The Community Development Financial Institutions Fund (CDFI Fund) is publishing this Capital Magnet Fund (CMF) Application Template (Application Template) in conjunction with the Notice for Public Comment on proposed and/or continuing information collection, as required by the Paperwork Reduction Act (PRA) of 1995, 44 U.S.C. 3506(c)(2)(A). This Application Template is provided for the purposes of soliciting comments on the appropriateness of the information collected in the Application. The CMF Application is an online form submitted through the CDFI Fund’s Award Management Information System (AMIS).
The Capital Magnet Fund (CMF) is administered by the CDFI Fund. Through the CMF, the CDFI Fund provides financial assistance grants to Certified Community Development Financial Institutions (CDFIs) and to qualified Nonprofit Organizations that have the development or management of affordable housing as one of their principal purposes.
In order to understand the requirements of the CMF, including eligible uses of financial assistance grants, potential Applicants should review the CMF Interim Rule (12 C.F.R. 1807). Capitalized terms not defined in this Application Template (other than titles) have meanings set forth in the CMF Interim Rule or the Notice of Funds Availability (NOFA). The CMF Interim Rule and most recent NOFA are available on the CDFI Fund’s website: www.cdfifund.gov/cmf.
In order to facilitate review of this Application Template in Comment, new or substantially revised questions compared with the FY 2020 CMF Application are highlighted. A number of less substantive changes were also made relative to the FY 2020 CMF Application, but these changes were not highlighted.
APPLICATION TEMPLATE INSTRUCTIONS
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This document provides the full question text and related guidance for the information that will be entered into the CMF Application in AMIS.
In order to facilitate the crosswalk between this Application Template document and AMIS, each Application question in this document will be presented in a table that contains the following information:
Full question text
Response
Notes/guidance relevant to that specific question or sub-question
AMIS Field Type
Below is an overview of the nine field types you will encounter in completing the Application in AMIS.
Auto-populated/Auto-calculated: These fields be will be automatically populated in AMIS based on other data inputs. No data entry is required for fields that are marked “auto-populated” or “auto-calculated.”
Checkmark: These fields allow the Applicant to check a box to select a corresponding option.
Currency: These fields allow the Applicant to enter currency data points and have a dollar sign in front. For example, Award Request Amount: $2,000,000.
Look-up: These fields allow the Applicant to search and select data fields for an existing list in the AMIS database. For example, when entering geographic areas, the Applicant can “look-up” counties or states.
Narrative: These fields allow the Applicant to enter text (non-numeric data). These fields will also have a character limit as indicated in each question.
Numeric: These fields allow the Applicant to enter a number (that is not a dollar figure or a percentage). For example, the number of hours to complete the Application: 100.
Percentage: These fields allow the Applicant to enter a percentage. For example, percentage of CMF Award that will be used as a Loan Loss Reserve: 23%.
Picklist: These fields allow the Applicant to select an option from a suite of choices (e.g. a dropdown of “Yes” or “No”).
Text: These are short text fields that allow the Applicant to enter up to 255 characters. They are used for names and short descriptions.
Program Profile and Creating an AMIS Application
Once your organization is registered in AMIS, the first step in completing the AMIS Application is to ensure that your CMF Program Profile has the correct “Entity Type.” On the Program Profile, you must make sure the field “Entity Type” is completed in order to create an Application. This selection will trigger certain validations on the AMIS Application. The options are listed below:
Financing Entity
Affordable Housing Developer/Manager
A Financing Entity is an entity whose predominant business activity is the provision of arm’s length transactions and services to independent, unrelated parties, each acting in its own best interest. Such transactions support and promote affordable housing and/or community development through the provision of financial products that serve low income communities, individuals or families with low incomes or underserved markets or communities.
An Affordable Housing Developer/Manager is a Nonprofit Organization whose primary mission is the construction, development, redevelopment, preservation or management of affordable housing. The Affordable Housing Developer may own the housing that is developed; may own it in part, such as a limited partnership; may sell the homeownership housing it develops once completed; or may sell but continue to manage the housing if rental housing. CDFIs who have the construction, development, redevelopment, preservation or management of affordable housing as a predominant purpose may elect to apply as an Affordable Housing Developer/Manager.
The first section in the Application is the Organization and Application Information section. Certain information in these questions may be auto-populated in AMIS based on data from the Applicant’s organizational profile. If you need to edit any of the auto-populated fields, you must edit the information directly in the organizational profile.
Question 1 – Organization Information
Most fields in this question are auto-populated in AMIS based on the Applicant’s AMIS Organizational Profile. If you need to edit any of the information in these fields, you need to do so in the Organizational Profile. You won’t be able to edit in the Application itself.
Question Text |
Response |
Question Tips |
Field Type |
a. Organization Name |
Auto-populated |
This must be the formal name of the Applicant organization as it appears on all relevant legal documents such as the Articles of Incorporation. Please make sure punctuation, capitalization and spelling are correct. If the name that is currently listed in this field is not the Applicant’s legal name, please contact the CDFI Fund through a Service Request. |
Auto-populated |
b. Address |
Auto-populated |
If the address populating in this field is not correct, it will need to be changed it on the Applicant’s Organizational Profile in AMIS. |
Auto-populated |
c. Employer Identification Number (EIN) |
Auto-populated |
Must match what’s on the Applicant’s SF-424 in Grants.gov. |
Auto-populated |
d. Dun & Bradstreet Data Universal Numbering System (DUNS) Number |
Auto-populated |
Must match what’s on the Applicant’s SF-424 in Grants.gov. |
Auto-populated |
e. Applicant’s Date of Incorporation |
Auto-populated |
Only Applicants that have been in existence as a legal entity for at least three years prior to the Application deadline are eligible to apply for funding. |
Auto-populated |
f. Applicant’s fiscal year end (month/day) |
Auto-populated |
The Applicant’s fiscal year end. |
Auto-populated |
g. Entity Type |
Picklist (Affordable Housing Developer/Manager or Financing Entity) |
Applicants select between Affordable Housing Developer/Manager and Financing Entity. |
Picklist |
h. Depository Institution Holding Company (DIHC) Subsidiary Name |
Text |
If the Applicant is a Certified CDFI Depository Institution Holding Company that intends to carry out the activities of a CMF Award through its Certified CDFI Subsidiary Insured Depository Institution, it must identify the name and EIN of this Certified CDFI Subsidiary depository institution. This field is optional. |
Text |
i. DIHC Subsidiary EIN |
Numeric |
See previous note. This field is conditional. It must be completed if an entry has been made in (g) above. |
Numeric |
Question 2 – Requested Award
Question Text |
Response |
Question Tips |
Field Type |
a. What is the total dollar amount of Award requested in this Application? |
$_______ |
|
Currency |
b. Is there an absolute minimum amount below which the Applicant would be unwilling to accept a CMF Award? |
Picklist (Yes/No) |
|
Picklist |
c. If Yes to 2(b), provide the minimum amount: |
$_______ |
|
Currency |
d. If Yes to 2(b), how was the minimum amount in 2(c) determined? |
Narrative – 2,000 characters |
|
Narrative |
Question 3 – States Served
Question Text |
Response |
Question Tips |
Field Type |
a. Identify the type of Service Area requested for this Award. |
__ Statewide (or territory-wide)
__ Multi-State (more than one state or territory)
|
|
Picklist |
b. Identify the particular states where the Applicant will deploy its CMF Award. |
Look-up |
|
Look-up |
c. Indicate which of the states selected in (b) that the Applicant has not managed, developed, or financed affordable housing or economic development in the last five years. |
Checkmark |
|
Checkmark |
Question 4 – Application Contacts
Question Text |
Response |
Question Tips |
Field Type |
a. Select a first Application Point of Contact from the Applicant’s AMIS contacts. |
________ |
When you select an Application Point of Contact in AMIS, their email and phone number will populate. Please ensure this information is accurate or you may miss important information about the Application. |
Look-up |
b. Select a second Application Point of Contact from the Applicant’s AMIS contacts. |
________ |
The Applicant must provide at least two different Application contacts and the second Application Point of Contact must be different than the first Application Point of Contact. |
Look-up |
c. Select a third Application Point of Contact from the Applicant’s AMIS contacts. |
________ |
The Applicant does not have to select a third point of contact, but it is recommended. Adding more individuals makes it less likely the Applicant will miss a communication. |
Look-up |
Question 5 – Applicant Eligibility Criteria
Question Text |
Response |
Question Tips |
Field Type |
a. Is the Applicant a Certified CDFI as of the date of the NOFA publication? |
Auto-populated (Yes/No) |
The Applicant’s CDFI certification status should auto-populate in AMIS from the Applicant’s Organization Profile. If it does not, please contact the CDFI Fund as soon as possible to resolve the issue. |
Auto-populated |
b. If (a) is “Yes”, what is the CDFI certification number? |
Auto-populated |
The Applicant’s CDFI certification number should pre-populate in AMIS from the Applicant’s Organization Profile. If it does not, please contact the CDFI Fund as soon as possible to resolve the issue. |
Auto-populated |
c. Is the Applicant a Nonprofit Organization? |
Auto-populated (Yes/No) |
|
Auto-populated |
d. Are at least 33 and 1/3 % of the Applicant’s total assets dedicated to the development or management of affordable housing? |
Yes/No |
|
Picklist |
Question 6 – Affiliate Organizations
Question Text |
Response |
Question Tips |
Field Type |
a. Does the Applicant have any Affiliates (as defined by the CMF Interim Rule) that are also applying for a CMF Award in the same funding round? |
Yes/No |
|
Picklist |
b. If Yes to (a), list all Affiliates who will be applying for CMF funding in this funding round. |
Look Up |
|
Look Up |
c. Does the Applicant have any Affiliates or Subsidiaries that will have a role in executing the proposed business and leveraging strategy outlined in the application? If so, name these organizations and describe the business relationship with the Applicant and the role the organization will play in the CMF Award.
|
Narrative – 1,000 characters |
|
Narrative |
Question 7 – Total Estimated Hours to Complete the Application
Question Text |
Response |
Question Tips |
Field Type |
Estimate the number of hours required to complete the entire Application package: |
____ hours |
For the purpose of estimating Application completion hours, Applicants should focus only on the amount of time it took to complete and populate the questions asked in the Application materials. Other activities that are carried out in the normal course of business and are only indirectly related to the completion of this Application (e.g., identifying a project/lending pipeline, developing a strategic plan or marketing plan, etc.) should not be included in this estimate. This question will not be scored. |
Numeric |
Question 8 – Executive Summary
Question Text |
Response |
Question Tips |
Field Type |
Summarize the key elements of the CMF Proposal, including:
|
Narrative – 3,000 characters |
This is a high-level summary of the CMF Application strategy/vision. This will not be scored in the External Review phase.
|
Narrative |
Proposed Uses of a CMF Award
Question 9(a) – Eligible Activities
Please select all of the Eligible Activities that the Applicant intends to undertake with the CMF Award. As a condition of the Assistance Agreement, Applicants will be restricted to using their CMF Award for the Eligible Activities selected in Q. 9(a).
Question Text |
Response |
Question Tips |
Field Type |
i. Capitalize Loan Loss Reserves |
Checkmark |
Loan Loss Reserves (LLR) means proceeds from the CMF Award the Applicant will set aside in the form of cash reserve, or through accounting-based accrual reserves, to cover losses on loans, accounts, and notes receivable for Affordable Housing Activities and/or Economic Development Activities. |
Checkmark |
ii. Capitalize a Revolving Loan Fund |
Checkmark |
Revolving Loan Fund means a pool of funds managed by the Applicant wherein repayment on loans for Affordable Housing Activities or Economic Development Activities are used to provide additional loans. |
Checkmark |
iii. Capitalize an Affordable Housing Fund |
Checkmark |
Affordable Housing Fund means a loan, grant or equity investment fund that is managed by the Applicant and that uses its capital to finance Affordable Housing Activities. |
Checkmark |
iv. Capitalize a fund to support Economic Development Activities |
Checkmark |
A fund to support the development, preservation, acquisition and/or rehabilitation of Community Service Facilities and/or other physical structures in which neighborhood-based businesses operate. Must be In Conjunction With Affordable Housing Activities and part of a Concerted Strategy. |
Checkmark |
v. Make Risk-Sharing Loans |
Checkmark |
Risk-Sharing Loans mean loans for Affordable Housing Activities and/or Economic Development Activities in which the risk of borrower default is shared by the Applicant with other lenders. |
Checkmark |
vi. Provide Loan Guarantees |
Checkmark |
Loan Guarantee means the use of the CMF Award to support an agreement to indemnify the holder of a loan all or a portion of the unpaid principal balance in case of default by the borrower. The proceeds of the loan that is guaranteed with the CMF Award must be used for Affordable Housing Activities and/or Economic Development Activities. Examples include arrangements where the Applicant will assume or repay all or a portion of the debt if the borrower defaults. |
Checkmark |
vii. For Direct Administrative Expenses |
Checkmark |
The Applicant may use no more than 5% of its CMF Award for Direct Administrative Expenses. Any portion of the amount available for Direct Administrative Expenses may be used for direct costs related to the effective tracking and evaluation of program or evidence-based outcomes for CMF-assisted Projects. |
Checkmark |
Question 9(b) – Financing Activities
Please indicate which the following types of activities will be financed with CMF Award dollars (and any Program Income earned during the 5 year Investment Period). Applicants selected for an Award will not be held to these selections in their Assistance Agreement.
Question Text |
Response |
Question Tips |
Field Type |
i. Predevelopment Financing |
Checkmark |
Refers to costs related to determining the feasibility of a particular project, such as the costs of preliminary financial applications, legal fees, architectural fees, and engineering fees. |
Checkmark |
ii. Property/Site Acquisition Financing |
Checkmark |
This category refers to financing any costs associated with obtaining control of the site. |
Checkmark |
iii. Construction Financing |
Checkmark |
This category refers to financing costs associated with the construction of a Project. |
Checkmark |
iv. Bridge Loans or Other Similar Short-Term Financing |
Checkmark |
This category is for short term financing that doesn’t fit into the categories in (i) – (iv). |
Checkmark |
v. Permanent Financing (1st Lien) |
Checkmark |
This category refers to permanent financing (1st Lien). |
Checkmark |
vi. Permanent Financing (2nd Lien or lower) |
Checkmark |
This category refers to permanent financing (2nd Lien or lower). |
Checkmark |
vii. Refinancing |
Checkmark |
This category refers to refinancing. |
Checkmark |
viii. Loan Loss Reserves or Loan Guarantees |
Checkmark |
See Q. 9(a) for the definitions of these terms. Note that these should be restricted accounts. |
Checkmark |
ix. Equity |
Checkmark |
This category refers to equity investments. |
Checkmark |
x. Down payment/Closing Cost Assistance |
Checkmark |
This category refers to purchase assistance including down payment and closing cost assistance for home purchasers. |
Checkmark |
Question 9(c) – Proposed Uses
Please select all of the proposed uses that the Applicant intends to undertake with the CMF Award. Applicants will be restricted in the Assistance Agreement to using the CMF Award for Homeownership, Rental Housing, and/or Economic Development Activities based on the selections in Q. 9(c).
Question Text |
Response |
Question Tips |
Field Type |
i. Homeownership (Development) |
Checkmark |
Development includes any combination of land acquisition, demolition of existing facilities, and construction of new facilities for Homeownership units for Affordable Housing. |
Checkmark |
ii. Homeownership (Rehabilitation) |
Checkmark |
Rehabilitation includes any repairs and/or capital improvements related to Homeownership units for Affordable Housing. |
Checkmark |
iii. Homeownership (mortgage finance and/or Purchase assistance) |
Checkmark |
If the Applicant plans to use the CMF Award to provide mortgages to eligible Families to purchase Homeownership units and/or other Purchase assistance (i.e. down payment or closing cost assistance). |
Checkmark |
iv. Rental Housing (Development) |
Checkmark |
Rental development includes any combination of land acquisition, demolition of existing facilities, and construction of new facilities for rental Affordable Housing units. |
Checkmark |
v. Rental Housing (Preservation, and/or Rehabilitation) |
Checkmark |
Rental Rehabilitation includes any repairs and/or capital improvements related to rental Affordable Housing. Preservation includes acquisition, with or without rehabilitation of at-risk affordable rental housing (already subsidized and restricted), as well as recapitalization of expiring LIHTC properties. Note, in this scenario, the existing affordability and use restrictions must be extended by a minimum of 10 years. Preservation also includes using CMF to convert non-restricted rental housing, such as “naturally occurring affordable housing” to Affordable Housing (with or without rehabilitation). |
Checkmark |
vi. Economic Development Activities (commercial facilities) |
Checkmark |
No more than 30% of the CMF Award may be used for Economic Development Activities. Commercial facilities are physical structures in which neighborhood-based businesses operate. |
Checkmark |
vii. Economic Development Activities (Community Service Facilities) |
Checkmark |
No more than 30% of the CMF Award may be used for Economic Development Activities. |
Checkmark |
Question 10 – Community Analysis and Financing Gaps
Question Text |
Response |
Question Tips |
Field Type |
a. Describe the challenges facing the Low-Income Families and communities within the requested Service Area. The discussion should address:
|
Narrative – 4,000 characters |
|
Narrative |
b. What financing gaps in the requested Service Area are contributing to the challenges described in 10(a)? Describe what types of financing are missing or not available at the appropriate rates and terms, and why this financing is unavailable in the marketplace. |
Narrative –4,000 characters |
|
Narrative |
Question 11 – Proposed CMF Award Financing Activities
|
|||
Question Text |
Response |
Question Tips |
Field Type |
a. Provide the requested data on the Applicant’s proposed products in Appendix 1. |
Appendix 1 |
See Appendix 1. |
|
b. Describe how the Applicant will use the requested CMF Award as part of a financing strategy to address the challenges and financing gaps identified in Qs. 10(a) and 10(b), referencing the proposed financial products from Appendix 1 as necessary. Be sure to describe:
|
Narrative – 4,000 characters |
|
Narrative |
c. Secondary market activity: If the Applicant intends to sell CMF-financed loans on the secondary market, describe the anticipated transaction(s), including the intended purchaser(s); the scope of the sale; the nature of the loans (rental or homeownership); timing; and how all CMF requirements will remain in place for each loan for the duration of the Affordability Period. |
Narrative – 2,000 characters |
|
Narrative |
d. Loan Loss Reserves or Loan Guarantees: If the Applicant intends to use its CMF Award for Loan Loss Reserves (LLR) or Guarantees, describe the strategy, the structure of the LLR/Loan Guarantees, and the role of a CMF Award.
|
Narrative – 2,500 characters |
|
Narrative |
Track Record and Projections
Questions 12 and 13 focus on the Applicant’s track record and projections. These questions elaborate on the data requested in the Track Record and Projections tables which can be found in Appendix 2.
Question 12 – Track Record
Question Text |
Response |
Question Tips |
Field Type |
a. Provide data on the Applicant’s track record in Appendix 2, Tables A1, B1, and C1 (as applicable). |
|||
b. Describe the Applicant’s track record of Affordable Housing and Economic Development Activities (as applicable). Be sure to address:
|
Narrative – 5,000 characters |
|
Narrative |
Question 13 – Projected Performance and Pipeline
Question Text |
Response |
Question Tips |
Field Type |
a. Provide data on the Applicant’s projected CMF Award performance and financing activities for the next five years in Appendix 2, Tables A2, B2, and C2 (as applicable). |
See Appendix 2, Tables A2, B2, and C2.
|
||
|
$_________ $_________ |
|
Currency |
c. Describe why the Applicant’s projections in Tables A2, B2, C2 (as applicable) are realistic and achievable. Be sure to address the following factors:
|
Narrative – 3,000 characters |
|
Narrative |
d. Provide the requested data on the Applicant’s proposed pipeline in Appendix 3. |
|
See Appendix 3 |
|
e. For Rental Housing, describe how the Applicant will build/manage a pipeline of potential CMF projects. Be sure to address:
|
Narrative – 3,000 characters |
|
Narrative |
f. For Homeownership, describe how the Applicant will build/manage a pipeline of potential CMF projects/borrowers, addressing the following items:
|
Narrative – 3,000 characters |
|
Narrative |
g. For Economic Development Activities, describe how the Applicant will build/manage a pipeline of potential CMF projects. Be sure to address:
|
Narrative – 3,000 characters |
|
Narrative |
Leveraging the CMF Award
The CMF authorizing statute requires that Recipients use the CMF Award to finance/support Projects with Eligible Project Costs totaling at least ten times the CMF Award amount. The CDFI Fund refers to this as “leveraging” the CMF Award. Questions 14-17 ask the Applicant to detail its strategy for leveraging the CMF Award. While the Application asks the Applicant to describe its leveraging approach in three different categories (i.e. Enterprise-Level, Reinvestment, and Project-Level), there is no preference for one category of leverage over another.
Question 14 – Overall Leverage Summary
In this question, please provide information on the overall plans for leveraging the CMF Award.
Question Text |
Response |
Question Tips |
Field Type |
a. The Applicant’s CMF Award Request: |
Auto-Calculated
|
This will auto-populate based on the response to Q. 2(a). |
Auto-Calculated |
b. Enter the amount of the CMF Award that will be used for Direct Administrative Expenses |
$_________
|
This amount can be no more than 5% of the award request in (a). The figure entered here is an estimates. All CMF Award Recipients will be allowed to use up to 5% of their Award for Direct Administrative expenses. |
Currency |
c. What are the estimated total Eligible Project Costs that will be financed/supported with the CMF Award? |
$_________
|
Enter the estimated Eligible Project Costs (EPC) that will be financed/supported by the CMF Award. Further guidance on what counts as Eligible Project Costs is available in the Application FAQs. Note that the Eligible Project Costs for a Project will not exceed the total development cost for that Project. |
Currency |
d. The Applicant’s projected Leverage Multiplier: |
Auto-Calculated |
Projected Leverage Multiplier = Projected Eligible Project Costs ÷ CMF Award Amount Requested |
Auto-Calculated |
e. How much does the Applicant anticipate generating in Leveraged Costs with the CMF Award? |
Auto-Calculated
|
|
Auto-Calculated |
f. How much of 14(e) above will be financed/supported by private sources? |
$_________ |
|
Currency |
g. How much of 14(e) above will be financed/supported by public sources? |
$_________ |
|
Currency |
h. The Applicant’s overall Private Leverage Multiplier: |
Auto-Calculated |
|
Auto-Calculated |
Question 15– Enterprise-Level Leverage (if applicable)
The questions below focus on the Applicant’s plans to use its CMF Award to leverage “Enterprise-Level Capital.” “Enterprise-Level Capital” is capital earned, borrowed, or raised by the Applicant or its Affiliates, which is designated for use and ultimately used to pay for Leveraged Costs but is not initially restricted for use for specific properties at the time the capital is earned, borrowed or raised. Enterprise-Level Capital can include, but is not limited to, Program-Related Investments (PRIs), loans from third parties, and the organization’s own contributed capital (equity or retained earnings).
Example: An Applicant requests a $2 million CMF Award which it intends to leverage 10 times to create a $20 million Affordable Housing Fund. The Affordable Housing Fund will be comprised of the requested $2 million in CMF Award and $18 million in leveraged funds. Of the $18 million, $16 million is from private sources ($15 million in a new bank line of credit and $1 million from an existing foundation Program Related Investments (PRI). The Affordable Housing Fund also includes $1 million in funds from the city (not restricted to a specific project) and the Applicant is contributing $1 million of its own funds. The total Enterprise-Level Capital in this example is $18 million. $17 million is private Enterprise-Level Capital.
Note: If the Applicant does not plan to leverage its CMF Award at the Enterprise-Level, it should enter $0 to Qs. 15(a) and 15(b). The Applicant only needs to respond to Qs. 15(d), 15(e), and 15(f) if Q. 15(c) is greater than $0. Questions 15(d) – 15(f) will not appear in AMIS if Qs. 15(a) – 15(c) are all $0.
Question Text |
Response |
Question Tips |
Field Type |
a. How much Enterprise-Level Capital will the Applicant raise from private sources with the CMF Award? |
$________ |
|
Currency |
b. How much Enterprise-Level Capital will the Applicant raise from public sources with the CMF Award? |
$________ |
Any capital designated by the capital provider for a specific, identified project cannot be included here. Do not include the CMF Award request in this field. |
Currency |
c. Total amount of Enterprise-Level Capital the Applicant plans to leverage. |
Auto-Calculated |
|
Auto-Calculated |
d. Describe the Applicant’s strategy to leverage the CMF Award by using it to attract Enterprise-Level Capital for the organization, especially private capital. |
Narrative – 3,500 characters |
|
Narrative |
e. Discuss the Applicant’s prior relevant experience raising and deploying private and public Enterprise funds from the sources being targeted for Enterprise-Level Capital (or similar sources). |
Narrative – 3,500 characters |
|
Narrative |
f. If the Applicant has identified potential sources of Enterprise-Level Capital to leverage with the CMF Award, they should be included in Appendix 4. |
See Appendix 4 |
|
See Appendix 4 |
Question 16 – Reinvestment (if applicable)
The questions below focus on the Applicant’s plans to redeploy repaid capital during the five-year Investment Period (i.e. redeployment of CMF Award and Enterprise-Level Capital). If the Applicant does not anticipate redeploying CMF Award dollars or Enterprise-Level Capital, the amount entered in 16(a), 16(b), and 16(c) should be zero. Program Income in the form of principal and equity repayments of the CMF Award earned during the Investment Period must be reinvested by the Recipient. The required conditions for that reinvestment of Program Income will be specified in the Assistance Agreement and may vary depending on whether the Applicant intends to leverage the CMF Award through reinvestment, as indicated in their response to this question.
Note: The Applicant only needs to respond to Qs. 16(d), 16(e) and 16(f) if Qs. 16(a), 16(b), or 16(c) are greater than 0. Questions 16(d) – 16(f) will not appear in AMIS if Qs. 16(a) – 16(c) are all 0.
Question Text |
Response |
Question Tips |
Field Type |
a. How much of the repaid CMF Award (i.e. Program Income) will be reinvested into additional Projects completed during the five year Investment Period? |
$_________ |
|
|
b. How much of the repaid Enterprise-Level Capital from private sources will be reinvested into additional Projects completed during the five year Investment Period? |
$_________ |
|
Currency |
c. How much of the repaid Enterprise-Level Capital from public sources will be reinvested into additional Projects completed during the five year Investment Period? |
$_________ |
|
Currency |
d. Based on the responses to 16(a), 16(b), and 16(c), please specify how much the Applicant plans to reinvest every year during the five-year Investment Period. |
Yr. 1: $_____ Yr. 2: $_____ Yr. 3: $_____ Yr. 4: $_____ Yr. 5: $_____ |
|
Currency |
e. If the response to 16(a), 16(b), or 16(c) was greater than $0, describe the Applicant’s strategy for reinvesting the CMF Award and any Enterprise-level Capital. In particular, discuss:
|
Narrative – 3,500 characters |
|
Narrative |
f. If the response to 16(a), 16(b), or 16(c) was greater than $0, discuss the Applicant’s track record of managing the repayment and reinvesting of capital, particularly private capital. |
Narrative – 3,500 characters |
|
Narrative |
Question 17 – Project-Level Leverage (if applicable)
Project-Level Leverage is the difference between the total Eligible Project Costs of the Project and the amount of financing or capital provided to the Project by the Applicant. It is capital used to pay Leveraged Costs that is restricted to a specific project when it is raised. Project-Level Leverage can, among other things, include mortgages secured by the property, proceeds from the sale of bonds, equity investment raised through LIHTC, deferred developer fees, loans and grants from local and state government made directly to a specific Project. Project-Level Leverage does not include Enterprise-Level Capital or Reinvestments. Here are two examples:
Example 1: The Applicant is using a CMF Award to support a multi-family rental Project with total Eligible Project Costs of $2.5 million. In total, the Applicant will be providing $500,000 in financing from their own funds (Enterprise-Level) and $500,000 from its CMF Award to the project. $1 million will be funded by a private lender mortgage and the city has awarded $500,000 for that specific Project. The amount of Project-Level Leverage in this example is $1.5 million, with $1 million from private sources and $500,000 from public sources.
Example 2: The Applicant is using a CMF Award to seed an Affordable Housing Fund that will provide soft second mortgages to Low-Income Families. This fund provides a second mortgage of $10,000 ($5,000 of its own funds and $5,000 in CMF) to a homebuyer to help finance a home purchase of $100,000. The balance of $90,000 is funded by a private mortgage. The amount of Project-Level Leverage is $90,000.
Note: The Applicant only needs to respond to Qs. 17(d) and 17(e) if Q. 17(c) is greater than $0. Questions 17(d) – 17(e) will not appear in AMIS if Q. 17(c) is $0.
Question Text |
Response |
Question Tips |
Field Type |
a. How much capital does the Applicant anticipate leveraging at the Project-Level from private sources? |
$________ |
Examples may be a mortgage secured by the property or equity investment raised through LIHTC. |
Currency |
b. How much capital does the Applicant anticipate leveraging at the Project-Level from public sources? |
$________ |
Examples may be grants or loans from local, state, or federal government. Do not include the CMF Award amount for this question. |
Currency |
c. Total amount of Project-Level Leverage |
Auto-Calculated |
This field will be auto-calculated. It is the sum of 18(a) and 185(b). |
Auto-Calculated |
d. Describe the Applicant’s approach to leveraging at the Project-Level, specifically discussing private and public sources of leverage, as applicable. If the Applicant plans to fund projects that have not secured all the necessary sources of financing, be sure to discuss the strategy for managing the risk that these other sources will not be available. |
Narrative – 3,500 characters |
|
Narrative |
e. Discuss the Applicant’s track record in the last five years of securing Project-Level Leverage from private and public sources, as applicable. |
Narrative – 3,500 characters |
|
Narrative |
Adaptability
Question 18 – Adaptability
Question Text |
Response |
Question Tips |
Field Type |
Discuss the adaptability of the Applicant’s business and leveraging strategy to changing market conditions, including loss of anticipated pipeline projects, changes to interest rates, availability and/or cost of capital. |
Narrative – 2,000 characters |
Where relevant, discuss the Applicant’s track record in adjusting its strategy and/or pipeline due to changing market conditions, availability or cost of capital or other external pressures. |
Narrative |
Potential Outcomes and Impacts
Question 19 – Housing and Economic Development Impacts
Question Text |
Response |
Question Tips |
Field Type |
a. Housing Impacts: The CMF Program has identified six housing impacts that are priority impacts for the CMF Program. Select at least one impact (and no more than three) that will result from the Affordable Housing strategy proposed in this application. For each impact selected, also select the metrics that the Applicant plans to track to monitor if the impact is being achieved.
1. Improved financial stability and wealth building for Low-Income Families.
2. Improved health outcomes for Low-Income individuals and Families, particularly seniors, children, formerly homeless, persons with disabilities, or people with other health challenges.
3. The opportunity for Low-Income residents to avoid dislocation and remain in their affordable homes and/or neighborhoods.
4. Improved access to educational opportunities or transportation for Low-Income Families.
5. Assist in the long term recovery and rebuilding of affordable housing in federally designated disaster areas through disaster-prevention or disaster-resistant design.
6. Reduction in the racial homeownership gap.
|
Picklist/ Checkmark |
|
Picklist/ Checkmark |
b. For each housing impact selected, select the metrics you will track associated with this impact. Also, in the accompanying narrative, describe how the proposed CMF strategy in this Application will contribute to that impact and discuss the plan for tracking the impact metric(s) identified above. |
Narrative – 2,000 characters |
|
Narrative |
c. If the Applicant intends to finance/support Economic Development Activities, select which of the impacts below will result from these Economic Development Activities. The Economic Development impact options are:
|
Picklist/ Checkmark |
|
Picklist/ Checkmark |
d. For each economic development impact selected, select the metrics you will track associated with this impact. Also, in the accompanying narrative, describe how the proposed CMF strategy in this Application will contribute to that impact and discuss the plan for tracking the impact metric(s) identified above. |
Narrative – 2,000 characters |
|
Narrative |
e. Will the Applicant commit that it will use its CMF Award to finance/support Economic Development Activities located only in Low-Income Areas or Underserved Rural Areas? |
Picklist |
|
Picklist |
Geographic and Income Targeting
The CMF authorizing statue indicates that the CMF Program should target affordable housing that revitalizes Areas of Economic Distress or targets Low- and Very-Low Income Families outside of Areas of Economic Distress. In terms of income targeting, the CMF Program prioritizes Applicants targeting Low-Income Families (80% AMI or below) for Homeownership and Very Low Income Families (50% AMI or below) for Rental Housing. Given this different level of targeting and the differences between Homeownership and Rental, the Geographic and Income Targeting section has different questions for Rental and Homeownership.
Rental Housing - Geographic and Income Targeting
For rental Housing, Applicants will be asked to separately discuss their income targeting plans and the extent to which they intend to use the Award to target High Opportunity Areas and Areas of Economic Distress. For rental housing, the CMF Program is targeting the financing and production of housing at 50% AMI or below.
AMIS Note: These questions will only appear in the AMIS Application if the Applicant indicates in Q. 9(c) that it plans to undertake Rental Housing.
Question 20 – Rental Housing: Areas of Economic Distress and High Opportunity Areas
Question Text |
Response |
Question Tips |
Field Type |
a. What is the percentage of the Applicant’s total CMF-financed/supported Rental units that will be located in Areas of Economic Distress? |
______% |
|
Percentage |
b. What is the percentage of the Applicant’s total CMF-financed/supported Rental units that will be located in High Opportunity Areas? |
______% |
|
Percentage |
c. In total, what percentage of Rental units will be either located in an Area of Economic Distress or High Opportunity Areas? |
______% |
|
Percentage |
d. Describe how you will achieve the percentage listed in (c) if selected for a CMF Award. Specifically discuss:
|
Narrative – 3,000 characters |
|
Narrative |
Question 21 – Rental Housing Income Targeting |
|||
Question Text |
Response |
Question Tips |
Field Type |
a. If the Applicant is proposing to finance/produce rental housing with a CMF Award, indicate the minimum percentage of the total number of rental housing units that the Applicant will commit to financing/producing for Very Low-Income Families (50% of the area median income or below). |
______% |
|
Percentage
|
b. Describe how you will be able to achieve the percentage listed in (a) based on your Application strategy and track record of financing/producing housing for Very Low-Income Families Be sure to also discuss and quantify:
|
Narrative – 3,000 characters |
|
Narrative |
Homeownership – Geographic and Income Targeting
AMIS Note: These questions will only appear in the AMIS Application if the Applicant indicates in Q. 9(c) that it plans to undertake Homeownership with the Award.
Question 22 – Geographic and Income Targeting for Homeownership
Question Text |
Response |
Question Tips |
Field Type |
a. What is the percentage of the Applicant’s total CMF-financed/supported Homeownership units that will be located in Areas of Economic Distress? |
______% |
|
Percentage |
b. What percentage of Homeownership units will be targeted to Low-Income Families (80% AMI or below)? |
______% |
|
Percentage |
c. In total, what percentage of Homeownership units will be either located in an Area of Economic Distress or targeted to Low-Income Families (80% AMI and below)? |
______% |
|
Percentage |
d. Describe how you will achieve the percentage listed in (c) if selected for a CMF Award. Specifically discuss:
|
Narrative – 3,000 characters |
|
Narrative |
e. Discuss how the CMF Award will enhance the Applicant’s ability to target to finance/produce housing in Areas of Economic Distress and/or for Low-Income homebuyers. Be sure to discuss and quantify:
|
Narrative – 3,000 characters |
|
Narrative |
Community Engagement and Strategy Alignment
Question 23 – Community Partnerships
Question Text |
Response |
Question Tips |
Filed Type |
Describe partnerships with other organizations (e.g. housing developers, lenders, community organizations) that will enhance the Applicant’s strategy and impact for Low-Income Families and help the Applicant to address priorities of the CDFI Fund. |
Narrative – 3,000 characters |
Potential areas of partnership include, but are not limited to: a) partnerships that facilitate supportive services for residents of CMF-financed Affordable Housing; b) partnerships that will allow the Applicant to reach new markets, significantly increase its Affordable Housing production, or undertake new activities; c) partnerships that facilitate the Applicant in addressing priorities of the CDFI Fund as identified in the Notice of Funding Availability (NOFA) for each funding round. |
Narrative |
Question 24 – Economic Development Activities (if proposed in Q.9(c))
Question Text |
Response |
Question Tips |
Field Type |
a. If the Applicant intends to finance Economic Development Activities (EDA), describe how the Applicant will ensure that its activities are certified as being part of a Concerted Strategy to stabilize or revitalize a Low-Income Area or Underserved Rural Area In Conjunction with Affordable Housing.
|
Narrative – 2,000 characters |
|
Narrative |
b. Describe how the planned EDA will serve nearby residents of affordable housing. |
Narrative – 2,000 characters |
|
Narrative |
Rural Areas
Question 25 – Rural Areas
The CDFI Fund is dedicated to achieving geographic diversity across Metropolitan and Rural Areas in the United States, and encourages Applicants to serve Rural Areas as a way to ensure that diversity. An Applicant is therefore required to provide the percentage of CMF dollars that it is willing to commit to investing in Rural Areas.
Rural Areas is defined per 12 CFR § 1282.1 (Enterprise Duty To Serve Final Rule) as (i) A census tract outside of a Metropolitan Statistical Area as designated by the Office of Management and Budget; or (ii) A census tract in a Metropolitan Statistical Area as designated by the Office of Management and Budget that is outside of the Metropolitan Statistical Area’s Urbanized Areas, as designated by the U.S. Department of Agriculture’s (USDA) Rural-Urban Commuting Area (RUCA) Code #1, and outside of tracts with a housing density of over 64 housing units per square mile for USDA’s RUCA Code #2. The CDFI Fund has published a dataset indicating which census tracts are designated as Rural Areas for the current Round on its website.
If the Applicant’s response to Q. 25(a) is greater than zero, the Applicant will be held to using a required percentage of CMF Award dollars in Rural Areas as a condition of its Assistance Agreement. The required percentage will equal the response to Q. 25(a).
Note: These questions will only appear in AMIS if the Applicant indicates that it is willing to commit to using a portion of its CMF Award in Rural Areas.
Question Text |
Response |
Question Tips |
Field Type |
a. Indicate the percentage of CMF Award dollars that the Applicant is willing to commit to deploy in Rural Areas: |
______% |
|
Percentage |
b. If the response to 25(a) is greater than 0%, briefly describe the Applicant’s track record of serving Rural Areas. Be sure to indicate:
|
Narrative – 3,000-characters |
|
Narrative |
c. For the Applicant’s activity over the last five years, provide the following information based on the total housing units produced located in Rural Areas:
|
$____ Costs _____ Units |
|
|
Question 26 – Key Personnel
Question Text |
Response |
Question Tips |
Field Type |
Complete Appendix 5 for key personnel that will be involved in managing the CMF Award. Applicants will be able to list up to 10 individuals. Select the individuals that will be most important in managing the CMF Award. |
See Appendix 5 |
See Appendix 5. |
See Appendix 5 |
Question 27 – Previous Awards
Question Text |
Response |
Question Tips |
Field Type |
a. Appendix 6 will list previous awards from the CDFI Fund received by the Applicant and any Affiliates. |
See Appendix 6 |
|
See Appendix 6 |
b. If the Applicant has received other Federal awards (not from the CDFI Fund), discuss the following:
|
Narrative – 4,000 characters |
|
Narrative |
c. Is the Applicant or any Affiliates currently the subject of an unresolved audit or investigation by the Office of the Inspector General (OIG) or equivalent related to previous federal awards? |
Yes/No |
|
Picklist |
d. If the Applicant or its Affiliates have received a CMF Award in one or more of the past five rounds, discuss your progress in deploying your past CMF Awards. Indicate how much of each CMF Award has been Committed and disbursed to Projects/borrowers as of the Application submission date. Also, indicate if any Projects under these Awards have achieved Project Completion. |
Narrative-3,000 characters |
|
Narrative |
Question 28 – Financial Health
Question Text |
Response |
Question Tips |
Field Type |
a. Enter the Applicant’s relevant financial data in Appendix 7. Note which fields are relevant for the Applicant entity type. |
See Appendix 7 |
For reference, see Appendix 7. |
See Appendix 7 |
b. Have any of the Applicant’s completed audits within the past three years indicated negative Net Income? |
Yes/No |
Net Income, also known as Earnings, is Revenue less Expenses. |
Picklist |
c. Have any of the Applicant’s completed audits within the past three years included an opinion other than unqualified/unmodified? |
Yes/No |
An unqualified/unmodified opinion is an independent auditor's judgment that a company's financial records and statements are fairly and appropriately presented, and in accordance with Generally Accepted Accounting Principles (GAAP). An unqualified/unmodified opinion is the most common type of auditor's report. |
Picklist |
d. Have any of the Applicant’s completed audits within the past three years included a “going-concern paragraph” or qualification? |
Yes/No |
The going concern principle is that it is assumed a business will continue in the future, unless there is evidence to the contrary. When an auditor conducts an examination of the accounting records of a company, he or she has an obligation to review its ability to continue as a going concern; if the assessment is that there is a substantial doubt regarding the company's ability to continue in the future (which is defined as the following year), a going concern qualification must be included in his or her opinion of the company's financial statements. |
Picklist |
e. Have any of the Applicant’s audits for the three most recently completed fiscal years (as of the date of the NOFA), including any Single Audits for those years, contained repeated findings of reportable conditions? |
Yes/No |
Reportable condition is a matter coming to the auditor's attention relating to significant deficiencies in the design or operation of the internal control that could adversely affect an entity's ability to fulfill future obligations and/or the satisfaction of liabilities. |
Picklist |
f. Have any of the Applicant’s completed audits within the three most recently completed fiscal years (as of the date of the NOFA), including its Single Audit, indicated material weaknesses in internal controls? |
Yes/No |
Material weakness in internal controls means that it could lead to a material misstatement in a company's financial statements. |
Picklist |
g. Is the Applicant currently delinquent with respect to any obligations owed by the Applicant to an investor or lender? |
Yes/No |
Please indicate if you are delinquent with respect to any obligations as of the date of the Application submission. |
Picklist |
h. Has the Applicant ever filed for bankruptcy or otherwise defaulted on financial obligations to a third party? |
Yes/No |
Please indicated whether the Applicant have filed for bankruptcy or defaulted on financial obligations. |
Picklist |
If “Yes” to any of the above, indicate the fiscal years of the occurrence, and describe the circumstances and corrective action taken. |
Narrative – 2,000 characters |
Be as thorough as possible in describing the circumstances around the occurrence; any corrective steps taken to address the issue; and the current status of the issue. |
Narrative |
i. Provide a narrative responding to the following questions on the Applicant’s financial health:
|
Narrative – 4,000 characters |
The CDFI Fund reserves the right to contact other governmental organizations to review the Applicant’s award status and reserves the right to obtain additional audited or interim financial statements from an Applicant to review its financial condition, prior to making a final award determination. Failure on the part of the Applicant to acknowledge issues related to the financial health of the organization in this question or elsewhere in the Application could result in the Application being deemed ineligible, dismissed from a subsequent stage of review, or in termination of an Award. |
Narrative |
Question 29 – Portfolio Health
Question Text |
Response |
Question Tips |
Field Type |
Discuss the Applicant’s portfolio performance. Describe key trends or changes in the portfolio for the three most recently completed fiscal years and the current fiscal year-to-date.
For Applicants that are Financing Entities:
Discuss the Applicant’s loan/equity portfolio. Refer to relevant loan/equity portfolio data entered in Table E. Explain any weaknesses, especially those related to delinquencies or net loan losses and discuss how the Applicant is trying to improve those areas. Compare the Applicant’s performance with industry benchmarks where appropriate.
For Applicants that are Affordable Housing Developers/Managers:
Discuss the Applicant’s property portfolio, as applicable. Refer to the relevant portfolio data entered in Table F as necessary. Explain any weaknesses, especially around low Net Operating Income (NOI), high vacancy rates, etc. Compare the Applicant’s performance with industry benchmarks where appropriate. |
Narrative – 3,000 characters |
|
Narrative |
Instructions for Completing Appendix 1
In this table, the Applicant will provide the following data for each product the Applicant plans to offer with its CMF Award. Comparative interest rates and terms should reflect what is available in the market for similar products. In the case of Developer/Managers, it is sufficient to indicate the activity type of financing that will be provided to projects using the CMF Award. Tie the products to needs and financing gaps described in this Application. Focus on the role of CMF Award when describing the financing products.
Appendix 1: Financing Activities/Products |
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AMIS Field Name |
Question Tips |
Field Type |
Description |
Describe the financing activity/financial product that will be supported by the CMF Award and discuss relevant terms not otherwise described in this table. |
Narrative - 500 Characters |
Activity Type(s) |
Select all activities that will be financed by this product:
|
Checkmarks |
Tenure Type |
Select the appropriate tenure type that will be supported by the financing product.
|
Checkmarks |
Maximum Loan Amount |
Enter the maximum loan amount that will be supported by the financing product. |
Currency |
Estimated Minimum Interest Rate |
Enter the estimated minimum interest rate. |
Percentage |
Estimated Maximum Interest Rate |
Enter the estimated maximum interest rate. |
Percentage |
Estimated Average Interest Rate |
Enter the estimated average interest rate. |
Percentage |
Comparative Average Interest Rate |
Identify the comparable average interest rate offered by others in the Service Area. |
Percentage |
Amortization Period |
Enter the Amortization Period in months |
Number |
Term |
Enter the term of the loan or investment in months. |
Number |
Fees |
Describe any fees that will be charged with this product (e.g. origination fees, etc.) |
Text |
Security Position (1st, 2nd, etc.) |
Select the security position (1st, 2nd, 3rd or Lower) |
Picklist |
Instructions for Completing Track Record Tables (Tables A1, B1, and C1)
Instructions for Tables A1, B1, and C1: Please provide the requested information on the Applicant’s track record of deployment and production in Tables A1, B1, and C1, as applicable. Tables A1, B1, and C1 (as applicable) should be completed based solely on activities undertaken by the Applicant, any Subsidiaries, and any Limited Partnerships or Limited Liability Corporations where the Applicant holds the controlling interest over the management, credit or investment decisions, or policies of the company. Do not include the activities of Affiliates that are not Subsidiaries of the Applicant in these tables (e.g. “parent” organizations or other organizations under a common “parent” that are not controlled by the Applicant). If the Applicant is a Certified CDFI Depository Institution Holding Company that intends to carry out the activities of a CMF Award through its Certified CDFI Subsidiary Insured Depository Institution, it must provide track record information only for its Certified CDFI Subsidiary Insured Depository Institution that will administer the CMF Award.
Instructions for Completing Projections Tables (Tables A2, B2, and C2)
Instructions for Tables A2, B2, and C2: Please provide the information requested about the Applicant’s projected deployment and production related to its CMF Award request in Tables A2, B2, and C2, as applicable. Tables A2, B2, and C2 (as applicable) should only contain data for activities undertaken as a result of the Applicant’s requested CMF Award. Do not include data on activities unrelated to the Applicant’s requested CMF Award. The projections in Tables A2 and B2 will be used to determine a minimum number of units to be produced with the CMF Award. This unit target will become a condition of the Assistance Agreement. If the Applicant is a Certified CDFI Depository Institution Holding Company that intends to carry out the activities of a CMF Award through its Certified CDFI Subsidiary Insured Depository Institution, it should include data on projected capital to be deployed by the Certified CDFI Subsidiary Insured Depository Institution that will administer the CMF Award.
Table A1: Track Record by Housing/Economic Development Activity Type
Data entered in Table A1 should be based on the date the Project was completed (e.g. for Homeownership, title transferred to homeowner; for rental, certificate of occupancy). Under the fields for Cost ($), the Applicant should enter the total project cost (inclusive of the Applicant’s financing and financing from other entities) as of the date the Project was completed. Under the fields for units, for Homeownership and rental housing, list the total number of units produced in each category. For Economic Development Activities, enter the total number of facilities produced in each category (i.e. one building is one unit for Economic Development Activities).
Table A1 – Track Record by Activity Type |
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AMIS Field Name |
Question Tips |
Field Type |
5 Year Total (2016-2020) |
New Development Cost (Rental) |
Enter the costs for rental housing new Development for the last five years. |
Currency |
$________ |
New Development Units (Rental) |
Enter the units for rental housing new Development for the last five years. |
Numeric |
________ |
Rehabilitation and/or Preservation Cost (Rental) |
Enter the costs for rental housing Rehabilitation and/or Preservation for the last five years. |
Currency |
$________ |
Rehabilitation and/or Preservation Units (Rental) |
Enter the units for rental housing Rehabilitation and/or Preservation for the last five years. |
Numeric |
________ |
Total Rental Housing Costs |
Totals for rental housing costs will be auto-calculated in this row. |
Auto-Calculated |
$________ |
Total Rental Housing Units |
Totals for rental housing units will be auto-calculated in this row. |
Auto-Calculated |
________ |
New Development Cost (HO) |
Enter the costs for new Development Homeownership for the past five years. |
Currency |
$________ |
New Development Units (HO) |
Enter the units for new Development Homeownership for the past five years. |
Numeric |
________ |
Rehabilitation Cost (HO) |
Enter the costs for Rehabilitation Homeownership for the past five years. |
Currency |
$________ |
Rehabilitation Units (HO) |
Enter the units for Rehabilitation Homeownership for the past five years. |
Numeric |
_________ |
Mortgage Finance, Refinance and/or Purchase Assistance Cost |
Enter the costs for homeowner mortgage finance and/or Purchase assistance for the past five years. |
Currency |
$________ |
Mortgage Finance, Refinance and/or Purchase Assistance Units |
Enter the units for homeowner mortgage finance and/or Purchase assistance for the past five years. |
Numeric |
________ |
Total Homeownership Costs |
Totals for Homeownership costs will be auto-calculated in this row. |
Auto-Calculated |
$________ |
Total Homeownership Units |
Totals for Homeownership units will be auto-calculated in this row. |
Auto-Calculated |
________ |
Community Service Facilities Costs |
Enter the costs for Community Service Facilities for the past five years. |
Currency |
$________ |
Community Service Facilities Units |
Enter the number of Community Service Facilities for the past five years. |
Numeric |
________ |
Commercial Econ. Dev. Activities Costs |
Enter the costs for commercial Economic Development Activities for the past five years. |
Currency |
$________ |
Commercial Econ. Dev. Activities Units |
Enter the number of commercial Economic Development Activity facilities for the past five years. |
Numeric |
________ |
Total Economic Development Costs |
Total Economic Development Activity costs will be auto-calculated in this row. |
Auto-Calculated |
$________ |
Total Economic Development Units |
Total Economic Development Activity units will be auto-calculated in this row. |
Auto-Calculated |
________ |
Total Cost |
Total costs will be auto-calculated in this row. |
Auto-Calculated |
$________ |
Total Units |
Total units will be auto-calculated in this row. |
Auto-Calculated |
________ |
Table A2: Projected Housing/Economic Development Activity Type
Data entered in Table A2 should be based on the date the Project will achieve Project Completion. In this table, only provide data for activities undertaken as a result of the Applicant’s requested CMF Award. Do not include data on activities unrelated to the Applicant’s requested CMF Award.
In the fields for cost ($), the Applicant must enter the projected total Eligible Project Costs (inclusive of financing by the Applicant and any other entity) as of the date the Project is projected to achieve Project Completion. Projected Total Costs in this table must equal the Eligible Project Costs entered in Q. 14c.
In the fields for units, for Affordable Housing Activities, list only the number of units that qualify as Affordable Housing under the CMF Program (i.e. units that comply with the affordability qualifications for Eligible-Income Families (120% of AMI or below). For Economic Development Activities, enter the projected number of facilities to be financed.
Table A2 – Projected Activity Type |
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AMIS Field Name |
Question Tips |
Field Type |
5 Year Total (2022-2026) |
New Development Cost (Rental) |
Enter the costs for rental housing new Development for the next five years. |
Currency |
$_______ |
New Development Units (Rental) |
Enter the units for rental housing new Development for the next five years. |
Numeric |
________ |
Rehabilitation and/or Preservation Cost (Rental) |
Enter the costs for rental housing Rehabilitation and/or Preservation for the next five years. |
Currency |
$_______ |
Rehabilitation and/or Preservation Units (Rental) |
Enter the units for rental housing Rehabilitation and/or Preservation for the next five years. |
Numeric |
________ |
Total Rental Housing Costs |
Totals for rental housing costs will be auto-calculated in this row. |
Auto-Calculated |
$_______ |
Total Rental Housing Units |
Totals for rental housing units will be auto-calculated in this row. |
Auto-Calculated |
________ |
New Development Cost (HO) |
Enter the costs for new Development Homeownership for the next five years. |
Currency |
$_______ |
New Development Units (HO) |
Enter the units for new Development Homeownership for the next five years. |
Numeric |
________ |
Rehabilitation Cost (HO) |
Enter the costs for Rehabilitation Homeownership for the next five years |
Currency |
$_______ |
Rehabilitation Units (HO) |
Enter the units for Rehabilitation Homeownership for the next five years. |
Numeric |
________ |
Homebuyer Mortgage Finance and/or Purchase Assistance Cost |
Enter the costs for homeowner mortgage finance and/or Purchase Assistance for the next five years. |
Currency |
$_______ |
Homebuyer Mortgage Finance and/or Purchase Assistance Units |
Enter the units for homeowner mortgage finance and/or Purchase Assistance for the next five years. |
Numeric |
________ |
Community Service Facilities Costs |
Enter the projected costs for Community Service Facilities for the next five years. |
Currency |
$_______ |
Community Service Facilities Units |
Enter the number of projected Community Service Facilities for the next five years. |
Numeric |
_________ |
Commercial Econ. Dev. Activities Costs |
Enter the projected costs for commercial Economic Development Activity costs for the next five years. |
Currency |
$_______ |
Commercial Econ. Dev. Activities Units |
Enter the projected number of commercial Economic Development Activity facilities for the next five years. |
Numeric |
________ |
Total Economic Development Costs |
Total Economic Development Activity costs will be auto-calculated in this row. |
Auto-Calculated |
$_______ |
Total Economic Development Units |
Total Economic Development Activity units will be auto-calculated in this row. |
Auto-Calculated |
_______ |
Total Cost |
Total projected costs will be auto-calculated in this row. |
Auto-Calculated |
$_______ |
Total Units |
Total projected units will be auto-calculated in this row. |
Auto-Calculated |
_______ |
Table B1: Track Record of Housing Units Production by Income Levels
Data entered in Table B1 should include projects completed in the last five years, based on Project Completion date. Applicants should enter the number of units for each income category. AMI stands for Area Median Income.
Areas of Economic Distress are census tracts: (a) where at least 20% of households that are Very Low-Income (50% of AMI or below) spend more than half of their income on housing; or (b) that are designated Qualified Opportunity Zones; or (c) that are Low-Income Housing Tax Credit Qualified Census Tracts; or (d) where greater than 20% of households have incomes below the poverty rate and the rental vacancy rate is at least 10% ; or (e) where greater than 20% of the households have incomes below the poverty rate and the homeownership vacancy rate is at least 10%; or (f) Are Underserved Rural Areas as defined in the CMF Interim Rule (as amended February 8, 2016; 12 CFR Part 1807). A spreadsheet of Areas of Economic Distress is available at: https://www.cdfifund.gov/programs-training/Programs/cmf/Pages/apply-step.aspx#step2.
Table B1 – Track Record Housing Unit Production by Income Levels |
Response |
||
AMIS Field Name |
Question Tips |
Field Type |
5 Year Total (2016-2020) |
Rental Housing |
|||
0-30% AMI Units |
Enter the number of units for 0-30% AMI. |
Numeric |
_______ |
31-50% AMI Units |
Enter the number of 31-50% AMI units. |
Numeric |
_______ |
51-80% AMI Units |
Enter the number of 51-80% AMI units. |
Numeric |
_______ |
81-120% AMI Units |
Enter the number of 81-120% AMI units. |
Numeric |
_______ |
Total Rental Housing Units |
This field will be auto-calculated. |
Auto-Calculated |
Auto-Calculated |
Homeownership Housing |
|||
0-30% AMI Units |
Enter the number of units for 0-30% AMI. |
Numeric |
_______ |
31-50% AMI Units |
Enter the number of 31-50% AMI units. |
Numeric |
_______ |
51-80% AMI Units |
Enter the number of 51-80% AMI units. |
Numeric |
_______ |
81-120% AMI Units |
Enter the number of 81-120% AMI units. |
Numeric |
_______ |
Total Homeownership Housing Units |
This field will be auto-calculated. |
Auto-Calculated |
Auto-Calculated |
All Housing |
|||
Total - All Housing Units |
This field will be auto-calculated. |
Auto-Calculated |
Auto-Calculated |
Areas of Economic Distress |
|||
Housing Activity in Areas of Economic Distress Units |
Enter the number of units in Areas of Economic Distress. This figure should be a subset of Total Rental Housing Units and Total Homeownership Units entered in Table A1. |
Numeric |
_______ |
High Opportunity Areas (Rental Only) |
|||
Rental Housing Activity in High Opportunity Areas Units |
Enter the number of units in high opportunity areas. This figure should be a subset of Total Rental Housing Units entered in Table A1. |
Numeric |
_______ |
Table B2: Projected Housing Units Production by Income Levels
Data entered in Table B2 should be based on the date the Project will achieve Project Completion. In this table, only provide data for activities that will be financed and/or supported by the Applicant’s requested CMF Award that will achieve Project Completion by the end of the five-year Investment Period. Do not include data on activities unrelated to the Applicant’s requested CMF Award.
Areas of Economic Distress are census tracts: (a) where at least 20% of households that are Very Low-Income (50% of AMI or below) spend more than half of their income on housing; or (b) that are designated Qualified Opportunity Zones ; or (c) that are Low-Income Housing Tax Credit Qualified Census Tracts; or (d) where greater than 20% of households have incomes below the poverty rate and the rental vacancy rate is at least 10%; or (e) where greater than 20% of the households have incomes below the poverty rate and the homeownership vacancy rate is at least 10%; or (f) Are Underserved Rural Areas as defined in the CMF Interim Rule (as amended February 8, 2016; 12 CFR Part 1807). A spreadsheet of Areas of Economic Distress is available at: https://www.cdfifund.gov/programs-training/Programs/cmf/Pages/apply-step.aspx#step2.
Please note that the number of units projected in Areas of Economic Distress in this table should align with the percentages entered in Q. 20(a) and/or Q. 22(b).
NOTE: As defined in 1807.104 of the CMF Interim Rule (12 C.F.R. 1807), Affordable Housing Activities means the Development, Preservation, Rehabilitation, and/or Purchase of Affordable Housing, meaning that they comply with the affordability qualifications set forth for Eligible-Income Families. Also, per 12 C.F.R 1807.400, each Recipient that uses its CMF Award for Affordable Housing Activities must ensure that 100% of Eligible Project Costs are attributable to Affordable Housing; meaning, that they comply with the affordability qualifications for Eligible-Income Families (120% of AMI or below).
Table B2 – Projected Housing Units Production by Income Levels |
Response |
||
AMIS Field Name |
Question Tips |
Field Type |
5 Year Total (2022-2026) |
Rental Housing |
|||
0-30% AMI Units |
Enter the number of units for 0-30% AMI. |
Numeric |
_______ |
31-50% AMI Units |
Enter the number of 31-50% AMI units. |
Numeric |
_______ |
51-80% AMI Units |
Enter the number of 51-80% AMI units. |
Numeric |
_______ |
81-120% AMI Units |
Enter the number of 81-120% AMI units. |
Numeric |
_______ |
Total Rental Housing Units |
This field will be auto-calculated. |
Auto-Calculated |
Auto-Calculated |
Homeownership Housing |
|||
0-30% AMI Units |
Enter the number of units for 0-30% AMI. |
Numeric |
_______ |
31-50% AMI Units |
Enter the number of 31-50% AMI units. |
Numeric |
_______ |
51-80% AMI Units |
Enter the number of 51-80% AMI units. |
Numeric |
_______ |
81-120% AMI Units |
Enter the number of 81-120% AMI units. |
Numeric |
_______ |
Total Homeownership Housing Units |
This field will be auto-calculated. |
Auto-Calculated |
Auto-Calculated |
All Housing |
|||
Total - All Housing Units |
This field will be auto-calculated. |
Auto-Calculated |
Auto-Calculated |
Areas of Economic Distress |
|||
Housing Activity in Areas of Economic Distress: Units |
Enter the number of units in Areas of Economic Distress. This figure should be a subset of Total Rental Housing Units and Total Homeownership Units entered in Table A2. |
Numeric |
_______ |
High Opportunity Areas (Rental Only) |
|||
Housing Activity in High Opportunity Areas: Units |
Enter the number of units in High Opportunity Areas. This figure should be a subset of Total Rental Housing Units entered in Table A2. |
Numeric |
_______ |
Table C1: Track Record of Financing Activities/Products (to be completed by Financing Entities only)
Table C1 is only applicable for Financing Entities and will not appear in AMIS for Housing Developers/Managers. The table focuses only on the Applicant’s track record of providing financing to projects and should reflect dollar amounts that the Applicant has loaned or invested directly to third party entities. The dollar amounts should reflect only the loans or equity investments made by the Applicant. Financing from third parties to projects (e.g. LIHTC, project-specific grants or bank construction loans) should not be included in this table.
Data entered in Table C1 should be based on the date the financing transaction closed.
Table C1 – Track Record by Financing Activities/Products |
|||
AMIS Field Name |
Question Tips |
Field Type |
5 Year Total (2016-2020) |
Predevelopment |
Enter dollar amount loaned or invested for predevelopment for the past five years. |
Currency |
$_______ |
Acquisition |
Enter dollar amount loaned or invested for acquisition for the past five years. |
Currency |
$_______ |
Construction |
Enter dollar amount loaned or invested for construction for the past five years. |
Currency |
$_______ |
Bridge Loans or Similar Short Term |
Enter dollar amount loaned or invested for bridge loans or similar for the past five years. |
Currency |
$_______ |
Permanent Financing (1st) |
Enter dollar amount loaned or invested for permanent financing (1st lien) for the past five years. |
Currency |
$_______ |
Permanent Financing (2nd or Lower) |
Enter dollar amount loaned or invested for permanent financing (2nd lien or lower) for the past five years. |
Currency |
$_______ |
Refinancing |
Enter dollar amount loaned or invested for refinancing for the past five years. |
Currency |
$_______ |
Loan Loss Reserves or Loan Guarantees |
Enter dollar amount allocated for loan guarantees and/or loan loss reserves for the past five years. |
Currency |
$_______ |
Equity |
Enter dollar amount invested or invested as equity for the past five years. |
Currency |
$_______ |
Down payment/Closing Cost Assistance |
Enter total dollar amount loaned, invested, or granted as down payment/closing costs assistance. Do not enter double enter data between this category and the Permanent Financing (2nd or Lower) category. |
Currency |
$_______ |
Total Financing Deployment |
Will sum automatically in AMIS. |
Auto-Calculated |
$_______ |
Table C2: Projected CMF Financing Activities/Products (to be completed by Financing Entities only)
Table C2 is only applicable for Financing Entities and will not appear in AMIS for Housing Developers/Managers. Table C2 focuses only on the projected financing that the Applicant will provide to Projects as a result of the CMF Award. The dollar amounts should reflect only the loans or equity investments projected to be made by the Applicant. Financing from third parties to Projects (e.g. LIHTC, project-specific grants or bank construction loans) should not be included in this table.
Data entered in Table C2 should be based on the date the financing transaction will close.
Table C2 – Projected CMF Financing Activities/Products |
|||
AMIS Field Name |
Question Tips |
Field Type |
5 Year Total (2022-2026) |
Predevelopment |
Enter projected dollar amount of financing for predevelopment for the next five years. |
Currency |
$_______ |
Acquisition |
Enter projected dollar amount of financing for acquisition for the next years. |
Currency |
$_______ |
Construction |
Enter projected dollar amount of financing for construction for the next five years. |
Currency |
$_______ |
Bridge Loans or Similar |
Enter projected dollar amount of financing for bridge loans or similar for the next five years. |
Currency |
$_______ |
Permanent Financing (1st) |
Enter projected dollar amount of financing for permanent financing (1st lien) for the next five years. |
Currency |
$_______ |
Permanent Financing (2nd or Lower) |
Enter projected dollar amount of financing for permanent financing (2nd lien or lower) for the next five years. |
Currency |
$_______ |
Refinancing |
Enter projected dollar amount of refinancing activity for the next five years. |
Currency |
$_______ |
Loan Loss Reserves or Loan Guarantees |
Enter projected dollar amount to be allocated for Loan Guarantees and/or Loan Loss Reserves for the next five years. |
Currency |
$_______ |
Equity |
Enter projected dollar amount of financing for equity investments for the next five years. |
Currency |
$_______ |
Down payment/Closing Cost Assistance |
Enter total dollar amount loaned, invested, or granted as down payment/closing costs assistance. Do not enter double enter data between this category and the Permanent Financing (2nd or Lower) category. |
Currency |
$_______ |
Total Deployment |
AMIS will sum the fields automatically. |
Auto-Calculated |
$_______ |
Appendix 3: Project Pipeline and Sources
In Appendix 3a, provide the requested information for the proposed pipeline of projects. Include at least two and up to eight projects. If you plan to use the Award to capitalize a Homeownership Program for Purchase (e.g. mortgage finance/down payment and/or closing cost assistance), complete the Homeownership Program information. For pipelines which exceed eight projects or where not all projects have yet been identified, provide estimated aggregate cost information on those projects in the “Total for Additional Projects” category. For each identified project, provide the requested information.
While the Applicant will not be held to financing the specific projects listed in the pipeline if selected to receive a CMF Award, please only describe projects in the Applicant’s pipeline for which the Applicant realistically anticipates using the CMF Award.
If your organization is planning to provide mortgage assistance/Purchase assistance to homebuyers, you may list the Homeownership program as one “project” in Appendix 3a.
If your organization is planning to use the CMF Award to finance/support Economic Development Activities, please ensure to include at least one project of this type in the pipeline.
In Appendix 3b, all anticipated sources of capital needed to finance Eligible Project Costs should be listed appropriately based on the status (i.e. “Sources Secured/Received” or “Anticipated/Projected”). Financing sources should be classified as either “Early Stage” or “Permanent”. Financing that is taken out/repaid by permanent financing should be listed as “Early Stage”. If financing is early stage but converts to permanent, it should be listed as “Permanent”. If the sources are unknown, indicate the estimated amount as “Other Private” or “Other Public”. Early Stage financing will be netted from permanent financing when calculating Eligible Project Costs. Eligible Project Costs should not exceed Total Development Costs. The Total Net Sources/Eligible Project Costs listed at the bottom of Appendix 3b should align with the Total Eligible Project Costs for the pipeline in Appendix 3a.
Appendix 3a: Project Pipeline |
|||||||||
Pipeline/Uses |
Project Name and Description |
Location (City, State) |
Project Type (HO/Rental/EDA) |
Start Year |
Year Complete |
Total Units |
Total CMF Units (120% AMI or below) |
Total Project Costs |
Eligible Project Costs |
Homeownership Program |
|
|
|
|
|
|
|
$ |
$ |
Project 1 |
|
|
|
|
|
|
|
$ |
$ |
Project 2 |
|
|
|
|
|
|
|
$ |
$ |
Project 3 |
|
|
|
|
|
|
|
$ |
$ |
Project 4 |
|
|
|
|
|
|
|
$ |
$ |
Project 5 |
|
|
|
|
|
|
|
$ |
$ |
Project 6 |
|
|
|
|
|
|
|
$ |
$ |
Project 7 |
|
|
|
|
|
|
|
$ |
$ |
Project 8 |
|
|
|
|
|
|
|
$ |
$ |
Total for additional projects, including projects not yet identified |
|
|
|
|
|
|
|
$ |
$ |
TOTALS |
|
|
|
|
|
Auto-Calc |
Auto-Calc |
Auto-Calc |
Auto-Calc |
Appendix 3b: Sources |
|||
|
Early Stage Financing |
Permanent Financing |
Total |
CMF Award |
$_______ |
$_______ |
Auto-Calculated |
Short Term CMF Financing Repaid/Taken Out by or before Permanent Financing |
|
|
Auto-Calculated |
Subtotal of Net CMF Financing |
|
|
Auto-Calculated |
Sources Secured or Received |
|
|
|
Private Financial Institution Debt/Equity (Legal Commitment or Received) |
$_______ |
$_______ |
Auto-Calculated |
Private Philanthropic/Foundation (Legal Commitment or Received) |
$_______ |
$_______ |
Auto-Calculated |
Debt or Equity from the Applicant/Affiliates (Legal Commitment or Approval) |
$_______ |
$_______ |
Auto-Calculated |
LIHTC (Awarded) |
$_______ |
$_______ |
Auto-Calculated |
Tax Exempt Bonds (Issued) |
$_______ |
$_______ |
Auto-Calculated |
FHLB (Legal Commitment, Awarded or Received) |
$_______ |
$_______ |
Auto-Calculated |
State Tax Credits (Awarded) |
$_______ |
$_______ |
Auto-Calculated |
Other Private (Legal Commitment or Received) |
$_______ |
$_______ |
Auto-Calculated |
Public Funds (excluding CMF Award and Awarded or Received |
$_______ |
$_______ |
Auto-Calculated |
Subtotal of Total Secured Leverage |
Auto-Calculated |
Auto-Calculated |
Auto-Calculated |
Secured Short Term Financing Repaid/Taken Out by or before Permanent Financing |
|
|
$_______ |
Subtotal of Net Secured Leverage |
|
|
Auto-Calculated |
Sources Anticipated/Projected |
|
|
|
Private Financial Institution Debt/Equity |
$_______ |
$_______ |
Auto-Calculated |
Private Philanthropic/Foundation |
$_______ |
$_______ |
Auto-Calculated |
Debt or Equity from the Applicant/Affiliates |
$_______ |
$_______ |
Auto-Calculated |
LIHTC |
$_______ |
$_______ |
Auto-Calculated |
Tax Exempt Bonds |
$_______ |
$_______ |
Auto-Calculated |
FHLB |
$_______ |
$_______ |
Auto-Calculated |
State Tax Credits |
$_______ |
$_______ |
Auto-Calculated |
Other Private |
$_______ |
$_______ |
Auto-Calculated |
Public Funds (other than CMF Award) |
$_______ |
$_______ |
Auto-Calculated |
Reinvested CMF Award |
$_______ |
$_______ |
Auto-Calculated |
Reinvested Enterprise Capital |
$_______ |
$_______ |
Auto-Calculated |
Subtotal of Total Anticipated/Projected Leverage |
Auto-Calculated |
Auto-Calculated |
Auto-Calculated |
Short Term Projected Financing Repaid/Taken Out by or before Permanent Financing |
|
|
$_______ |
Subtotal of Net Anticipated/Projected Leverage |
|
|
Auto-Calculated |
TOTAL SOURCES |
|
|
Auto-Calculated |
TOTAL NET SOURCES/ELIGIBLE PROJECT COSTS |
|
|
Auto-Calculated |
The Applicant will only be able to enter data in Appendix 4 if Q. 15 indicated that the CMF Award will be used to leverage Enterprise-Level Capital. If the Applicant plan to leverage Enterprise-Level Capital, it must provide at least one potential source of Enterprise-Level Capital in this Appendix. You may add as many sources as necessary.
Enterprise-Level Sources of Leverage
AMIS Field Name |
Response |
Question Tips |
Field Type |
Name of Investor |
__________ |
Enter the name of the investor. |
Text |
Dollar Amount Sought |
$_________ |
Enter the dollar amount sought from the investor. |
Currency |
Previous Investor |
Yes/No |
Select whether it’s a previous investor. |
Picklist |
Related to Applicant |
Yes/No |
Select whether the investor is related to the Applicant. |
Picklist |
Type of Financing |
Debt/Equity/Grant |
Choose the financing type from the dropdown. |
Picklist |
Status of Request |
Funds Received / Legal Commitment / Term Sheet / Letter of Interest / Application Pending / Estimate |
Select the appropriate status of the identified financing. The CDFI Fund reserves the right to request documentation substantiating this status during the Application review process. |
Picklist |
Est. Date of Receipt of Funds |
Date |
Please provide the estimated date of receipt of funds. |
Date |
Applicants may enter up to 10 individuals related to the Applicant’s affordable housing activities (from the management team, staff, consultants, or contractors) who are integral to the implementation of the Applicant’s CMF proposal. Do not include members of the Board of Directors. The CDFI Fund will only evaluate the 10 individuals entered in the Key Personnel Appendix.
For Certified CDFI Depository Institution Holding Companies Only: If the Applicant is a Certified CDFI Depository Institution Holding Company that intends to carry out the activities of a CMF Award through its Certified CDFI Subsidiary Insured Depository Institution, be sure to include information on key personnel of the Certified CDFI Subsidiary Insured Depository Institution that will administer the CMF Award.
Key Personnel
AMIS Field Name |
Response |
Question Tips |
Field Type |
Name |
__________ |
Enter the name of the key personnel. |
Text |
Title |
__________ |
Enter the title of the key personnel. |
Text |
Firm |
__________ |
Enter the name of the firm with which the key personnel is affiliated. |
Text |
Years in the Field
|
__________ years
|
Enter the number of years key personnel has worked in the field. |
Numeric |
Years with Applicant
|
__________ years
|
Enter the number of years key personnel has worked for the Applicant.
|
Numeric |
Position Held with Applicant (select all that apply) |
If Other, Please Specify ______________ |
Select more than one option if the person had held or holds more than one position with the Applicant. |
Check Boxes |
Duties to be Performed for the Applicant (select all that apply) |
If Other Duty to be Provided, Please Specify __________ |
|
Check Boxes |
Description of Key Staff Qualifications |
Narrative – 1,000 characters |
Discuss the individual’s qualifications that support his/her ability to perform his/her duties in administering a CMF Award, including their overall number of years of experience with similar activities. |
Narrative |
Description of Individuals’ Role in Managing the CMF Award |
Narrative – 1,000 characters |
Discuss the individual’s planned role and responsibilities in managing the CMF Award if received. |
Narrative |
The following information is for each of the prior CDFI Fund awards that the Applicant and/or any Affiliates have received (as of the Application deadline) will be auto-populated by AMIS.
Previous CDFI Fund Awards/Allocations
AMIS Field Name |
Response |
Question Tips |
Field Type |
Program Name |
__________ |
Name of CDFI Fund Program |
Auto-Calculated |
Award/Allocation Amount |
$__________ |
Amount of the Award/Allocation |
Auto-Calculated |
Year |
yyyy |
Year of the Award/Allocation |
Auto-Calculated |
Control Number |
__________ |
Award/Allocation Control Number |
Auto-Calculated |
An Applicant must provide data for the three most recently completed fiscal years prior to the date of the Notice of Fund Availability (NOFA) for which the Applicant has audited financials. For Certified CDFI Depository Institutions Only: Call Reports may be submitted in lieu of financial statements.
When entering data, ensure that the Financial Data 3 column contains financial data for the most recently completed fiscal year. Data for the middle year should be entered in the Financial Data 2 column. Data for the least recent year should be entered in the Financial Data 1 column.
Financial data may be provided on a consolidated or unconsolidated basis; however, the data in the Application must reflect the same basis as used in the audits attached to the Application. If submitting unconsolidated data for the Applicant entity only, it must be reflected in the attached audits. If the audit does not contain this unconsolidated data, you must enter consolidated data. If the attached audits contain both consolidated and unconsolidated financial information, you may choose which type to enter. However, you must enter the same type (consolidated/unconsolidated) for all three fiscal years. You will label the type of data submitted in AMIS. The data entered in Appendix 7 must match the attached audits.
For Certified CDFI Depository Institution Holding Companies Only: If the Applicant is a Certified CDFI Depository Institution Holding Company that intends to carry out the activities of a CMF Award through its Certified CDFI Subsidiary Insured Depository Institution, it must enter the financial data for the Certified CDFI Subsidiary Insured Depository Institution that will administer the CMF Award in Tables D and E.
Definitions for the relevant terms are listed in Tables D, E, and F below.
For any items where a timing dependent valuation is required, that valuation should be based on the appropriate fiscal year end date.
AMIS Note: Affordable Housing Developers/Manager Applicants may enter $0 in the fields that are only required for Financing Entities in Table D, as AMIS requires that data be entered in these fields.
Table D – Applicant Financial Data |
Responses (by Fiscal Year) |
|||||||
AMIS Field Name |
Question Tips |
Field Type |
Required For |
Financial Data 1 |
Financial Data 2 |
Financial Data 3 |
||
Fiscal Year |
Select the Fiscal Year for which the data is provided. |
Picklist |
All Applicants |
Least Recent Fiscal Year |
Middle Fiscal Year |
Most Recent Completed Fiscal |
||
Financial Data Type |
Select whether the financial information provided is Audited or Unaudited. |
Picklist |
All Applicants |
Audited or Unaudited |
Audited or Unaudited |
Audited or Unaudited |
||
Financial Data Consolidation |
Select whether the financial data is on Consolidated or Unconsolidated basis. |
Picklist |
All Applicants |
Consolidated or Unconsolidated |
Consolidated or Unconsolidated |
Consolidated or Unconsolidated |
||
Single Audit Required? |
Indicate whether the Applicant or its Affiliates were required to have a Single Audit completed in each of the Fiscal Years per 2 C.F.R. 200.501. |
Picklist |
All Applicants |
Yes or No |
Yes or No |
Yes or No |
||
Assets |
||||||||
Cash Restricted for Operations ($) |
The dollar amount of cash, if any, restricted by an organization to fund its operations. Restricted cash appears noted on an organization’s balance sheet as either "restricted cash" or as "other assets" restricted for operations. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Unrestricted Cash and Cash Equivalents ($) |
The value of unencumbered assets that are cash or can be converted into cash within three months, such as bank accounts or marketable securities. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Other Real Estate Owned (OREO) ($) |
In general, real estate, including capitalized and operating leases, that is acquired through any means, in full or partial satisfaction of a debt previously contracted. |
Currency |
Financing Entities |
$______ |
$______ |
$______ |
||
Current Assets ($) |
Current Assets are cash and other assets/resources commonly identified as those which are reasonably expected to be realized in cash or sold or consumed during the normal operating cycle of the business (or one year, whichever is longer). |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Allowance for Loan and Lease Losses ($) |
Account value for unidentified Loan or Investment losses, inclusive of depository loss reserve as of the reporting period end. This appears as a contra asset on the balance sheet. Note, this field should be entered as a positive number. |
Currency |
Financing Entities |
$______ |
$______ |
$______ |
||
Total Assets ($) |
The total value of the sum of all assets (current and non-current). |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Liabilities |
||||||||
Current Liabilities ($) |
The total value of debts, obligations and payables due within 12 months. Current liabilities include, but are not limited to, short-term debt, accounts payable, accrued liabilities and other debts. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Total Liabilities ($) |
The total value of short-term and long-term outstanding debts, obligations, and payables. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Net Assets (Net Worth) |
||||||||
Unrestricted Net Assets ($) |
The portion of Net Assets that is neither permanently restricted nor temporarily restricted by donor-imposed stipulations. Board designated unrestricted net assets should be considered Unrestricted Net Assets for the purposes of this Application. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Total Net Assets ($) or Equity |
Equal to Total Assets minus Total Liabilities as reported in an organization's balance sheet.
Credit Unions and Bank Applicants: Enter “0” and complete Net Worth (Credit Unions) or Tier 1 Capital (Banks) as appropriate. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Net Worth (Credit Union Applicants Only) ($) |
As defined by the appropriate federal or state regulating agency. |
Currency |
Credit Union Applicants |
$______ |
$______ |
$______ |
||
Tier 1 Capital (Bank Applicants Only) ($) |
In general, this term is used by financial institution regulators to assess capital adequacy and may include common Equity, noncumulative perpetual preferred stock, minority interests in consolidated Subsidiaries, less goodwill and other ineligible, intangible assets. |
Currency |
Bank Applicants |
$______ |
$______ |
$______ |
||
Available Financing Capital ($) |
Assets that can be used for lending and Equity Investments that have not already been committed, disbursed, or restricted for other purposes. |
Currency |
Financing Entities |
$______ |
$______ |
$______ |
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Total Financing Capital ($) |
All capital either currently available or currently in use for financing activities. Note: This data point includes “Available Financing Capital” and therefore should be equal to or greater than the value entered for “Available Financing Capital ($)” below. |
Currency |
Financing Entities |
$______ |
$______ |
$______ |
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Revenue and Expenses |
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Interest Revenue ($) |
A financial measure calculated as the sum of money the institution earns in interest on its assets (commercial loans, personal mortgages, etc.). This figure is calculated by adding up the amount of interest earned on assets. |
Currency |
Financing Entities |
$______ |
$______ |
$______ |
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Fee/Rental Revenue ($) |
Revenue generated from fees collected for services that are associated with an organization's mission. If the organization earns revenue from the rental of real property, include that amount here as well. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
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Earned Revenue ($) |
Revenue generated by assets and activities, excluding grants and contributions. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
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Operating Revenue ($) |
Revenue generated by assets and activities, including grants and contributions. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
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Government Grants ($) |
Financial assistance provided by Federal, State and local agencies to carry out a public purpose authorized by law, not including subsidies, Loans, Loan Guarantees, or insurance. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
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Total Revenue ($) |
The total value of revenue from all sources within the current operating cycle. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
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Interest Expense ($) |
The cost incurred by an entity for borrowed funds. It is essentially calculated as the interest rate times the outstanding principal amount of the debt. |
Currency |
Financing Entities |
$______ |
$______ |
$______ |
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Operating Expense ($) |
Expenses related to everyday business operations, such as staff salaries, professional fees, and any other expenses directly related to the organization’s business operations. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Non-cash Expenses ($) |
Non-cash expenses are “paper” expenses and do not involve an outflow of cash. Such non-cash expenses include depreciation expense and allowance for loan and lease losses expense on the income statement. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
||
Total Expenses ($) |
The total value of all operational and non-operational expenses (including Interest, financing cost, depreciation, amortization, and loan loss provision) incurred during the current reporting period, not including provision for income tax. |
Currency |
All Applicants |
$______ |
$______ |
$______ |
Table E – Loan/Equity Portfolio (Required for Financing Entities)
The data entered in items for the “On-Balance Sheet” data fields in Table E must be for the loan/investment portfolio maintained on the balance sheet of the Applicant entity. If the Applicant is a Certified CDFI Depository Institution Holding Company that intends to carry out the activities of a CMF Award through its Certified CDFI Subsidiary Insured Depository Institution, it should provide data on the loan/investment portfolio maintained on the balance sheet of its Certified CDFI Subsidiary Insured Depository Institution that will administer the CMF Award. When entering data, ensure that the Financial Data 3 column contains financial data for the most recently completed fiscal year. Data for the middle year should be entered in the Financial Data 2 column. Data for the least recent year should be entered in the Financial Data 1 column.
AMIS Note: This table is not required for Affordable Housing Developer/Manager Applicants and will not appear in the AMIS Application for these Applicants.
Table E – Loan/Equity Portfolio |
Responses (by Fiscal Year) |
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AMIS Field Name |
Question Tips |
Field Type |
Required For |
Financial Data 1 |
Financial Data 2 |
Financial Data 3 |
Loan and Investment Portfolio |
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Total On-Balance Sheet Loan Portfolio ($) |
The gross dollar amount ($) of loans receivable as reported in an organization’s statement of financial condition or balance sheet. Gross loans receivable are the principal amount of loans receivable held by an organization that represents the amount still owed to the organization by its borrowers, without giving effect to any allowance for the collectability thereof (i.e. before loan loss reserves are calculated). |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Total On-Balance Sheet Loan Portfolio (#) |
The total number (#) of loans receivable as reported in an organization’s statement of financial condition or balance sheet. |
Numeric |
Financing Entity |
_______ |
_______ |
_______ |
Commitments ($) |
The total dollar amount ($) of loan or Equity Investment commitments made by an organization to borrowers or investees that have not yet been disbursed, but for which the organization has reserved cash, cash equivalents, or other assets to fund at a later date (e.g., a loan that is closed but not yet disbursed, a loan that has been provisionally approved but will not be closed or disbursed until a borrower meets certain terms and conditions; a loan that has been approved by a loan committee, but not yet closed). |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Commitments (#) |
The number (#) of loan or Equity Investment commitments. |
Numeric |
Financing Entity |
$______ |
$______ |
$______ |
Total Charge-offs ($) |
The dollar amount ($) of a receivable, primarily a loan, that has been determined to be a loss or non-recoverable during the repayment cycle and that has been taken off the balance sheet as a loss during the reporting period and a direct reduction of the carrying amount of a financial asset measured at amortized cost resulting from the inability to collect the asset. A financial asset is considered uncollectible if the entity has no reasonable expectation of recovery. |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Total Charge-offs (#) |
The total number (#) of receivables, primarily loans, that have been determined to be a loss or non-recoverable during the repayment cycle and that have been taken off the balance sheet as a loss during the reporting period. |
Numeric |
Financing Entity |
_______ |
_______ |
_______ |
Troubled Debt Restructuring ($) |
The total dollar amount ($) of all debt restructured during the reporting period by a creditor for economic or legal reasons related to the debtor’s financial difficulties and/or inability to pay and perform as agreed. |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Troubled Debt Restructuring (#) |
The total number (#) of debt instruments restructured during the reporting period by a creditor for economic or legal reasons related to the debtor’s financial difficulties and/or inability to pay and perform as agreed. |
Numeric |
Financing Entity |
_______ |
_______ |
_______ |
Recoveries ($) |
The total dollar amount ($) of all gross recoveries on charged-off loans, less any related expenses, collected during the current reporting period. |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Recoveries (#) |
The total number (#) of loans with gross recoveries collected during the current reporting period. |
Numeric |
Financing Entity |
_______ |
_______ |
_______ |
Loans 90 Days (or more) Past Due ($) |
The total dollar amount ($) amount of all loans 90 or more days past due. Loans should be considered past due if any part of the payment is past due. |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Loans 90 Days (or more) Past Due (#) |
The total number (#) of loans 90 or more days past due. Loans should be considered past due if any part of the payment is past due. |
Numeric |
Financing Entity |
_______ |
_______ |
_______ |
Loans Delinquent 61 to 89 days ($) |
The total dollar amount ($) amount of all loans 61 to 89 days past due. Loans should be considered past due if any part of the payment is past due. |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Loans Delinquent 61 to 89 days (#) |
The total number (#) of all loans 61 to 89 days past due. Loans should be considered past due if any part of the payment is past due. |
Numeric |
Financing Entity |
_______ |
_______ |
_______ |
Total Equity Investments Portfolio ($) |
The total dollar amount ($) of Equity Investments held by an organization in portfolio companies in which it owns stock or other forms of ownership interest. Total Equity Investment portfolio should reflect the valuation of the organization’s interests after making adjustments for any investment gains or losses. |
Currency |
Financing Entity |
$______ |
$______ |
$______ |
Total Equity Investments Portfolio (#) |
The total number (#) of Equity Investments held by an organization in portfolio companies in which it owns stock or other forms of ownership interest. |
Numeric |
Financing Entity |
$______ |
$______ |
$______ |
Table F – Property Portfolio (Required for Affordable Housing Developers/Managers)
Affordable Housing Developers/Managers will enter their property portfolio data in Table F for the three most recently completed fiscal years prior to publication date of the applicable NOFA. When entering data, ensure that the Financial Data 3 column contains financial data for the most recently completed fiscal year. Data for the middle year should be entered in the Financial Data 2 column. Data for the most recent year should be entered in the Financial Data 3 column.
AMIS Note: This table is not required for Financing Entities and will not appear in the AMIS Application for these Applicants.
Question |
Response |
Question Tips |
Does the Affordable Housing Developer/Manager Applicant have a rental property portfolio under management? |
Yes/No |
Only Applicants who respond “Yes” to this question will be able to complete Table F. |
Table F – Property Portfolio (Developers of Rental Property Only) |
Responses (by Fiscal Year) |
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AMIS Field Name |
Question Tips |
Field Type |
Required For |
Financial Data 1 |
Financial Data 2 |
Financial Data 3 |
Total Number of Properties |
Enter the total number of properties in the Applicant’s property portfolio. |
Numeric |
Developer |
_______ |
_______ |
_______ |
Total Number of Units in the Portfolio |
Enter the total number of units in the Applicant’s property portfolio. |
Numeric |
Developer |
_______ |
_______ |
_______ |
Average Vacancy Rate for Portfolio |
Average annual vacancy rate for all units in Applicant’s property portfolio. Calculation: number of vacant units divided by total number of units. |
Percentage |
Developer |
_______% |
_______% |
_______% |
Total Percentage of Rent Collected for Portfolio |
Percentage of rent collected for the entire portfolio. Calculation: total rent collected divided by gross rental revenue due. |
Percentage |
Developer |
_______% |
_______% |
_______% |
Total NOI for Portfolio |
Total annual Net Operating Income (NOI) for the portfolio. Calculation: Total Income minus total operating expenses. |
Currency |
Developer |
$______ |
$______ |
$______ |
Total DCR for Portfolio |
Annual debt coverage ratio for portfolio. NOI divided by total debt service costs. |
Numeric |
Developer |
_______ |
_______ |
_______ |
Total Properties with HUD REAC Score Below 60 |
Total number of properties in the portfolio subject to HUD Real Estate Assessment Center (REAC) inspection with scores below 60. |
Numeric |
Developer |
_______ |
_______ |
_______ |
The following documents must be submitted as attachments as part of the Applicant’s AMIS Application. Please note that different Applicant types have different required attachments. Be sure to attach all required documents for your Applicant type or AMIS may prevent you from submitting the Application.
AMIS APPLICATION ATTACHMENTS |
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Audited Financial Statements (most recently completed 2 fiscal years as of the date of the NOFA)
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Required for All Applicants |
Any management letter related to the audited financial statements for the two most recently completed fiscal years as of the date of the NOFA |
Required for all Applicants |
State charter, articles of incorporation, or other establishing documents designating that the Applicant is a Nonprofit or not-for-profit entity under the laws of the organization’s State of formation |
Required only for Applicants that are not Certified CDFIs |
A certification or determination letter demonstrating tax-exempt status from the IRS1 |
Required only for Applicants that are not Certified CDFIs |
Articles of incorporation, by-laws or other establishing document demonstrating the Applicant has a principal purpose of managing or developing affordable housing |
Required only for Applicants that are not Certified CDFIs |
An organizational chart demonstrating the relationship between the Applicant and any Affiliate, Subsidiary or parent entity that will play a role in executing the CMF Award. |
Required for all Applicants. |
Appendix 9: Forms and Certifications
All CMF Applicants must complete the Environmental Review Form and Assurances and Certifications as part of their AMIS online application submission. Any Applicant that is a 501(c)(4) must complete the 501(c)(4) form as part of their AMIS online Application submission.
TIP: This form must be completed in AMIS by all Applicants. It is available on the AMIS Application under the Forms and Certifications Appendix. Note, by selecting “No” for the questions, the Applicant indicates that it does not have any projects that may require environmental review.
The CDFI Fund’s environmental review requirements are set forth in 12 CFR Part 1815. The Applicant should review such regulations carefully before completing this section. In order to assure compliance with those regulations and other requirements related to the environment, the Applicant shall provide the following information:
Environmental Review Form |
YES |
NO |
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If YES, would any of these actions normally require an environmental impact statement (see 12 CFR 1815.108)? |
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If YES to any of the above questions, attach a detailed description of each action, clearly identifying the category in which the action falls.
Notification |
As stated in 12 CFR 1815.105, if the CDFI Fund determines that the Application proposes actions which require an environmental assessment or an environmental impact statement, any approval and funding of the Application will be contingent upon:
In addition, as stated in 12 CFR 1815.106, if the CDFI Fund determines that an Application, or any part thereof, is not sufficiently definite to perform a meaningful environmental review prior to approval of the Application, final approval and funding of the Application shall require supplemental environmental review prior to the taking of any action directly using CDFI Fund Financial Assistance for any action that is not a categorical exclusion. |
AMIS TIP: In addition to signing the SF-424, an Applicant must indicate “Yes” that it is certifying the Assurances and Certifications in AMIS. It will do this under the area titled “Assurances and Certifications Form” on the Application main page in AMIS.
By signing the certification on the SF-424, the Applicant is certifying the Assurances and Certifications listed below. Certain Assurances and Certifications may not be applicable to the Applicant. An Applicant may not modify any of the Assurances and Certifications.
As the duly authorized representative of the Applicant, I certify that the Applicant:
Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management, and completion of the project described in this Application.
Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives.
Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.
Will initiate and complete the work (activities in Application) within the applicable time frame after receipt of approval of the awarding agency.
Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of Ohm’s Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L.88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.1681-1683, 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C.6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L.91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which Application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statutes which may apply to the Application.
Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases.
Will comply with the provisions of the Hatch Act (5 U.S.C.1501-1508 & 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C. 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), regarding labor standards for federally assisted construction sub agreements.
Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more.
Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L.91-190) and Executive Order 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451et seq.); (f) conformity of Federal actions to State Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L.93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L.93-205).
Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system.
Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance.
Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.
Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures.
Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984.
Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program.
Will comply with the requirements of Section 106(g) of the Trafficking Victims Protection Act (TVPA) of 2000, as amended (22 U.S.C. 7104) which prohibits grant award recipients or a sub-recipient from (1) Engaging in severe forms of trafficking in persons during the period of time that the award is in effect (2) Procuring a commercial sex act during the period of time that the award is in effect or (3) Using forced labor in the performance of the award or sub-awards under the award.
In addition to the assurances and certifications provided by the Applicant pursuant to OMB Standard Form 424, the Applicant hereby assures and certifies that:
It is duly organized and validly existing under the laws of the jurisdiction in which it was incorporated or otherwise established, and is (or within 30 days will be) authorized to do business in any jurisdiction in which it proposes to undertake activities specified in this Application;
Its Board of Directors (or similar governing body) has by proper resolution or similar action authorized the filing of this Application, including all understandings and assurances contained herein, and directed and authorized the person identified as the authorized representative of the Applicant to act in connection with this Application and to provide such additional information as may be required;
It will comply with all applicable requirements of the Community Development Banking and Financial Institutions Act of 1994 (the Act) [12 U.S.C. 4701 et seq.], regulations implementing the Act and all other applicable Department of the Treasury regulations and implementing procedures (and any regulations or procedures which are later promulgated to supplement or replace them);
It will comply, as applicable and appropriate, with the requirements of 2 C.F.R. 200 and any regulations and circulars which are later promulgated to supplement or replace them, including standards for fund control and accountability;
It has not knowingly and willfully made or used a document or writing containing any false, fictitious or fraudulent statement or entry as part of this Application or any related document, correspondence or communication. (The Applicant and its authorized representative should be aware that, under 18 U.S.C. 1001, whoever knowingly and willfully makes or uses such document or writing shall be fined or imprisoned for not more than five years, or both); and
It has not had proceedings instituted against it in, by, or before any court, governmental agency, or administrative body, and a final determination made within the last 3 years as of the date of the NOFA indicating that the Applicant has violated any of the following laws: Title VI of the Civil Rights Act of 1964, as amended (42 U.S.C.2000d); Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794); the Age Discrimination Act of 1975 (42 U.S.C. 6101-6107); Title VIII of the Civil Rights Act of 1968, as amended (42 U.S.C. 3601 et seq.); and Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency.
The information in this Application, and in these assurances and certifications in support of the Application, is true and correct to the best of the Applicant’s knowledge and belief and the filing of this Application has been duly authorized.
By signing and submitting this Application, the prospective primary participant (the Applicant) is providing the certification set out below.
The inability of a person to provide the certification required below will not necessarily result in the denial of participation in this covered transaction. The prospective Applicant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the CDFI Fund’s determination whether to enter into this transaction (approval and funding of the Application). However, failure of the Applicant to furnish a certification or an explanation shall disqualify such person from participation in this transaction.
This certification is a material representation of fact upon which reliance is placed when the CDFI Fund determines to enter into this transaction. If it is later determined that the Applicant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the CDFI Fund may terminate this transaction for cause or default.
The Applicant shall provide immediate written notice to the CDFI Fund if at any time the Applicant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
The terms “covered transactions,” “debarred,” “suspended,” “ineligible,” “lower tier covered transaction,” “participant,” “person,” “primary covered transaction,” “principal,” “proposal”, and “voluntarily excluded,” as used in this clause (certification), have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the CDFI Fund for assistance in obtaining a copy of those regulations (31 C.F.R. part 19).
The Applicant agrees by submitting this Application that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the CDFI Fund.
The Applicant further agrees by submitting this Application that it will include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction,” to be provided by the CDFI Fund, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions (see 31 C.F.R. part 19, Appendix B).
A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the No Procurement List.
Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the CDFI Fund may terminate this transaction for cause or default.
The prospective primary participant (the Applicant) certifies to the best of its knowledge and belief, that it and its principals:
are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;
have not within a three-year period preceding this Application been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and
Have not within a three-year period preceding this Application had one or more public transactions (Federal, State or local) terminated for cause or default.
Where the Applicant is unable to certify to any of the statements in this certification, such Applicant shall attach an explanation to this proposal.
The Applicant certifies that it will provide a drug-free workplace by:
publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the Applicant’s workplace and specifying the actions that will be taken against employee for violations of such prohibition;
establishing a drug-free awareness program to inform employees about:
the dangers of drug abuse in the workplace;
the Applicant’s policy of maintaining a drug-free workplace;
any available drug counseling, rehabilitation, and employee assistance program;
the penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
making it a requirement that each employee to be engaged in the performance of the award be given a copy of the statement required by subparagraph (a);
notifying the employee in the statement required by subparagraph (a) that, as a condition of employment in such grant, the employee will:
abide by the terms of the statement; and
notify the employer of any criminal drug use statute conviction for a violation occurring in the workplace no later than five calendar days after such conviction;
notifying the granting agency in writing, within ten calendar days after receiving notice of a conviction under subparagraph (d) (ii) from an employee or otherwise receiving actual notice of such conviction;
taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(ii), with respect to any employee who is so convicted:
taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or
requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
making a good faith effort to continue to maintain a drug-free workplace through implementation of subparagraphs (a), (b), (c), (d), (e), and (f).
The Applicant may insert in the space provided below the site(s) for the performance of work (activities carried out by the Applicant) to be done in connection with the award (Place of Performance (Street Address, City, County, State and zip Code)): Not Applicable.
The Applicant certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the Applicant, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement;
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Application, the undersigned shall complete and submit Standard Form LLL, “Disclosure Form to Report Lobbying“ in accordance with its instructions; and
The Applicant shall require that the language of this certification be included in the award documents for all sub-awards of all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance is placed when this transaction is made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
AMIS TIP: An Applicant must only complete this form in AMIS if it is recognized as a 501(c)(4) entity. No other Applicants should complete this form.
This questionnaire is necessary for the CDFI Fund to determine whether an Applicant with a 501(c)(4) designation from the IRS is eligible to receive an award from the Fund (see 2 U.S.C. 1601, et al.). Please read all definitions before responding to the questions and continue to refer to such definitions in responding to this questionnaire. If the answer to any question is yes, please describe in detail on a separate sheet(s) of paper the facts and circumstances, including: subject matter; date(s); names and titles of all individuals and their employers and their organizations. The CDFI Fund reserves the right to seek follow-up responses from an Applicant. Failure to complete this questionnaire and, if applicable, respond timely to follow-up questions, will delay the CDFI Fund’s processing of the Application, and may result in the disqualification of the Application from further consideration. After submitting responses to this questionnaire, the Applicant is under a continuing obligation to: (1) supplement its responses upon a change in circumstances; and (2) revise or modify its responses within 10 business days of having actual or constructive knowledge that the responses previously submitted and certified are no longer complete, accurate, or true. You may contact the CDFI Fund’s Office of Legal Counsel at (202) 653-0300 if you have any questions about this form.
Scope: The scope of this questionnaire is limited to activities on or after January 1, 1996.
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Signing the certification on SF-424 certifies that the answers to the 501(c)(4) Questionnaire and the written explanations attached thereto are true, accurate, and complete to the best of its information, knowledge, and belief and that, since January 1, 1996, the Applicant has not engaged in Lobbying Activities as defined in Section 3 (7) of the Lobbying Disclosure Act of 1995, P.L. 104-65, as amended.
i “Contacted” (or “contacted”) means any oral or written communication, including an electronic communication.
ii “Covered Executive Branch Official” means: (a) the President; (b) the Vice President; (c) any officer or employee, or any other individual functioning in the capacity of such an officer or employee, in the Executive Office of the President; (d) any officer or employee serving in an Executive Level I-V position, a “Schedule C” position, or any official in a Senior Executive Service position; (e) any member of the uniformed services serving at grade O-7 or above; or (f) any officer or employee serving in a position of a confidential, policy-determining, policy-making, or policy-advocating character described in section 7511(b)(2) of title 5, United States Code.
iii “Covered Legislative Branch Official” means: (a) a member of Congress; (b) an elected officer of either House of Congress; (c) any employee of the House or Senate, including employees of Members, committees, leadership and working groups or caucuses organized to provide legislative services or other assistance to Members of Congress; and (d) any other legislative branch employee serving in a position described under section 109(13) of the Ethics in Government Act of 1978 (5 U.S.C. App.).
1 For Applicants that are governmental instrumentalities only, and as long as all other eligibility requirements are met, the Applicant must submit a legal opinion from counsel, in form and substance acceptable to the CDFI Fund, opining that the Applicant is exempt from Federal income tax, if the Applicant does not otherwise have such determination in a document from the IRS.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | CMF PRA Application for Comment |
Author | Aiello, Daniel |
File Modified | 0000-00-00 |
File Created | 2021-05-01 |