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109.03.5 Exhibit 5 A-1. Non Borrower Occupant Income Affidavit.

AR ADC 109.03.5 Exhibit 5 A-1Arkansas Administrative Code

West's Arkansas Administrative Code
Title 109. Development Finance Authority
Division 03. Single Family Housing
Rule 5. Mortgage Loan Origination
Ark. Admin. Code 109.03.5 Exhibit 5 A-1
109.03.5 Exhibit 5 A-1. Non Borrower Occupant Income Affidavit.
Currentness
EXHIBIT 5 A-1
NON BORROWER'S OCCUPANT INCOME AFFIDAVIT
The undersigned, __________ duly states under oath that:
1. I intend to be an occupant of the residence located at: __________
2. My gross monthly income is $__________ (Gross monthly income is the sum of monthly gross pay, any additional income from overtime, part-time employment, bonuses, commissions, dividends, income from assets, interest, royalties, shift differential, pensions, VA compensation, net rental income, etc., and other income such as alimony, child support, mileage, military allowance, public assistance, sick pay, social security benefits, unemployment compensation, income received from trusts, and income received from business activities or investments, etc.).
3. Three years of Federal Income Tax Returns are required.
I am providing tax returns with W-2's attached for the following years: __________; __________; __________.
I have not filed, and was under no obligation to file, the following income tax years: __________; __________; __________.
4. (CHECK APPROPRIATE RESPONSE). I have __________ I have not __________ had a present ownership interest in a principal residence of mine at any time during the three-year period prior to the date of executing the mortgage on said residence.
I UNDERSTAND THAT FOR THE PURPOSES OF THE FOREGOING, EXAMPLES OF INTERESTS WHICH CONSTITUTE A PRESENT OWNERSHIP INTEREST (AND THUS WOULD RESULT IN MY NOT MEETING SUCH REQUIREMENTS) ARE THE FOLLOWING:
a. A fee simple interest:
b. A joint tenancy, a tenancy in common, or a tenancy by the entirety;
c. The interest of a tenant-shareholder in a cooperative;
d. A life interest;
e. A land contract (i.e., a contract pursuant to which possession and the benefits of ownership transferred although a legal title is not transferred until some later date);
f. An interest held in trust for the mortgagor (whether or not created by the mortgagor) that would constitute ownership interest if held directly by the mortgagor;
g. A lease with an option to purchase for a nominal sum; and
h. An interest in a mobile home that has been, and is now, permanently affixed to real property.
EXAMPLES OF INTEREST WHICH DO NOT CONSTITUTE PRESENT OWNERSHIP INTEREST AND THUS WOULD NOT RESULT IN MY FAILING TO MEET THE REQUIREMENTS ARE THE FOLLOWING:
a. A remainder interest;
b. A lease without an option to purchase or a lease with an option to purchase at fair market value;
c. A mere expectancy to inherit an interest in a principal residence;
d. The interest that a purchaser of a residence acquires on the execution of a purchase contract;
e. An interest in other than a principal residence during the previous three years;
f. An interest in a mobile home that has not been, and is not now, permanently affixed to a real property.
OCCUPANT (x)__________
Name: __________
Date: __________
ACKNOWLEGMENT
STATE OF ARKANSAS
)
COUNTY OF ____________________
)
On this __________ day of __________, 20 __________, before me, a Notary Public within and for the said County and State, personally appeared __________ to me known to be the person(s) subscribed therein and who, being by me first duly sworn, executed the foregoing Occupant's Income Certification Affidavit, and acknowledged, deposed and said that he/she/they executed the same as his/her/their free act and deed and stated that the information and certifications contained therein are true and correct.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this __________ day of __________, 20 __________.
__________
Notary Public
My Commission Expires:
__________
(SEAL)
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 109.03.5 Exhibit 5 A-1, AR ADC 109.03.5 Exhibit 5 A-1
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