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Homebuyer Completion Report Attachment H <br /> ADDI or HOME or Program <br /> HomeSight First Time Homebuyers Program Mark the appropriate box: <br /> ❑ Original Submission ❑ Revision <br /> Part A: Activity Information <br /> 1.Activity Number 2. Name of Participant 3.Participant's Tax ID Number 4.CHDO Tax ID Number <br /> 5. Name&Phone Number of person completing this form 6.Type of Property(check one): <br /> (1)❑ 1-4 Single Family (3)❑Cooperative <br /> (2)❑ Condominium (4)❑ Manufactured Home <br /> Part B: Financial Structure of Activity <br /> Type of Activity Financed(check one): <br /> (1)❑ Rehabilitation Only (3)❑Acquisition Only (5)❑Acquisition&New Construction <br /> (2)❑ New Construction Only (4) ❑Acquisition&Rehabilitation <br /> Activity Costs <br /> 1. ❑ADDI Funds❑ HOME Funds El CDBG Funds <br /> Annual Interest Rate Amortization Period <br /> (1)Direct Loan % Yrs. $ <br /> (2)Grant $ <br /> Annual Interest Rate Amortization Period <br /> (3)Deferred Payment Loan(DPL) % Yrs. $ <br /> (4)Community Housing Development Organization(CHDO)Loan <br /> a.TA Loan $ <br /> b.Seed Loan $ <br /> Total CHDO Loan(Total Items 4a and 4b) $ <br /> (5)Other $ <br /> Total ADDI,HOME OR CDBG Funds(Total Items 1-5) $ <br /> 2. Public Funds <br /> (1)Other Federal Funds $ <br /> (2)State/Local Appropriated Funds $ <br /> (3)State/Local Tax Exempt Bond Proceeds $ <br /> Total Public Funds(Total Items 1-3) $ <br /> 3. Private Funds <br /> (1)Private Loan Funds Annual Interest Rate Amortization Period <br /> 0/0 Yrs. $ <br /> (2)Owner Cash Contribution $ <br /> (3)Private Grants $ <br /> Total Private Funds(Total Items 1-3) $ <br /> 4. ADDI, HOME OR CDBG Program Income $ <br /> 5. Total Activity Costs(Total All Items) $ <br /> Part C: Financial Assistance to Homebuyer Note: Complete for homebuyer activities only. <br /> 1. Initial Purchase Price $ <br /> (-t 2.Appraised Value $ <br /> G- 1 <br />