• Section 2 Project Data (for phased projects, data entered in this section must be totals for entire project)

Estimated total cost: Estimated total rehabilitation costs (QRE):

Number of buildings in project: Floor area before/after rehabilitation Start date (estimated): Completion date (estimated): Application includes phase(s) Use before/after rehabilitation: / # of dwelling units before/after rehabilitation: / # of low-moderate income dwelling units before/after rehabilitation: /

• of low-moderate income dwelling units before/after rehabilitation:

/

7. Application category and fee

Select one category: Total estimated fee: Due with Initial Application: Qualified residence I attest that I own and occupy, or will occupy within two years, the subject qualified residence, and that my modified adjusted gross income is $200,000 or less. Qualified rehabilitation expenditure under $1,000,000 Qualified rehabilitation expenditure $1,000,000 or more

Total estimated fee: Due with Initial Application:

8. 25% Bonus Criteria

Select which criteria are used to qualify for a 25% bonus credit. Qualification requirements are in the Instructions.

Federal surplus property obtained through local agency under Government Code 54142

Surplus state real property defined by Government Code 11011.1 Transit-oriented development

Surplus land defined by Government Code 54221(b) Affordable housing for lower income households Designated census tract defined by Government Code Military base reuse authority as per Government Code 17053.73(b)(7) Title 7.86

9. Section 3 Applicant Tax Identification Number:

Applicant from number 3 above tax ID:

TIN