Habitat Minnesota Fund

HFH-IA Fund

Mortgage Information Sheet

1. Name of the Homeowner(s): ______

1. Address of the Property:______

______

1. Mortgage
2. Original Principal Amount______
3. Original Date______
4. Outstanding Principal
   balance as of ______
5. Maturity Date______
6. Monthly Principal Pmt.______

(Attach a copy of the first mortgage showing recording information along with a copy of the first mortgage Note. You will need the original Note at the time of loan closing.)

1. Is there now or has there ever been a default on this loan? ______
   (Attach a complete payment history for this loan)

1. Are real estate taxes and insurance escrowed on this loan? ______

1. Who currently services the loan?______

1. Has anyone else taken a lien on the property? ___If yes, please specify ______

1. The property has been appraised by ______to have a market value of ______as of ______(date).
   (Attach a copy of the appraisal report)

1. Please specify whether there is title insurance or an attorney’s opinion of title for the property. ______. Attach a copy of the title policy or the opinion. If the title insurance policy or opinion does not state that the homeowner has clear title to the property you will need a clear title before the loan can be made.

1. Is the property located in a flood plain and if so, is the property appropriately insured? ______Attach a copy of a Standard Flood Hazard Determinationindicating whether or not the property is in a flood hazard area.

1. What was the family income at the time your affiliate approved this homeowner to receive this home? ______(Attach a copy of the application form submitted by the homeowner showing your independent verification of their income along with a copy of their federal tax return for the year that they were selected.)

1. What company provides the homeowner’s property and liability insurance? ______(Attach documentation showing that the policy is paid/ current)

1. Number of Adults (18 or older) in Household ____ Children _____ Ages of the adults ______

1. Please answer the following questions for each person in the household:

Ethnicity (select only one) ____ Hispanic or Latino ____ Not Hispanic or Latino

Race (select one or more)Disabled ____ yes ____ no

____ American Indian or Alaska Native

____ Asian

____ Black or African American

____ Native Hawaiian or Other Pacific Islander

____ White

____ Other (specify)

Summary of Attachments:

1. Copy of recorded first mortgage.
2. Copy of promissory note.
3. Homeowner payment history for mortgage to be pledged.
4. Appraisal
5. Title opinion or title guaranty
6. Copy of the Standard Flood Hazard Determination
7. Homeowner application and copies of verification of income documents.
8. Homeowner’s property insurance statement showing that it is current.