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2. Section 1: Applicant Information
4. Nonprofit Organization Name*
6. Contact Person*
7. Contact Person Title*
9. Contact Phone Number*
10. Contact Email*
12. Mailing Address*
13. City*
15. State*
16. Zip Code*
17. Federal EIN (Employer Identification Number)*
21. Section 2: Project Information
23. Property Address*
25. City*
26. State*
27. Zip Code*
29. Type of Property*

    1. Single-family home
    2. Duplex
30. If a duplex, is the duplex being converted into two owner-occupied units?

    1. Yes
    2. No
32. Assessed Value of Property*

    Upload evidence of property ownership and assessed value. 

34. Current Condition of Property*

    Brief description of deteriorated state, including photos if available. 

36. Condition of Property Photos
38. Proposed Scope of Work

    Attach detailed list of expenses, materials, and labor involved below. 

40. Exterior Improvements

    Siding, Roof, Windows, etc.

41. Interior Improvements

    Insulation, Electrical, Plumbing, etc.

42. Life Safety/Accessibility Upgrades
44. Total Project Cost*

    Upload estimated cost breakdown 

45. Loan Amount Requested (up to $50,000 per unit)*
49. Section 3: Eligibility
51. Does this project serve LMI (low-to-moderate income) individuals/families making 100% or less of the Area Median Income (HUD definitions apply)?*

    1. Yes
    2. No
53. Is this property located in a neighborhood of high LMI concentration (Census Tracts 241.01 or 241.02)?*

    1. Yes
    2. No
57. Section 4: Nonprofit Organization’s Financial Statement
59. Attach current financial statement (i.e. an annual budget):*
63. Section 5: Loan Details
65. Loan Amount Requested (up to $50,000 per unit):*
66. Projected Completion Date:*
    Projected Completion Date:

    Must be within 18 months from loan disbursement; borrower may request a six-month extension in extenuating circumstances.

68. Repayment Timeline*

    1. I Agree

    By selecting the box above, you acknowledge that the loan will become due upon sale and transfer of title by nonprofit to a qualified buyer and interest at 4% will accrue annually and be payable upon sale.

70. Fees*

    1. I Agree

    By selecting the box above, borrower agrees to pay $500 in closing costs, which will be deducted from the total loan amount. 

72. Collateral*

    1. I Agree

    By selecting the box above, borrowers agree to a lien, which shall be recorded against the property for the loan amount.

76. Section 6: Property Covenant *

    1. I Agree

    By selecting the box above, you acknowledge you have read the following statement.  

    Any nonprofit granted funding must include the following within their Purchase and Sales Agreement:

    The property described in Section 2 is subject to the following covenant, which shall run with the title to and encumber said property for a period of 10 years from the date of the deed.

    In the event that the above-named Grantee or any subsequent Grantee conveys the title to the above-described property within 10 years of the date of this deed, the new Grantee’s income shall qualify under the then-current income guidelines for the WEALTH Fund or any such successor program.

    The purpose of this covenant is to ensure that the above-described property remains affordable to future buyers for a period of 10 years.

80. Section 7: Additional Information
82. Is the loan being used to refinance an existing loan?*

    1. Yes
    2. No
83. Will the loan be used solely for physical improvements to homes?*

    1. Yes
    2. No
87. Section 8: Certification and Signature

    I hereby certify that the information provided in this application is true and accurate to the best of my knowledge, and that the nonprofit organization named above meets all eligibility requirements for the WEALTH Revolving Loan Fund. By typing my name below, I acknowledge that this typed name serves as my electronic signature. 

89. Name*
90. Date*
    Date
92. Submission Instructions

    Completed applications along with required attachments should be submitted to:

    
    

    Attn: Community Development Office

    City of Waterville

    1 Common Street

    Waterville, ME 04901

    
    

    For any questions, please contact:

    Michael Hall

    Email: mhall@waterville-me.gov

Leave This Blank:


94. 1. Receive an email copy of this form.
95. Email address

    This field is not part of the form submission.

96. Submit

* indicates a required field