OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

Reinstatement (R) Payment Assistance Term Sheet

Criteria  Terms 

Brief description  Provide funds to cover mortgage reinstatement to allow a homeowner reinstate a mortgage up to $2

pay other housing‐related costs related to a period of forbearance, delinquency, or default.Component will include Insurance Assistance Payment (homeowners, flood, and/or mortgage). HAF Fhomeowner’s insurance, flood insurance, and/or mortgage insurance that are not included in the hompayment.

 Insurance Policy Assistance Payment need not be delinquent but must be within 90 days of p

Non‐delinquency of Insurance policies will help with reducing the risk in lapsed insurances.

 Payment assistance for insurances will provide up to (1) annual homeowner's insurance prem

maintain housing stability.

 This will apply when these fees are not escrowed into the homeowner’s monthly mortgage p

If HAF funds are not sufficient to cure delinquency (homeowners who are delinquent over $25K), ADOto the servicer as a partial payment to be applied to the homeowner’s mortgage account. These fundwith any available loss‐mitigation options the servicer is able to provide and shall be applied in the be

Maximum amount of assistance per homeowner 

Maximum Amount of Assistance:

 Maximum monthly assistance across all programs of $3,500 Maximum $25,000 per household

Mortgage Reinstatement (R Program):

 Maximum amount of past due mortgage payments to be rescued can be up to but no more t Program will allow for an additional three (3) months of monthly mortgage payment assistan AZ requests a 60 day Foreclosure hold be placed upon sending an “I” Record in a CDF exchan

Insurance Assistance Payment (Homeowners, Flood, and/or Mortgage):

 Up to (1) annual homeowner's insurance premium to assist homeowners maintain housing st

 Payment assistance for insurances will provide up to (1) annual homeowner's insuran

homeowners maintain housing stability.

 Insurance Policy Assistance Payment need not be delinquent but must be within 90 d

payment – Non‐delinquency of Insurance policies will help with reducing the risk in la

 A Reverse Mortgage may be brought current for property charges, which include, pro

hazard insurance premiums, flood insurance premiums, condominium fees, and hom

 This will apply when these fees are not escrowed into the homeowner’s monthly mortgage p

Homeowner eligibility criteria and documentation requirements 

Same as General Eligibility Requirements Across All Programs plusHomeowners are eligible to receive funding if they

1. Attest that they experienced a financial hardship after January 21, 2020 associated with the C2. Provide income documentation and are found to be at or below 150% of Arizona’s Area Med3. Currently own and occupy a primary residence in Arizona (the applicant must own and occup

assistance).
OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

Criteria  Terms 

Documentation requirements:

 Proof of identity, which may include a photo identification or other means of identification th Deed or Proof of Ownership Proof of Income

 Paystubs, W2s or other wage statements, IRS Form 1099s, tax filings, depository inst

demonstrating regular income, or an attestation from an employer

 Attestation of financial hardship due to COVID‐19. Mortgage Documents Third Party Authorization (for Servicer CDF Exchange)

Loan eligibility criteria specific to the program 

Delinquent by at least one payment, including any payments during a forbearance period.

Form of assistance  Assistance will be structured as a non‐recourse grant.Payment requirements  Payments will be made directly to the mortgage servicer and/or applicable third party authorized to c

electronic funds transfer or check.
OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

Utility / Internet / Broadband (U) Payment Assistance Term Sheet

Criteria  Terms Brief description  Provide funds to resolve delinquent payments for utility and/or internet access services.

Utility / Internet Payment Assistance will allow payment assistance for homeowner’s utilities, includinhome energy, and water and payment assistance for homeowner’s internet service, including broadbdefined in 47 CFR 8.1(b);HAF funds may be used to pay delinquent amounts in full under circumstances in which a delinquencinternet services. The provided assistance must bring the homeowner’s account current. HAF funds w(6) months outside of utility reinstatement assistance payments. Utility/Internet/Broadband paymentconjunction with a utility reinstatement assistance payment.Funds may be used to pay prospective charges for up to the first 90 days following approval if the hompayments and

1. Funds are not available from other utility assistance programs to cover these amounts;

Self‐Attestation of Continued Need

1. After 90 days of future assistance homeowner will received notification to log into the applic

attestation that attests to continued need for assistance. This would allow the program to copayments an additional 90 days.

Maximum amount of assistance per homeowner 

Maximum Amount of Assistance:

 Maximum monthly assistance across all programs of $3,500 Maximum $25,000 per household

Homeowner eligibility criteria and documentation requirements 

Same as General Eligibility Requirements Across All Programs plus:

 Homeowner is at least one installment payment in arrears on one or more of the following: u

propane, garbage, home energy, and water or internet service, including broadband internet 

 No delinquency is required on filling a propane (gas) tank Program will allow one (1) Propane Tank fill up to assist homeowners with utility pay

 HAF funds will allow a homeowner up to six (6) months outside of utility reinstatement assist

payments are available only in conjunction with a utility reinstatement assistance payment.

Self‐Attestation of Continued Need

 After 90 days of future assistance homeowner will received notification to log int

a self‐attestation that attests to continued need for assistance. This would allow on utility payments an additional 90 days.

 Assistance sufficient to resolve the delinquency is not available from other utility assistance p

assistance, the homeowner is likely to lose services

Documentation requirements:

 Proof of identity, which may include a photo identification or other means of identification th Deed or Proof of Ownership
OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

 Proof of Income

 Paystubs, W2s or other wage statements, IRS Form 1099s, tax filings, depository inst

demonstrating regular income, or an attestation from an employer

 Attestation of financial hardship due to COVID‐19. Utility and/or Internet Billings for each utility company if applying for utility assistance

Loan eligibility criteria specific to the program 

Delinquent by at least one installment payment in arrears on one or more of the following: utilities, sgarbage, home energy, and water or internet service, including broadband internet access service. Prrequire delinquency, includes a one‐time propane tank fill up.

Form of assistance  Assistance will be structured as a non‐recourse grant.Payment requirements  Funds will be paid directly to the utility provider, internet provider, or other applicable third party aut

delinquencies via check or electronic funds transfer.
OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

Monthly Mortgage (U) Payment Assistance Term Sheet

Criteria  Terms Brief description  Provide full monthly payment assistance to homeowners unable to make full mortgage payments due 

hardship associated with the Coronavirus pandemic.HAF funds will allow a homeowner up to three (3) months outside of reinstatement assistance paymepayments are available only in conjunction with a reinstatement assistance payment.

 Monthly Mortgage assistance can be provided if not all funds have been expended after Rein

Utility/Internet/Broadband payment assistance.

Maximum amount of assistance per homeowner 

Maximum Amount of Assistance:

 Maximum monthly assistance across all programs of $3,500 Maximum $25,000 per household

Monthly Mortgage (U Program):

 Maximum amount of past due mortgage payments to be rescued is $25,000. Program will all

monthly mortgage payment assistance outside of reinstatement based on need and addition

Homeowner eligibility criteria and documentation requirements 

Same as General Property Eligibility Criteria Across All Programs plus

 Homeowner is delinquent by at least one payment, including any payments during a forbeara Maximum amount of past due mortgage payments to be rescued is $25,000. Program will all

monthly mortgage payment assistance outside of reinstatement based on need and addition

Documentation requirements:

 Proof of identity, which may include a photo identification or other means of identification th Deed or Proof of Ownership Proof of Income

 Paystubs, W2s or other wage statements, IRS Form 1099s, tax filings, depository inst

demonstrating regular income, or an attestation from an employer

 Attestation of financial hardship due to COVID‐19. Mortgage Documents Third Party Authorization (for Servicer CDF Exchange)

Loan eligibility criteria specific to the program 

Delinquent by at least one payment, including any payments during a forbearance period.

Form of assistance  Assistance will be structured as a non‐recourse grant.Payment requirements  Payments will be made directly to the lender or servicer or applicable third party authorized to collec

electronic funds transfer or check
OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

Delinquent Property Tax (DPT) Payment Assistance Term Sheet

Criteria  Terms Brief description  Provide a one‐time reinstatement payment of delinquent property tax payment assistance to preven

foreclosure, paid in increments of 1 year (2 installments); unless Tax Authority does not accept future then account will only be brought current. This will apply when the property tax is not escrowed into mortgage payment.

Maximum amount of assistance per homeowner 

Maximum Amount of Assistance $25,000 per household.

Homeowner eligibility criteria and documentation requirements 

Same as General Property Eligibility Criteria Across All Programs plusAdditional Mortgage Type:

 Reverse Mortgages

Documentation requirements:

 Proof of identity, which may include a photo identification or other means of identification th Deed or Proof of Ownership Proof of Income

 Paystubs, W2s or other wage statements, IRS Form 1099s, tax filings, depository inst

demonstrating regular income, or an attestation from an employer

 Attestation of financial hardship due to COVID‐19. Mortgage Documentation Property Tax Statement

Loan eligibility criteria specific to the program 

Delinquent by at least one installment of delinquent property taxes.

 One time reinstatement payment assistance to reinstate property taxes and bring account cu

 If household is one installment in arrears, the program will pay up to one full year (2 

reinstatement; unless Tax Authority does not accept future installment payments whbrought current.

 Will apply when property taxes are not escrowed into the homeowner’s monthly mortgage p Will apply when there are property tax delinquencies for applicants with Reverse Mortgages. Ongoing assistance is not available through this component, provided as a one‐time reinstate

Form of assistance  Assistance will be structured as a non‐recourse grant.Payment requirements  Funds will be paid directly to the County Treasurer’s office or applicable third party authorized to coll

check or electronic funds transfer.
OMB Approved No.: 1505‐0269

Expiration Date: 10/31/2021

Association Fees & Lien (AFL) Payment Assistance Term Sheet

Criteria  Terms Brief description  Association Fee & Lien Assistance will allow reinstatement to bring the account current. If fees are pa

premium, payment assistance will make a one‐time payment of one (1) complete annual premium foor liens, condominium association fees, or common charges. This will apply when association and/or that there is a risk of displacement of an eligible homeowner.Homeowner Association liens or fees, Condominium Association liens or fees, or common charges, anunit occupancy agreement by a resident member/shareholder in a cooperative housing development eligible housing cost if there is a risk of displacement of an eligible homeowner.

Maximum amount of assistance per homeowner  Maximum Amount of Assistance is $25,000 per householdHomeowner eligibility criteria and documentation requirements 

Same as General Property Eligibility Criteria Across All Programs plus:Documentation requirements:

 Proof of identity, which may include a photo identification or other means of identification th Deed or Proof of Ownership Proof of Income

 Paystubs, W2s or other wage statements, IRS Form 1099s, tax filings, depository inst

demonstrating regular income, or an attestation from an employer

 Attestation of financial hardship due to COVID‐19. Billing Statement from:

 Homeowner Association Condominium Association Cooperative Housing Development

Loan eligibility criteria specific to the program 

Allow reinstatement to bring the account current.Allow payment assistance of one (1) annual premium for homeowner’s association fees or liens, condcommon charges if arrearages are under one (1) year delinquent.This will apply when association and/or lien fees are delinquent enough that there is a risk of displace

Form of assistance  Assistance will be structured as a non‐recourse grant.Payment requirements  Funds will be paid directly to the Condominium, Homeowner’s Association, Cooperative Housing Dev

party authorized to collect eligible charges via check or electronic transfer.

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of this burden estimate and suggestions for reducing this burden should be directed to the Office of Privacy, Transparency and Records, Department of the Treasury, 1500 Pennsylvania 

DO NOT send the form to this address. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid control nu