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Today’s date:LOAN APPLICATIONInternetToday’s date:Loan Amount Requested:PurchasePurpose:Rehabilita onNew Construc onRefinanceFormedState Formed:Borrowing Entity NameOtherDate formedPrincipal(s) Name(s))Business hone:PhoneBusinessFaxFax:SSNSSN:Mobile PhoneEmailBorrower FedFedIDID# #Borrower(EIN/TIN)(EIN/TIN)Type of Entity:For Profit CorporationSole ProprieterNot-for-profit CorporationLLCPartnershipLPBASIC PROPERTY INFORMATIONProject NameCitySectionProperty TypeResidentialCommercialMixed UseNumber of Floors Above Basement GradeNumber of Studio ApartmentsNumber of 1-Bedroom ApartmentsNumber of 2-Bedroom ApartmentsOther ApartmentsTotal Number of Residential UnitsTotal Residential Square FeetNumber of Vacant UnitsBuilding AddressStateBlock/LotOwnershipLease holdSimpleFeeNumber of Commercial UnitsTotal Commercial Square FeetCommercial Business Type(s)Year of ConstructionYear of Last Renovation. Feet:Date of PurchaseTotal Purchase PriceTotal Current MortgageZipCountyElevator:YesNoIf yes, number of elevatorsNumber of Parking SpacesEstimated Cost of Rehab or ConstructionDimensionsSize of Building One Plot Number of AcresType of ConstructionBrick JointWood FrameFireproofOtherPrimary Building TypeMid-RiseLow-Rise(1-4 Stories)(5-8 StoriesPrimary Occupancy TypeSingle/coupleSeniorHigh-Rise(9-29 Stories)StudentSupportive/Special NeedsSkyscraper(30 storiescommunityp.comPage 1 of 7FamilyGarden Style/ Townhouse (no commonhallways)
BUILDING ENERGY AND WATER INFORMATIONUtility PaymentFor each of the following, indicate if the primary utility usage is paid for by the tenant or ownerApt ElectricityTenantOwnerHeatingTenantOwnerHot g will be paid by owner if tenant electricity usage in apartments is paid by owner, or if owner provides centrally distributed cooling (in mostcases a chiller).Fuel TypeFor each of the following, indicate primary fuel:HeatingElectricGasOilOtherHot Laundry (Dryers)ElectricGasOilOtherN/ASystems SurveyPlease indicate the type of heating and cooling systems:Central PlantsSteam Boiler – 1 pipe systemApartment UnitsRadiator/BaseboardPackaged Air HandlingMakeup Air UnitSteam Boiler – 2 pipe systemElectric Resistance BaseboardPackaged Indoor UnitHydronic (Heating Hot Water) BoilerPTAC (Packaged Terminal Air Conditioner)Packaged Rooftop UnitFurnacePTHP (Packaged Terminal Heat Pump)Split SystemDistrict Steam SupplyWSHP (Water Source Heat Pump)Ground Source Heat Pump (Geothermal)Fan Coil UnitChillerWindow/Wall ACChiller-HeaterDuctless Mini Split System (Heat Pump)Cooling TowerUnit Heater (Furnace or Boiler)OtherOtherPlease indicate any renewable or on-site generation equipment that is used at your property:SizeTypeSolar/PVCogeneration/CHPOtherPage 2 of 7
BUILDING ENERGY AND WATER INFORMATION CONTINUEDMeteringIndicate the metering type installed for each.ElectricityWaterGasResidential tenant metering (select N/AMasterDirectSub-meterN/ACommercial tenant metering (select N/AMasterDirectSub-meterN/ADefinitions “Master” metered: A meter serves all the tenant spaces and common areas combined. This meter is maintained by the utility. “Direct” metered: Each tenant space is served by an individual meter maintained by the utility. The common areas are also served by one ormore separate meters. “Sub-metered”: There is a utility-maintained master meter, and a third party meter has been installed to separate and measure usageamong individual tenants.Additional QuestionsIs water used for landscape irrigation?YesNoPlease indicate the number of dishwashers on site:Please indicate the number of laundry machines on site: washing machines driersHow many of these machines are located in a common area?Does the building have in-unit thermostats?YesNoWill this building be constructed/renovated using modular panels or units?YesNoIf yes, please describe:List any amenities and common spaces below that may accountfor additional owner-paid utility usage (i.e. parking, garage,community rooms, gym, pool, commercial kitchen). Indicate ifeach space is conditioned.Amenity/SpaceHeatedAdditional Property Notes:CooledPage 3 of 7
Existing Mortgage Information (for Subject Property)Mortgagee and AddressOutstanding Principal BalanceAnnual PaymentAmortizationMaturity DateArrearsContact NameInterest RateAccount #Interest RateAccoAccount #Phone NumberAdditional Mortgagee and Address(if applicable)Outstanding Principal BalanceAnnual PaymentAmortizationMaturity DateArrearsContact NamePhone NumberCan each existing mortgage be prepaid?YesNoIf there is a prepayment penalty, estimate how much for each mortgage. Mortgage 1: Mortgage 2: Government Participation (if applicable)*If Government financing has been requested for a portion of this loan, please complete the following:Source 1 AgencyName of ProgramContact PersonAmountRequestedPhoneGovernment Financing StatusApprovedDeclinedPurposeSource 2 AgencyName of ProgramContact PersonAmountRequestedPhoneGovernment Financing StatusApprovedDeclinedPurposeSource 3 AgencyName of ProgramContact PersonPhoneAmountRequestedPurposeGovernment Financing StatusApprovedDeclinedPerson(s) Responsible for Performing Rehabilitation & Construction Work (e.g. contractor(s), architect, etc.)CONTRACTOR (Contact Name)PhoneAddressARCHITECT (Contact Name)PhoneAddressBUILDING MANAGER (Contact Name)PhoneAddressReferences (include 3 business references)Name of ContactCompany NamePhoneRelationshipHave you applied for a loan for this property with any other financial institutions?Yes NoIf3 yes, list all financial institutions where you have submitted an application for the subject property.1.3.2.Page 4 of 7PendingPendingPending
Principal OwnersALL PERSONS IN THE BORROWING ENTITY HOLDING 10% OR GREATER INTEREST MUST PROVIDE THE FOLLOWING INFORMATION:Stockholder # of shares or %Name (Principal Owner 1)SSNHome PhoneinterestHome AddressCityState ZipMobile PhoneBusiness AddressCityState ZipBusiness PhoneDate of ExpirationRefugee StatusDate of IssueDate ReceivedAre you a U.S. Citizen?YesNoCountry of CitizenshipVisa TypePermanent Residency #Stockholder # of shares or %interestHome PhoneName (Principal Owner 2)SSNHome AddressCityStateZipMobile PhoneBusiness AddressCityStateZipBusiness PhoneAre you a U.S. Citizen?YesNoCountry of CitizenshipPermanent Residency #Visa TypeDate of ExpirationRefugee StatusDate of IssueDate ReceivedCurrent CPC Borrower InformationIf you have an existing loan with CPC, please list the loan number(s) and/or property address(es) below.Loan NumberAddressSustainability Information1.Which sustainable design elements (or measures to improve energy efficiency) will you incorporate into your project scope?Green Physical Needs Assessment (GPNA) or Energy AuditHigh-efficiency heating systemOn-site renewable energy generation (i.e. solar)Sustainability Certification (i.e. LEED, Enterprise Green Communities, Energy Star, NYSERDA)Net Zero EnergyPassive HouseOther2. Are you interested in learning more about CPC's sustainability initiatives and technical assistance program?YesNoPage 5 of 7
Borrowing Entity Financial Statement*THE FOLLOWING IS REQUIRED FOR THE BORROWING ENTITY; ANY PRINCIPAL OWNER OF THE BORROWING ENTITY HOLDING10% OR GREATER INTERST, MUST COMPELTE A PERSONAL STATEMENT (SEE SEPARATE FORM) & PAGE 4*AN ACCOUNTANT PREPARED OR AUDITED STATEMENT MAY BE SUMITTED IN LIEU OF THIS STATEMENT, BUT DECLARATION SECTION MUST BECOMPLETED AND SIGNEDNAME OF BORROWING ENTITYDATEPlease attach the following supplemental documents: Real Estate Owned Schedule (Attach or contact loan officer for template) Copy of last 2 years of tax returns Current Securities statements Current Bank Statements Copy of a government-issued photo IDASSETSLIABILITIESCASHNOTES PAYABLE TO BANKSREAL ESTATENOTES PAYABLE TO OTHERSSECURITIESMORTGAGES ON REAL ESTATECASH VALUE OF LIFE INS.INSTALLMENT/LINES OF CREDITOTHER ASSETSOTHER LIABILITIESTOTAL LIABILITIESTOTAL ASSETSNET WORTHPersonal Data (Complete only if Borrower & Principal are the same)EmployerEmployer AddressZipCityStateJob TitleWork PhoneAnnualOtherSalaryIncomeDeclarations from Principals of the BorrowerSource ofOther IncomeYesAre there any outstanding judgements against you?Have you ever declared bankruptcy?Are you party to a lawsuit?Do you have any contingent liabilities? If yes, Have you ever been convicted of a felony?Are you Presently delinquent or in default on any loan, mortgage financial obligation, bond or loan guarantee?Have you, directly or indirectly been involved in any loan which resulted in a foreclosure, transfer of title in lieu offoreclosure or judgment?IF YES TO ANY OF THE ABOVE, PLEASE EXPLAIN BY ATTACHING A SEPARATE SHEETI/We certify that all information contained on this financial statement is true and correct in every detail and represents thefinancial condition of the principals of the Borrower on the date given below.The undersigned declares that he/she has read and understands the statements above.Authorized Signature of Principal DateAuthorized Signature of Principal DateBank ReferenceInstitutionAccount #InstitutionAccount untRepresentativePage 6 of 7No
CERTIFICATIONThe Undersigned certify the following:1. I/We have applied for a mortgage loan from The Community Preservation Corporation or one of its affiliates (“CPC”). Inapplying for the loan, I/We completed a loan application containing various information on the purpose of the loan, theamount and source of the down payment, employment and income information, and assets and liabilities. I/We certifythat all of the information is true and complete. I/We made no misrepresentations in the loan application or otherdocuments, nor did I/We omit any pertinent information.2. I/We understand and agree that CPC reserves the right to change the mortgage loan review process to a fulldocumentation program. This may include verifying the information provided on the application with the employeeand/or the financial institution.3. I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any falsestatements when applying for this mortgage, as applicable under the provisions of Title 18, United States Codes, Section1014.4. This application shall remain the property of CPC.5. Prior to closing the loan, the undersigned(s) agree(s) to promptly advise CPC of any change to information contained inthis application.Authorization to Release InformationTo Whom It May Concern:1. I/We have applied for a mortgage from CPC. As part of the application process, CPC may verify information contained inmy/our loan application and in other documents required in connection with the loan, either before the loan is closed oras part of its quality control program.2. I/We authorize you to provide to CPC, and to any investor to whom CPC may participate with or sell my mortgage, anyand all information and documentation that they request. Such information includes, but is not limited to, employmenthistory and income; bank, money market, and similar account balances; credit history; and copies of income tax returns.3. CPC or any investor that participates in or purchases the mortgage may address this authorization to any party named inthe loan application.4. A copy of this authorization may be accepted as an original.5. Your prompt reply to CPC or the investor that participates with or purchases the mortgage is appreciated.(Authorized Signature)DateDate(Authorized Signature)Page 7 of 7
Water Master Direct Sub-meter N/A Master Gas Master Direct Sub-meter N/A Master Definitions "Master" metered: A meter serves all the tenant spaces and common areas combined. This meter is maintained by the utility. "Direct" metered: Each tenant space is served by an individual meter maintained by the utility.
