Verification of Non-Monetary Assets I/We certify that the following assets in excess of $1,000 in value accurately represent my/our household's holdings, and will be used by HACSB staff for purposes of determining Income Certification eligibility.In signing below, I/we understand that any misrepresentations and/or omissions may result in disqualification from participating in the City of Goleta's Affordable Home Purchase Program. The following assets in excess of $1,000 in value are the property of the applicant and/or member of the applicant's household. Please provide a description of the asset. At minimum, include the following: Physical, and real property assets which, although owned by more than one person allowed unrestricted access by the applicant such as TRUST FUNDS, STOCKS; Personal property valued over $1,000, such as CASH AT HOME, real estate property, automobiles, antiques, jewelry, coin collections, antique vehicles, computers, cameras, etc. Automobiles (include registration and loan paperwork in application) Asset Value _________________________ _________________________ Signature of applicant Date _________________________ _________________________ Spouse/Co-applicant Date Applicant’s name:_______________________________ Date:_______________________________
Verification of Non-Monetary Assets I/We certify that the following assets in excess of $1,000 in value accurately represent my/our household's holdings, and will be used by HACSB staff for purposes of determining Income Certification eligibility.In signing below, I/we understand that any misrepresentations and/or omissions may result in disqualification from participating in the City of Goleta's Affordable Home Purchase Program. The following assets in excess of $1,000 in value are the property of the applicant and/or member of the applicant's household. Please provide a description of the asset. At minimum, include the following: Physical, and real property assets which, although owned by more than one person allowed unrestricted access by the applicant such as TRUST FUNDS, STOCKS; Personal property valued over $1,000, such as CASH AT HOME, real estate property, automobiles, antiques, jewelry, coin collections, antique vehicles, computers, cameras, etc. Automobiles (include registration and loan paperwork in application) Asset Value _________________________ _________________________ Signature of applicant Date _________________________ _________________________ Spouse/Co-applicant Date Applicant’s name:_______________________________ Date:_______________________________
Winslowe-ICA.docx