<p> TEXAS DEPARTMENT OF HOUSING AND COMMUNITY AFFAIRS OFFICE OF COLONIA INITIATIVES TEXAS BOOTSTRAP LOAN PROGRAM Form 3 Loan Submission Form Owner-Builder Applicant: Owner-Builder Co-Applicant: Property Address: City, State & Zip Code: Census Tract Number: Set-Aside: Two-Third One-Third (Statewide)</p><p>Flood Zone: Yes No</p><p>PURPOSE OF LOAN Interim Construction Residential Construction Purchase Money</p><p>Existing New Construction</p><p>NONPROFIT OWNER-BUILDER HOUSING PROIVDER INFORMATION NOHP: NOHP Address: City, State & Zip Code: NOHP Contact: L.O.A. NUMBER: NOHP Email Address: NOHP Phone Number: TITLE COMPANY INFORMATION Title Company Name: Title Company Address: City, State & Zip Code: Contact Name: Email Address: Phone Number: </p><p>TDHCA USE ONLY County: ______Household Size: ______</p><p>60% AMFI: $______Household Income: $______</p><p>Statewide AMFI: $______Qualifying Income: $______</p><p>Form 3-March 2016 Page 1 of 3 LIENHOLDER INFORMATION The CSHC/NOHP must provide information for all funding sources (loans, forgivable loans & grants) that will be utilized to complete this loan. </p><p>1 st Lien Holder</p><p>Name of Lien Holder: </p><p>Loan Amount: </p><p>Funding Source: </p><p>Interest Rate: </p><p>Loan Term: </p><p>Payments (amount of monthly payment): </p><p>Escrow Monthly Amount (taxes): </p><p>Escrow Monthly Amount (insurance): </p><p>Estimated Closing Date: </p><p>1st Payment Due: </p><p>Late Charge Amount: </p><p>Lien Required: Yes No</p><p>Lien Holder</p><p>Name of Lien Holder: </p><p>Loan Amount: </p><p>Funding Source: </p><p>Interest Rate: </p><p>Loan Term: </p><p>Payments (amount of monthly payment): </p><p>Escrow Monthly Amount (taxes): </p><p>Escrow Monthly Amount (insurance): </p><p>Estimated Closing Date: </p><p>1st Payment Due: </p><p>Late Charge Amount: </p><p>Lien Required: Yes No</p><p>Form 3-March 2016 Page 2 of 3 Lien Holder</p><p>Name of Lien Holder: </p><p>Loan Amount: </p><p>Funding Source: </p><p>Interest Rate: </p><p>Loan Term: </p><p>Payments (amount of monthly payment): </p><p>Escrow Monthly Amount (taxes): </p><p>Escrow Monthly Amount (insurance): </p><p>Estimated Closing Date: </p><p>1st Payment Due: </p><p>Late Charge Amount: </p><p>Lien Required: Yes No</p><p>Lien Holder</p><p>Name of Lien Holder: </p><p>Loan Amount: </p><p>Funding Source: </p><p>Interest Rate: </p><p>Loan Term: </p><p>Payments (amount of monthly payment): </p><p>Escrow Monthly Amount (taxes): </p><p>Escrow Monthly Amount (insurance): </p><p>Estimated Closing Date: </p><p>1st Payment Due: </p><p>Late Charge Amount: </p><p>Lien Required: Yes No</p><p>Form 3-March 2016 Page 3 of 3</p>