Trust(s) that will own the IDD Unit

Contact TOCB if you have any questions regarding your expected ownership model.

Income and Asset Information: To determine eligibility, please provide income and asset information for the Applicant.


NOTE: Enter all income and expense numbers in this form as whole numbers (no dollar signs, commas, decimal points, or alphanumeric characters). Unless specifically stated, all numbers should be annual estimates.

Are you employed?
Yes
No
Do you have another employer?
Yes
No
Do you have another employer?
Yes
No

Other Income

How much do you expect to receive in other income in the next 12 months from the following sources?

Monthly Supplemental Security Income (SSI)

How are you paid?

Monthly Social Security (i.e., SSDI)

How are you paid?

Monthly Retirement Benefits

How are you paid?

Monthly Public Assistance (excluding food assistance / SNAP)

How are you paid?
Do you expect to receive any lump sum amounts from delay of payments for SSI or VA Disability?
Yes
No

Assets Section

Do you have a checking account?
Yes
No
Do you have cash that is not deposited in an account?
Yes
No
Do you own a life insurance policy?
Yes
No
What type of insurance policy do you have?
Whole
Universal
Term
Do you have access to any other assets, property, insurance policies, businesses, etc.?
Yes
No
Are you a beneficiary of a trust?
Yes
No
If Yes, what type of a trust is it?
1st Party Special Needs Trust
3rd Party Special Needs Trust
Other, please specify
Are you authorized to withdraw funds directly from the trust?
Yes
No

Medical Expenses


Health Insurance #1 should be your primary carrier (i.e., Medicaid or Medicare, if you are eligible and have coverage). Health Insurance #2 is for any other supplemental medical insurance you may have beyond your primary coverage.

Do you have an HMO, a medical plan, or health insurance policy (other than Medicare or Medicaid), which pays all or part of the cost of your medications?
Yes
No
If you must pay for medicines yourself, are you later reimbursed for all or part of the cost?
Yes
No

Other Medical Expenses

Disability Assistance Expense: Subsidized households are entitled to a deduction for unreimbursed, anticipated costs for attendant care and

“auxiliary apparatus” for a person with disabilities, to the extent these expenses are reasonable and necessary to enable any adult to be employed. The deduction may not exceed the earned income received by the family member or members who are enabled to work by the attendant care or auxiliary apparatus. If the Applicant does not work, they do not qualify for a Disability Assistance Expense deduction.

As a disabled individual, do you pay for care or expenses that allow you to work?
Yes
No
Do you pay for equipment that allows you to work (e.g. costs to equip a vehicle to make it accessible in order to allow a disabled member to drive or be driven to work.)?
Yes
No

APPLICANT CERTIFICATION


1) By signing this document, I certify that the statements made herein are true and complete. I understand that providing false statements or information is punishable under Federal Law.


2) The information provided herein will be maintained in a secure and confidential manner in accordance with applicable federal and state privacy laws, including HIPAA. Access to this information will be limited to authorized personnel who require it to administer the program and determine eligibility.


3) If any portion of this form was completed by someone other than the applicant, they must sign the statement below acknowledging that they are legally-authorized to assist the applicant and the information provided is true, complete, and accurate to the best of their knowledge.

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I/We are legally-authorized to, and have completed, all or part of this form on behalf of the Applicant.

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