AEOA 1-1 Counseling Session Application

  • Items needed for counseling session:

    • Copy of most recent pay stubs for all household members to cover 3 months
    • Copy of ALL household income including SSI, SSD, Child Support, Tip income, Copies of award letter
    • Last 3 months of banking statements Checking/Savings
    • Copy of a credit report or release for us to pull one
    • Copy of a Loan Estimate(LE) from your lender
    • Copy of a Purchase Agreement if you already signed a purchase agreement if applicable
    • Realtor Contact information (email, phone # office #)
    • Lender Contact information(email, phone# office #)
    • Copy of the Home Stretch or FRAMEWORK Certificate
    • Fill out all attached forms, sign and return
    • Please send only copies, you keep originals
    • Any questions please contact Sandy O'Fallon 218-999-0828
    • Mail counseling packet back to 
      Sandy O'Fallon/KOOTASCA Community Action Inc. 
      201 NW 4th ST. Suite 130,
      Grand Rapids, MN 55744

    1 2014

  • Instructions: Please fill out as completely as possible. For questions or concerns , call Sandy O'Fallon at 218-999-0828 or

  • Individual # 1

  • Name:

  • Individual # 2

  • Name:

Individual # 1 (only) please continue

  • Income Please include income for all sources (work, disability, child support, investment income, etc.)

    click to add

  • Disclosure Statement

    While you may learn about the advantages/disadvantages of specific loan products during the Home Stretch workshop and counseling sessions, you are free to choose lenders, loan products and homes of your own choosing regardless of the recommendations made by the educator/counselor. By signing below, you acknowledge that you have read this disclosure notice.

  • Authorization to Release Information

    This workshop is funded in part by the Homeownership Education Counseling and Training (HECAT) Fund. The agency providing this workshop plans to share information on this form with the HECAT funders. The HECAT funders include: Minnesota Housing, Minnesota Home Ownership Center, Greater Minnesota Housing Fund, and the Family Housing Fund. The Minnesota Home Ownership Center (Center) is responsible for al aspects of reporting for the HECAT fund. The funders will use the information for program review, research and oversight purposes.

    The Center will follow strict rules to protect your confidentiality. You will never be named in any reports. Although your responses may be looked at individually by the Center, or contractors hired by the Center to collect and analyze the data, your name will not be associated with any analysis data provided on this form. Only group results will be reported, no individual results will be shared. Failure to provide and authorization will not have any adverse impact on the services provided. By signing, below you authorize the release of information contained on this form.

  • Homeowner Education Counseling and Training Fund (HECAT) Combined Privacy Act Notice

    • We at Arrowhead Economic Opportunity Agency value your trust and are committed to the responsible management, use and protection of personal information. This notice describes our policy regarding collection and disclosure of personal information. The following programs are funded in part by the Homeownership Education Counseling and Training (HECAT) fund: Homebuyer Education (Home Stretch & Pathways Home), Homebuyer Counseling, and Home Equity Conversion Mortgage Counseling or Reverse Mortgage Counseling. The HECAT funders include: Minnesota Housing, Minnesota Homeownership Center, Greater Minnesota Housing Fund, and the Family Housing Fund.

      Social Security Numbers
      The Privacy Act of 1974 makes it unlawful for any Federal, State or local government agency to deny your participation in this Homebuyer Counseling program if you refuse to provide your social security number. If you do not provide your social security number services to you may be more limited, but you will continue to be eligible to receive services we can provide without a social security number. 

      Other Private Data
      Under Minnesota Statutes, your name and address are public data. All other data we may ask about you is private data on individuals. Agreeing to share your public data is mandatory for participation in the HECAT funded programs listed above. Sharing your private data is not mandatory for participation in the program. However, if you do not provide private information (such as income, debts, and assets) services to you may be more limited. 

      We collect private information for the purposes of program management, compliance monitoring, research and program evaluation to:
      • Support homebuyer education
      • Support homebuyer counseling
      • Support reverse mortgage counseling

      We collect your private information from the following sources: information that we receive from you on applications or other forms, information about your transactions with us, and information we receive from a consumer reporting agency.

      We may disclose the following types of private information about you;
      • Information we receive from you on applications or other forms, such as your name, address, social security number, employer, assets, debts, and income;
      • Information about your transactions with us, and
      • Information we receive from a consumer credit reporting agency, such as credit bureau reports, you credit history and your creditworthiness.

      We may disclose your private information to the following entities or their representatives identified above and to other entities properly authorized under law to review it.
      • Staff at this organization who need it to work on your case;
      • HECAT funders: Minnesota Housing Finance Agency, Family Housing Fund, Greater Minnesota Housing Fund, and the Homeownership Center.
  • Notice to Prospective Client

    This program is being assisted with Community Development Block Grant (CDBG) funds provided to us by St. Louis County, who receives CDBG funds from the U.S Dept. of Housing and Urban Development (HUD). HUD requires that we collect data on race and ethnicity for statistical purposes, program administrative reporting or civil rights compliance reporting. Therefore, we must require that you answer the questions below. This information will not be released without your consent, except to St. Louis County and to HUD, and as required or permitted by law.

  • Assets

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  • Automobiles/Boats/Motorcycles/Snowmobiles/Campers:Year:

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  • Monthly Expenses

  • Household Income

    Add for each member of family
  • Household Expenses
    Mortgage / Rent
    Home / Rental Insurance
    Heat (Gas / Oil)
    Water / Sewer / Trash
    Phone (Landline / Cell)
    Cable / Satelite
    Installment / Personal Loans
    Auto Loan
    Auto Loan (1)
    Credit Card
    Credit Card (1)
    Credit Card (2)
    Credit Card (3)
    Recreational Vehicle Loan
    Health Insurance - Not deducted from paycheck
    Co-Pays / Prescriptions
    Health Club Membership
    Pet Expenses
    News Paper / Magazines
    Charitable Gifts
    Daycare-Child Care
    Auto Insurance
    Monthly Bill for Transportation
    Auto Repairs / Maintenance
    License / Tabs
  • Questions
    Have you had any outstanding judgements in the past 7 years?
    Have all previously satisfied judgements been recorded (If applicable)
    Have you ever declared bankruptcy?
    Have you ever had property foreclosed upon or Given the title or deed in lieu thereof in the last 7 years?
    Are you presently delinquent or in default on a loan
    Are you party to a lawsuit?
    Are you a co-signer on any other loans or notes?
    In the past year have you ever been over 30 days past due on any debt?
    Have you ever been divorced?
    Do you have a certified copy of the decree?
    Have you owned real estate in the past 3 years?
    Is any part of the down payment borrowed other than AEOA assistance?
  • AEOA Down Payment and Closing Cost Assistance is a 10 year Deferred Loan and may have to be paid back if you re-finance and/or sell your home before 10 years.

  • Arrowhead Economic Opportunity Agency Counseling Agreement

    In order to learn about home ownership and to solve any problems related to purchasing a home and qualifying for a home loan, the client recognizes the need for loan counseling and pledges full cooperation with the counselor. The client authorizes the counselor to act on his/her behalf in order to improve his/her home eligibility situation and obtain necessary services.

    The client understands that any information that is required to obtain the help needed must come from the client. The client further authorizes the counselor to obtain other information from outside sources when necessary. The need to exchange information or pass on information is also recognized by the client.

    The counselor pledges to preserve strict confidentiality concerning the client and will neither give nor seek information except where other have the right to it. After the client has completed the purchase process and moved into their new home, AEOA will provide additional information for reporting purposes only. The counselor will make no decisions and take no actions without the knowledge and consent of the client. At all times, the counselor will protect and promote the best interest of the client.

    The client understands that AEOA has no authority to approve or deny a loan application not submitted to AEOA. AEOA does have the authority to approve and deny loans for Down Payment and Closing Cost Assistance. The client also understands that AEOA is not a lending institution.

    The client understands that any lending institution that received an application from the client has the clients permission to give a copy of the application to AEOA and to discuss the application with AEOA Any lending institution that makes the client a loan has the clients permission to discuss the loan and any loan delinquency with Arrowhead Economic Opportunity Agency.

    The client understands that completion of AEOA loan counseling program does not guarantee that the clients loan application will be approved by any lending institution. The client also understands that completion of AEOA loan counseling program and referral to a lending institution is not a commitment by the lending institution to make a loan. AEOA will provide recommendations of services which might include AEOA services, the client understands it is their decision if they use our recommendation, not a requirement of our Homeownership Program.

    The client further understands that the loan counselor is not an agent for either buyer or seller within the home purchase transaction. The loan counselor's role is restricted to home ownership education, preliminary loan counseling and client support and assistance throughout the home loan application process.

    The client acknowledges that AEOA counselors may refer the client to programs both within and outside of AEOA. The counselor is making these suggestions in what they believe to be the clients best interest. The client is not obligated in any way to follow this advice. The client may continue to receive services if they take or do not take the counselors advice.

    As a client(s) of AEOA, I/we understand that the assistance provided will be free of charge. I/we understand that the staff providing will not:

    1. Break their pledge of confidentiality
    2. Accept fees from any services they recommend
    3. Recommend services in which they have financial interest

    Terminate this counseling relationship without giving reason for such

    In consideration for receiving services from Arrowhead Economic Opportunity Agency, I/we hold Arrowhead Economic Opportunity Agency, the lending institution and their staff to be free and harmless from any claims, liabilities or injuries from these services.

  • Arrowhead Economic Opportunity Agency

    Homeownership Loan Program

    Servicing Disclosure Statement

    Lender: Northeast Home Consortium (AEOA Down Payment & Closing Cost Assistance)

    Notice to mortgage applicants: The right to collect your mortgage loan payment may be transferred. Federal law gives your certain related rights. If your loan is made, save this statement only if you understand its contents.

     Because you are applying for a mortgage loan covered by the Real Estate Settlement Procedures Act ( RESPA ) (12U.S.C. Section 2601 et seq. ) you have certain rights under the federal law relating to the servicing of your loan.

    This statement informs you what the chances are that the servicing for this loan may be transferred to a different loan servicer. “Servicing” refers to collecting your principle, interest, and escrow payments, if any.  If your loan servicer changes, there are certain procedures that must be followed. This statement generally explains those procedures.

    Transfer practices and requirements If the servicing of your loan is assigned, sold or transferred to a new server, you must be given written notice of that transfer.  The present loan server must send you notice in writing of the assignment, sale or transfer of the servicing not less than 15 days before the effective date of that transfer. The new loan server must also send you notice within 15 days after the effective date of the transfer.  The present server and the new server may combine this information in one notice, so long as the notice is sent to prospective transfer is provided to you at settlement. The lay allows a delay in time (not more than 30 days after the transfer) for server to notify you, upon the occurrence of certain business emergencies.

    Notice must contain the effective date of transfer, the name address and toll free number of the new server. During the 60 day period following the effective date of the transfer of the loan servicing, a loan payment received by your old server before its due date may not be treated by the new loan server as late, and a late fee may not be imposed on you.

    Complaint Resolution Section six of RESPA (12U.S.C. Section 2605) gives you certain consumer rights whether or not your loan servicing is transferred. If you send a “qualified written request” to your server, then your server must provide you with a written acknowledgement within 20 business days of receipt of your request. A “qualified written request” is a written correspondence, other than notice in a payment coupon or other payment medium supplied by the server, which includes your name and account number, and the information regarding your request. No later than 60 business days after receiving your request, your server must make any appropriate corrections to your account, or  you must not provide information to a consumer reporting agency concerning any overdue payment related to such period or qualified written request.

    Damages and Cost Section 6 of RESPA also provides for damages and costs for individuals or classes of individuals in circumstances where services are shown to have violated the requirements of that section.

  • Servicing Transfer Estimates

    1. The following is the best estimate of what will happen to the servicing of your mortgage loan:


    A. _____ We will assign, sell or transfer the servicing of your loan while the loan is outstanding.

    We are unable to service your loan, and it will be serviced by:


    _____ Northeast Home Consortium              St. Louis County Community Development               307 First Street South               Virginia, MN 55792

    B. _____ We do not service mortgage loans and we have not services mortgage loans in the past three years.

    _____ We presently intend to assign, sell or transfer the servicing of your mortgage loan. _____ You will be informed about your server.

    2.      For all of the HOME mortgage loans that we make in the 12 month period after your   mortgage loan is funded, we estimate that the percentage of such loans we will transfer servicing is between:


    ___0 to 25% ___26 to 50% ___51 to 75% ___76 to 100%

    This estimate does include assignments, sales and transfers to affiliates or subsidiaries. This is only our best estimate and it is not binding.  Business conditions or other circumstances may affect future transferring decisions.

     Acknowledgement of Mortgage Loan Applicant(s)

    I (we) have read and understand this disclosure. We understand this disclosure is a required part of the mortgage application as evidenced by my (our) signatures below:

  • Homeownership Loan Program

    Estimate of settlement costs:

  • The information provided below reflects estimates of the charges which you are likely to incur at the settlement of your loan. The fees listed are estimates the actual charges may be more or less. Your transaction may not involve a fee for every item listed. These estimates are provided pursuant to the Real Estate Settlement Procedures Act of 1974, as amended (RESPA).

    The numbers listed beside the estimates generally correspond to the numbered lines contained in the HUD‐1A settlement statement that you will be receiving at Closing. The HUD‐1 settlement statement will show you the actual costs for items paid at Closing.

  • *All the above fees will be added to your deferred loan agreement as part of your closing cost assistance. If you have any questions regarding this statement, I can be reached at 218‐999-0828.