Oakland Community Land Trust Homeownership Application
3790 Manila Avenue, Oakland, CA 94609

This is an application to purchase a resale-restricted home through the Oakland Community Land Trust. Please review all
eligibility requirements for this opportunity before submitting an application. They can be viewed online athttps://oakclt.org/3790manila. Applicants must attend an OakCLT Homebuyer Orientation Workshop to be considered
eligible for this opportunity (Register online at: https://oakclt.org/buyrent).
Completed applications may be submitted via one of three following ways:
1. Preferred method: Fill out the online version of this application at https://oakclt.org/3790manila
2. Fill out this form and mail it to Oakland Community Land Trust, ATTN: Application, 101 Broadway, Ste. 310,Oakland, CA 94607
3. Fill out this form and email a legible copy to apply@oakclt.org (If you are unable to print the application andwould like a copy to mailed to you, please email your address and request to apply@oakclt.org)
Applicants must submit both a certificate of completion of an 8-hour HUD-certified Homebuyer Education course and amortgage pre-approval letter from one of OakCLT’s approved lenders with your application.
The deadline for submitting an application online or via email is: May 30, 2023 at 11:59pm Pacific Time. (PleaseNote: Applications returned by mail must be postmarked by May 30, 2023 and received at OakCLT’s office by June 5,2023.)

Applicant Contact Information

Please provide the following contact information for the primary applicant (and co-applicant, if there is one). The primary
applicant is considered to be the Head of Household and will be the main contact for the purpose of this application.

Primary Applicant

Co-Applicant (if there is one)

Legal Name First

Legal Name First

Last

Last

Preferred Name

Preferred Name

Pronoun(s)Pronoun(s)Current Address

Current Address
StateZip

City

Email Address

Zip

Email Address
Phone Number

Phone Number

Circle One: Home / Mobile / Work

Circle One: Home / Mobile / Work

Date of Birth

Date of Birth

Primary Language

Primary Language

Do you require translation or interpretation?

State

YES | NO

Do you require translation or interpretation?

Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

YES | NO

Page |1City

Household Information

Please provide the following information for all members of the applicant household, including yourself. This generally includes
all the people that live with you. For more details, please review the OakCLT Purchase Manual.

Legal Name (First & Last)

PreferredName

Date of BirthFull-Time
Student(Y/N)

Relationship toApplicant(Ex. Child, Parent,
Grandparent, Cousin,etc.)

Does this person
live in the house
more than 50%of the time?
(Y/N)

ApplicantCo-Applicant(if there is one)Current Housing Situation

Please provide the following information related to your current housing arrangement.
Please Circle What Best Describes Your Current Situation

Rent | Own | Live w/ Friends/Family | In Program/Shelter | Other

Current Monthly Rent / Mortgage (in dollars)$Current Monthly Utilities (Gas/Water/Electricity, etc.)$

Number of Bedrooms in Your Home
Number of People Living in Your Home
Number of Years at This Address
Do you have a current, transferable Section 8 voucher orsimilar subsidy?

YES | NOIf Yes, please describe:

Reasonable AccommodationDo you (or any of your household members) have a disability?
Does any member of your household) have a condition that requiresa housing unit to accommodate the following needs:

YES | NOIf Yes, please describe:

Mobility Impairment
Ground Floor Access

Hearing Impairment
Vision Impairment

Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

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Are there other reasonable accommodations that you require for equal access to housing? Please explain below:

Household Income Information (Please refer to the OakCLT Purchase Manual to review income requirements)

Please provide the following income details for all adult members of the applicant household, including yourself. Attach
additional sheets if necessary. If you are invited to submit an offer for a home, each household member over 18 will berequired to submit most recent 3 years of tax returns, previous year’s W2, and 3 most recent months of paystubs.

Income Source #1
Household Member Name
Employer

Position/Job Title

Company Address

CityStateZip

Employer Contact Phone
Anticipated Annual Gross Income $Pay Frequency (circle one): Monthly | 2x Per Month | Other:__________

Income Source #2
Household Member Name
Employer

Position/Job Title

Company Address

CityStateZip

Employer Contact Phone
Anticipated Annual Gross Income $Pay Frequency (circle one): Monthly | 2x Per Month | Other:__________

Income Source #3
Household Member Name
Employer

Position/Job Title

Company Address

CityStateZip

Employer Contact Phone
Anticipated Annual Gross Income $Pay Frequency (circle one): Monthly | 2x Per Month | Other:__________

Income Source #4
Household Member Name
Employer

Position/Job Title

Company AddressCityStateZip

Employer Contact Phone
Anticipated Annual Gross Income $Pay Frequency (circle one): Monthly | 2x Per Month | Other:__________

Other Income Sources (Including SSI/SSDI, Child Support, Alimony, Interest Income, etc.)
Income Source

Annual Gross Income from Source

NOTE: If you are deemed income eligible based upon our initial screening, you will need to submit copies of the last three
paystubs for each income source, recent benefit statements, and recent Federal tax returns. You can access a free credit report
online at annualcreditreport.com.
Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

Page |3Household Member NameHousehold Assets Information

Please provide the following asset details for all adult members of the applicant household, including yourself. Attach
additional sheets if there are additional asset sources for your household.

Type of Asset

Current Asset Value(Ex. Cash, Checking, Savings, Retirement, Money
Market Accounts, Stocks, CDs, Inheritance, etc.)

Bank / Institution NameHousehold Credit/Debt Information

Please provide the following debt/credit details for all adult members of the applicant household, including yourself. Attach
additional sheets if there are additional debt/credit sources for your household.

Type of Debt / Liability(Examples: Credit Card, Student Loan, MedicalBills, Department Store Card, Lease Payments,
Car Loan, Mortgage, Line of Credit)

Current Balance(in dollars)

Current
Monthly
Payment

Name of Creditor(in dollars)

Are You
Delinquent?
(Y/N)

Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

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Please use the space below if you would like to explain any details about your household assets and/or debts listed above:

OakCLT Homebuyer Selection Criteria

Please review the OakCLT Homebuyer Selection Criteria document for a detailed description of the categories below.
REMINDER: For any responses below where you have answered YES, you will need to provide documentation to substantiate
your response prior to being invited to submit a purchase offer.

1. Is the Applicant, or any adult member of the Applicant’s Household, a current OakCLTLessee? If Yes, please circle all that apply to your situation below:
a. Current OakCLT homeownerb. Current OakCLT residential tenant or subtenant of an OakCLT nonprofit lessee
partner organizationc. Worker/Employee/Worker-owner for an OakCLT commercial tenant

YESNO

YES
YES

NO
NO

YES
YES
YES

NO
NONO

YESNO

YESNO

YESNO

YESNO

YESNO

YESNO

2. Has a member of the Applicant’s Household lived in Oakland within the last eight years
and was displaced, or likely will be displaced, for any of the following specific reasons(please circle any/all that apply):a. No-Fault Eviction (“No Fault Eviction” includes Ellis Act Eviction, Owner Removal of Rental Unit
from the Market, Owner Move-In Eviction, or Eviction for Repairs)b. Expiring affordability restrictions at an existing affordable housing projectc. Currently experiencing rent burden (paying more than 50% of gross income for rent)d. City of Oakland Code Enforcement ActivitiesDisplacement due to code enforcement includes situations in which a tenant vacates a unit in
response to a notice to vacate, a notice to abate a life-threatening condition, or adeclaration of a substandard condition issued by the City or a court of law.

e. A City-sponsored or City-assisted development project

3. Is the Applicant eligible for the Oakland Housing Authority’s Section 8 Homeownership
Program?
To qualify as an applicant who is eligible for the Section 8 Homeownership Program, the applicant household must currently
hold a Section 8 Housing Choice Voucher from the Oakland Housing Authority (OHA), meet all applicable Section 8
Homeownership Program requirements, and use their voucher to purchase the home for which they are applying.

4. Is the Applicant currently an Oakland Worker?
Work is defined for purposes of this policy as owning or operating a business located within the City of Oakland,
employment for wages or salary for an employer located within the City of Oakland, contract employment where the actual
work is conducted within the City of Oakland, or commission work where the applicant’s principal location from which theywork is located within the City of Oakland. Even if the work causes the applicant to be in Oakland frequently, the applicant
does not qualify as an Oakland worker if the business is not located in Oakland. An adult applicant who is an active
participant in an education or job training program located within the City of Oakland is also eligible for the Oakland
worker preference.

5. Is the Applicant currently an Oakland Resident?

6. Has the Applicant previously submitted an eligible application for OakCLT
homeownership?
A “Previous Applicant” means a household with at least one adult member who has submitted a complete application meetingbaseline eligibility for OakCLT homeownership opportunities. Applicants who submitted a full application for a home thatthey did not qualify for (i.e. they did not meet minimum household size requirements, were over-income, or did not qualify fora mortgage) are ineligible for points in this category.

Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

Page |5To be eligible for this category, applicant’s household must include at least one adult member whose principal place ofresidence is within the City of Oakland as of the date of the submitted application.

Optional Information

If you choose to provide the following information, it will be used to help OakCLT improve the outreach for our housing
opportunities, as well as for reporting purposes. This information will not be used when screening any housing application.
Please feel free to provide the following information for the Head of Household / Primary Applicant only. Please also feel
free to provide this information for each household member on the additional pages provided.

Ethnic Categories
Please check the applicable category:

Hispanic or Latino
NOT Hispanic or Latino

Racial Categories
Please check ALL that apply:WhiteBlack or African-American
American Indian / Alaska Native
Asian
IndianChinese
Filipino
Japanese
KoreanVietnamese
Other Asian: ______________________________
Native Hawaiian or Other Pacific Islander
Native Hawaiian
Guamanian or Chamorro
SamoanOther Pacific Islander: _________________________________
Other
Please Specify: ____________________________________

Gender Identity
Please check any that apply:

MaleFemale

Transgender

Non-Binary

Other: ________________________

American Indian or Alaskan Native: A person having origins with any of the original peoples of North, Central & South America, and who maintains
tribal affiliation or community recognition.
Asian: A person having origins with any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for ex:
Cambodia, China, India, Indonesia, Japan, Korea, Malaysia, Pakistan, the Philippines, Thailand, and Vietnam.
Black or African American: A person having origins in the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander: A person having origin in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

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White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Certification
1. I/we understand that it is the responsibility of each applicant to provide any and all information required todetermine eligibility.
2. I/we understand that if an applicant fails to meet the eligibility requirements for the available housing opportunity,
a written notice of denial stating the reason for denial will be mailed to applicant. An applicant has three businessdays to request an appeal.
3. I/we understand that the above information is being collected to determine my/our eligibility for an OakCLT
homeownership opportunity. I/we authorize OakCLT, its agents and employees to make any and all inquiries toverify this information either directly or through information exchanged now or later with tenant screening
agencies, investigative consumer reporting agencies, or other public agencies, and to contact previous or current
landlords or other sources for verification information which may be released by appropriate federal, state, local
agencies, or private persons to OakCLT.
4. I/we understand I/we must provide written notification to OakCLT of any changes to the information on this form.
5. If my/our application is approved and I/we are invited to submit an offer to purchase an OakCLT home, I/wecertify that only those persons listed in this application will occupy the home, that I/we will maintain no other placeof residence, and that there are no other persons for whom I/we have or expect to have responsibility forproviding housing.
6. I/we understand that an applicant with a disability has a right to request a reasonable accommodation. All
requests will be evaluated and a decision will be made based on the reasonable nature of the request.
7. I/we certify that the foregoing information is true, complete, and correct. I/we understand that false statements oromissions are grounds for disqualification, eviction, and/or prosecution under the full extent of California law.

Signature(s)By signing below you acknowledge that you have read the certification passage above. Please ensure that your application iscomplete and that all adult applicants have signed and dated below.
Primary Applicant

Name: ______________________________________
Signature: ___________________________________
Date: _______________________________________

Co-Applicant(if there is one)

Name: ______________________________________
Signature: ___________________________________
Date: _______________________________________

Applicant #3(if there is one)

Name: ______________________________________
Signature: ___________________________________

Oakland Community Land Trust | 101 Broadway, Ste. 310, Oakland, CA 94607 | 510-463-2887 | oakclt.org
The Oakland Community Land Trust is an equal opportunity housing provider

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Date: _______________________________________