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2015 Samaritan HouseEXHIBIT 10-B.3a HOME Program Annual Certification for Rental Housing as of 111/2014 Grantee: Project Name _ and Address: C'�ti � I �L 6� l a-tL H C? f=� S � I T 1'LC� `1 ; ` - ' I- �`e. � �' �a l l pc l r r S� `� 1--�- 5" f , � 1 Name of GRANTEE: r~ ----.. Name of OWNER (if not the J Grantee) t't5 Name, Address, & Phone Number of Property Management Company, if applicable: Check box if Property Management Company changed since last Annual Certification Name, Phone Number & E-mail of Person Completing Form: L r �� i G J _ - 1-.. � clv—i FACILITY INFORMATION —1 ik ou Feume: Attach rent schedule(s) in effect during the time period covered by certification a. Check the Rent Standard(s) used for the project, Attach the applicable rent schedule(s), if other than HOME rents are used. ® HOME Rents HOMEILIHTC Blended Rents Project Based Section 8 Rents Rural Development 515 Rural Development 538 Other (specify) r NOTE: MDOC must approve all rent schedules. t;x.i;ib; ?� must be submitted to MDOC at least ' 30-45 days before expected tenant notification date_ Rent schedules may only be changed once a year. 2. Unit Mix a. # of HOME -assisted Units b. # of Non -HOME -assisted units 0 BR 1 BR 2 BR 3 BR 4 BR S or more BR c. For projects that are not 100% HOME -assisted, are the HOME units 0 Fixed or Floating �JunLy rknuwances: a. Does tenant pay any utilities? LK No El Yes b. If YES, identify the source of the utility allowance used (e.g., Section 8, Rural Development, etc.) 1) If other than Section 8, ATTACH copy(ies) of applicable utility allowance schedule used HOME Use Only tches Onsite File: ❑ Yes ❑ No etches Onsite File: ❑ Yes ❑ No HOME Investment Partnerships Program Montana Department of Commerce HOME Administration Manual 108.3-1 January 2014 Item 2) If Section 8 utility allowance used, circle the applicable Section 8 region and check the utilities the tenant pays for below and identify fuel type for each utility tenant pays for Specify Fuel Type Section 8 Re ions (Circ I 0 ❑ Heating... ........... IJ Natural Gas ❑ Bottled Gas ❑ Electric ❑ Oil ❑ Coal/Other ❑ CookingRegion .............❑ Natural Gas El Gas El El oil El Coal/Other 1 Region 2 Region 2 ❑ Water Heating ... El Natural Gas ❑ Bottled Gas ❑ Electric ❑ Oil ❑ Coal/Other Region 4 Region 5 Region 6 ❑ Other Electric Date(s) of Section 8 Utility Schedule Used: Region 7 Region 8 Region 9 ❑ water fl i - j J1r� �! � 1G' - - - ZG'( Region 1D Region 11 Region 12 ❑ Sewer J Region 13 Region 14 Region 15 ❑ Trash Collection Region 16 Region 17 Region 18 ❑ Air Conditioning 4. Lease/Rental Agreements (REQUIRED for ALL HOME -assisted units a. Describe the term of the lease/rental agreement b. when (date) was your lease or rental agreement last updated? If leaselrental agreement has changed during the last year, attach a current copy to this annual certification. NOTE: If the property management company has changed since the last certification, attach a copy of the current lease/rental agreement HOME Use Only Does termination of tenancy by owner stipulate a 30-day written notice be given? ❑ Yes El No Are there any prohibited lease terms? (See HOME Admin Manual, Chapter 7) ❑ Yes ❑ No 5. Identify where the Fair Housing posters are displayed. 6. Have you updated your tenant selection criteria in the last 12 months? Yes L ! No If yes, attach the updated selection criteria/ policy NOTE: If the property management company has changed since the last certification, attach a copy of the current tenant selection criteria r. Now many: a. Section 8 tenants are currently residing in the project? b. Section 8 clients have applied for tenancy at the project in the last 12 months? S. Projects with 5 or more HOME -assisted units are required to have an - - - (AFHMP) in place. a. If you have an AFHMP, what date was it last reviewed? b. Are you maintaining a file that documents your Affirmative Fair Housing Marketing activities throughout the year? 0 Yes No NOTE: If the property management company has changed since the last certification, attach a copy of the new Affirmative Fair Housing Marketing Plan Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No 9. Attach copies of the Project's Requirements met? a. Financial statements for the past year, including a Statement of Financial Position, Statement of Activities, and Statement of Cash Flows ❑ Yes ❑ Yes b. Operating budget for the current year HOME Investment Partnerships Program HOME Administration Manual Montana Department of Commerce 108.3-2 January 2014 1 o C rr Q C CD CD Sll 3 r�r (D 3 m �T v o� 7 a- E3 2 3 (D n T m o cn m 0 co w a Cy FT tQ Unit Number a HOME -designated Unit (Y1N) Low (L) or High (H) HOME Rent Unit Designation —f— Tenant Last Name Size of Household Disabled Household, if identified by tenant) (YIN) Ca E Annual (Gross) Income ** c� V w. _ Percent of Area Median Income Code *** 4: 4: - Date of Initial Income Certification JO s` s �� �� v, �� c Date of Last Income —_- Recertification EJk _ _ - S1 n Tenant Rent C> i s m ' Subsidy Amount (if any)rk — S (s f V- � S Utility Allowance (for tenant - paid utilities) i c I 0 t Total Rent17-1 4 i I c-, C� Number of Bedrooms Date of Last HQS or UPCS Inspection Z' Date of Move -In Date of Move -out (if applicable) Project Based Unit (YIN) EXHIBIT 10-13.3a HOME Program Annual Certification for Rental Housing as of 1/1/2014 Grantee: Project Name L i �S C. 1q C and Address: r 13 q*i,1 A-f'e- toes+ I tec- Name of GRANTEE: +c �; , � i i"p"�. ( ( Name of OWNER (if not the Grantee) 1-juie, Huaress, & rnone Number of Property Management Company, if applicable: Name, Phone Number & E-mail of Person Completing Form: C.hr'(✓ ki c(cyer (:neck hox if Property Management Company changed since last Annual Certification 0'r I . I'rq�j e r ice- FACILITY INFORMATION 4C(°) 2Z- 7 "G ! 1. Rent Schedule: Attach rent schedule(s) in effect during the time period covered by certification a. Check the Rent Standard(s) used for the project. Attach the applicable rent schedule(s), if other than HOME rents are used. 0 HOME Rents ❑ HOMEILIHTC Blended Rents Project Based Section 8 Rents Rural Development 515 ❑ Rural Development 538 Other (specify) NOTE: MDOC must approve all rent schedules_ Exribi 7-L must be submitted to MDOC at least ' 3p-45 days before expected tenant notification date_ Rent schedules may only be changed once a year. HOME Use Only itches Onsite File: ❑ Yes ❑ No 2. Unit Mix 0 BR 1 BR 2 BR 3 BR 4 BR 5 or more BR Matches Onsite Fiile� a. # of HOME -assisted Units ❑ Yes ❑ No b. # of Non -HOME -assisted units c. For projects that are not 100% HOME -assisted, are the HOME units ❑ Fixed or Floating 3. Utility Allowances: a. Does tenant pay any utilities? = No ®Yes b. If YES, identify the source of the utility allowance SeC+ic Fs' used (e.g., Section 8, Rural Development, etc.) 1) If other than Section 8, ATTACH copy(ies) of applicable utility allowance schedule used HOME Investment Partnerships Program Montana Department of Commerce HOME Administration Manual 10B.3-1 January 2014 Item 2) If Section 8 utility allowance used, circle the applicable Section 8 region and check the utilities the tenant pays for below and identify fuel type for each utility tenant pays for Specify Fuel Type Heatin g.......•......❑ Natural Gas ❑ Bottled Gas ❑ Electric ❑ Oil ❑ Coal/Other Section 8 Regions (Circle One Cooking ........ ..... ❑ Natural Gas El Bottled Gas El Electric El Oil ❑ Coal/Other Region 1 Region 2 Region 2 ❑ Water Heating ...❑ Natural Gas El Bottled Gas ❑ Electric El oil ❑ Coal/Other Region 4 Regions Region s ❑ Other Electric Dates) of Section 8 Utility Schedule Used: Region 7 Region 8 Region 9 ® Water ® � egion 10 Region 11 Region 12 Sewer ❑ Trash Collection ❑ Air Conditioning 4. Lease/Rental Agreements (REQUIRED for ALL HOME -assisted units a. Describe the term of the lease/rental agreement Region 13 Region 14 Region 16 Region 17 Region 15 Region 18 b. When (date) was your lease or rental agreement last updated? If leaselrental agreement has changed during the last year, attach a current copy to this annual certification. NOTE: If the property management company has changed since the last certification, attach a copy of the current lease/rental agreement HOME Use Only Does termination of tenancy by owner stipulate a 30-day written notice be given? ❑ Yes Are there any prohibited lease terms? (See HOME Admin Manual, Chapter 7) ❑ Yes 0 No 5. �V1Rily vvhure the i-air dousing posters are displayed. 6. Have you updated your tenant selection criteria in the last 12 months? Yes If yes, attach the updated selection criteria 1 policy 0 No NOTE: If the property management company has changed since the last certification, attach a copy of the current tenant selection criteria 7. How many: a. Section 8 tenants are currently residing in the project? b. Section 8 clients have applied for tenancy at the project in the last 12 months? �. Pwiecfs with b or more HOME -assisted units are required to have an - -- (AFHMP) in place. - a. If you have an AFHMP, what date was it last reviewed? b. Are you maintaining a file that documents your Affirmative Fair Housing Marketing activities throughout the year? Yes No NOTE: If the property management company has changed since the last certification, attach a copy of the new Affirmative Fair Housing Marketing Plan Requirements met? ❑ Yes ❑ N o Requirements met? El Yes El No Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No k'Uj,1cs ui the vrotecrs a. Financial statements for the past year, including a Statement of Financial Position, ,� Requirements met? Statement of Activities, and Statement of Cash Flows ❑ Yes ❑ Yes b. Operating budget for the current year HOME Investment Partnerships Program Montana Department of Commerce HOME Administration Manual 10B.3-2 January 2014 (NI,k) ;iun paseg IOGfOJd (algieoildde jl);no-avow jo alea UI-BnOA 10 ales uoi;oadsul sodn jo SOH Ise] 10 a;e❑ 0 c� 4 swoolpag }o jagwnN a ;uaN le;ol t� �n p E Q C) EE o W (sa!;l1!;n pied �- 0 -;usua; Jo;) aouemouv Aimi l s c° o m + (Aue;i);unowy Ap!sgnS o $ 4 + ;usualt r L .3 Z O uogeoulljaoad awooul }spy 10 a;eclLU U p 3 d � r_ N UO1WD4!)JGO aw03UI JEiMul1O a;eQ a� -Y K o� � v awoouJ r ueipaw e9.1y10;uaoiad 75 :2 a . waoui (ssojO) lenuuy `x ,� c� c3 > (ILIA) (;ueua; _v Co Ag popuap! p `PloyasnOH palgeslQ � CA .E w PlogasnOH;a aziS oom v aweN ;sel ;ueual v E 0 Uoi;eu6isaQ i!un .0 ;ua�i 3wOH (H) 461H Jo ('I) mo-i o m CL (NIA) iiun pa;Eeu6isap-3WOH - L- 3 cz ]-- �- o m JagwnN;iunl 4A r L9 cl1 0o 0 r E n a) a.. a a) ;_ E m`U a d C E a i.0 m 2 c4 0 a _2i EXHIBIT 10-13.3a HOME Program Annual Certification for Rental Housing as of 1f112014 Grantee: Project Name and Address: Sayrl(L!_i civ� 1`�� .SE i 1atG Iq:5- e)tlt 14tle- Name of GRANTEE: Name of OWNER (if not the Grantee) ­omu, nuoress, & F'none Number of Property Management Company, if applicable: Name, Phone Number & E-mail of Person Completing Form: (:neck ,box it Property Management Company changed since last Annual Certification FACILITY INFORMATION i . vent 5cneaule: Attach rent schedule(s) in effect during the time period covered by certir ation a. Check the Rent Standard(s) used for the project. Attach the applicable rent schedule(s), if other than HOME rents are used. 1z HOME Rents HOME/LIHTC Blended Rents Project Based Section 8 Rents ❑ Rural Development 515 ❑ Rural Development 5381-1 Other (specify) NOTE: MDOC must approve all rent schedules. Exh bit ,"-L must be submitted to MDOC at least 30-45 days before expected tenant notification date_ Rent schedules may only be changed once a year. 2. Unit Mix D BR 1 BR 2 BR 3 BR 4 BR 5 or more BR a. # of HOME -assisted Units b. # of Nan -HOME -assisted units c. For projects that are not 100% HOME -assisted, are the HOME units Fixed or Floating C vunLy �-uiuwances: a. Does tenant pay any utilities? No Yes b. If YES, identify the source of the utility allowance 's e C' -Neel used (e.g., Section 8, Rural Development, etc.) 1) If other than Section 8, ATTACH copy(ies) of applicable utility allowance schedule used HOME Use Only atches Onsite File, ❑ Yes ❑ No atches Unsite File, ❑ Yes ❑ No HOME Investment Partnerships Program Montana Department of Commerce HOME Administration Manual 10B.3-1 January 2014 2) If Section 8 utility allowance used, circle the applicable Section 8 region and check below and identify fuel type for each utility tenant pays for Item I Specify Fuel Type ❑� Heating ..... ......... N Natural Gas ❑ Bottled Gas ❑ Electric ❑ Oil ❑ Coal/Other the utilities the tenant pays for Section 8 Regions (Circle One) Cooking .............❑ Natural Gas ❑ Bottled Gas Q Electric ❑ Oil ❑ Coal/Other Region 1 Region 2 Region 2 Water Heating ...❑ Natural Gas ❑ Bottled Gas IN Electric ❑ Oil ❑ Coal/Other Region a Region 5 Region s ® Other Electric Date(s) of Section 8 Utility Schedule Used: Region 7 Region 8 Region 9 19 Water A_ 31 4611 51� egion 1p `. Region 11 Region 12 Sewer O ❑ Trash Collection Region 13 Region 14 Region 15 ❑ Air Conditioning Region 16 Region 17 Region 18 4. Lease/Rental Agreements (REQUIRED for ALL HOME -assisted units a. Describe the term of the lease/rental agreement b. When (date) was your lease or rental agreement last updated? S4-P �I-kL e�L Lc t C If lease/rental agreement has changed during the last year, attach a current copy to this annual certification. NOTE: If the property management company has changed since the last certification, attach a copy of the current lease/rental agreement HOME Use Only Does termination of tenancy by owner stipulate a 30-day written notice be given? ❑ Yes Are there any prohibited lease terms? (See HOME Admin Manual ter 7 Chapter ❑ No p } I1 Yac n K1_ 5. iUenury wnere the Fair Housing posters are displayed. L& V o" hc"C rcl i 6. Have you updated your tenant selection criteria in the last 12 months? `V = Yes No If yes, attach the updated selection criteria 1 policy NOTE: If the property management company has changed since the last certification, attach a copy of the current tenant selection criteria rww iiiany. a. Section 8 tenants are currently residing in the project? b. Section 8 clients have applied for tenancy at the project in the last 12 months? E-1 ss. ►'rojects with 5 or more HOME -assisted units are required to have an n (AFHMP) in place. a. If you have an AFHMP, what date was it last reviewed? b. Are you maintaining a file that documents your Affirmative Fair Housing Marketing activities throughout the year? EE]Yes No NOTE: If the property management company has changed since the last certification, attach a copy of the new Affirmative Fair Housing Marketing Plan Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No Requirements met? ❑ Yes ❑ No u. ,Axtacn copies of the Project's a. Financial statements for the past year, including a Statement of Financial Position, Requirements met? Statement of Activities, and Statement of Cash Flows ❑ Yes ❑ Yes b. Operating budget for the current year HOME Investment Partnerships Program Montana Department of Commerce HOME Administration Manual 1 [)B.3-2 January 2014 (N/A) PA pase8 loafoid (algeolldde ;i);no-anon;o G12C] I11-nAnlhi in J -•M S- -T-$J \ =V uopedsul SOdn jo SOH Ise-1 10 a}eQ t' � _2 swooJp9810 jagwnN � Q1 --yy zy Iua�{ lelol rn ,-. a) E ❑ U II o` W (saijggn pied - p -lueua} col) aouemolIV Apian M s[? !4 c` O p + m c (Aue;l) junowV ApisgnS �.- 4 �J O m 0 W 5A V 0 - }ua�l Jueual ', N N N z o m �%. Q IJRJ DOM aw0oul;se-11 jo aileQ `4-�l Z V a > c a uolleoiillaO awooul ler;iul 10 aje❑ �w E� O O �` Q = apo0 owoouI ue!paVV eaJy;o;uaa-lad m awooul (ssoa0) lenuuy a -6 c °1 (NIA) (1ueual _ a.- Aq paUquapl jl 'plogesnoH palgeslQ 0 T ,s ui plogasnoH 10 aziS _ ooz v L o ?WEN Ise-l;ueuaj- %) v O aj uolieu6lsaa im "� }ua�l 3WOH (H) ui5lH ao (-1) mol c CL .Q (N/A) i!un Pa;eu6lsaP-3WOH o jagwnN }!un ct J C ��t= JJ L co 0 ; a� QE E U) o a� U 0 ca CL � m c � E cu Ch a a) >p c co LU C c� O o =2 Tenant Income must be re-examined annually. Owners/property managers must review full source documentation for all tenants every sixth year of the affordability period of the project. Other years, each tenant's income may be verified through self -certification by the tenant (signed and dated). HOME rent/income limits are at: -`IVJ'�f.(LC1�G�L'i'Og�ICES'Cl3fC� i HOME Use Only 1. How many units are occupied by tenants whose incomes are: Are Income targeting 0 to 30% of AMI? 31 to 50% of AMI? 51 to 60% of AMI? 61 to 80% of AMI? levels being met? ❑ 2. Do rents meet the selected rent standard? El Yes No ❑ Yes ❑ No 3. For projects with 5 or more HOME units, do 20% of the tenants have incomes at or below 50% of AMI and rents not greater than the Low HOME Rent or 30% of monthly income? �EEIIY ❑ No Call (406) 841-2820 with any questions regarding the referenced HOME requirements. Grantee: C 14-'S- . , I, Spa( Project Year: i G 9 '7 Project Name: 1-9, ,VVkLf-JLCL 1 }46,,CSe. I certify that the information included in this report represents a true and complete statement of the facts. SIGNATURE of Person Completing Report I r%— Print/Type Nam --and SIGNATURE of( x _ of the cutive Director/ CEO 1 Chief Elected Official ctor 1 CEO 1 Chief Elected Official Form reviewed by HOME Program Officer: Date: Return completed, signed forms to. HOUSING DIVISION — HOME PROGRAM MT DEPARTMENT OF COMMERCE P.O. BOX 200545 HELENA, MT 59620-0545 �-51 r:� /�; Date HOME Investment Partnerships Program Montana Department of Commerce HOME Administration Manual 10B.3-6 January 2014 124-9" Ave. YY . Kalispell, MT 59901. 406-257-5801 Thank you for your interest in renting an apartment at The Samaritan Houser INC. Enclosed you will find a rental application and price list. All apartments require a security deposit equal to the amount charged for rent. The deposit is payable at move -in. rental prices are as follows. 124 9t' Ave. west: Studio transitional apartments $190month (Without bathroom) Studio transitional apartments $210month (With bathroom) 135 Vh Ave. west: 1 bedroom loft apartment $325month (Utilities not included in rent) Has electric heat 140 9th Ave. west: 1 bedroom apartment $360month Studio apartment $305month (Utilities included) 145 9"' Ave. west: 1 bedroom loft apartment $325month (Utilities not included) Has gas heat All apartments are non-smoking! All rentals are required to sign a rental agreement. Please attach pmof of incomeff identification (picture ID and social security cards). We cannot process any application without these items.