Name
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First Name
Last Name
Email
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Phone
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date of Birth
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Country of Origin
Can we text you?
Yes
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Wealth Building
What financial services are you interested in?
One-on-one Financial Coaching
Small Business Development
Credit Repair / Counseling
Buying a Home
All Programs
Culturally-Based Programs
New American (I was born outside of the United States, or my parents were born outside of the United States.)
Southeast Asian Community (I identify as a member of at least one of the following cultural groups: • Hmong • Lao • Vietnamese • Karen/ Karenni • Burmese • Filipino • Cambodian.)
Afghan Evacuees (I immigrated to the US from Afghanistan after July 31, 2021.)
Any Additional Information/Questions
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Disclosure Statement
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CAPI USA understands the purpose of the housing counseling program is to provide one-on-one counseling to help clients qualify for affordable rentals and mortgages. Therefore, the counselor will analyze my/our credit and financial situation, identify barriers preventing me/us from obtaining a rental unit or a mortgage and develop a plan to help remove those barriers. The counselor will also assist with the preparation of a budget.
I/We understand that the counselor will guide us through the process by providing professional insight and education, but it will not be the counselor’s responsibility to fix the problems.
I/We understand that the counseling agency provides counseling assistance to clients who can resolve their housing issues in 24 months or less. I/We understand that if my/our housing issue is expected to take longer, I/We will be referred to another agency.
I/We understand that I/We will be required to attend group workshops as well as individual counseling sessions.
I/We understand that it is my/our responsibility to work in conjunction with the counseling agency and that if I/We fail to cooperate, I/We can be asked to discontinue the program. This includes but is not limited to missing 2 or more consecutive appointments.
I/We understand that I/We are not obligated to receive any services by this agency or its exclusive partners. As a condition of our services, and in alignment with meeting our counseling goals, and in compliance with HUD’s Housing Counseling Program requirements, we may provide your information to HUD and other applicable third parties.
Financial Management, Budget Counseling
This session will include reviewing and discussing topics such as budgeting, income, expenses and assets, savings, affordability, setting financial goal/s, understanding credit scores & reports, and the impotence of building credit, etc. This counseling will be included in each one-on-one counseling program, and it will typically last for one-two hours. Counselor and client will review credit reports, determine financial goals, and create a custom action plan.
Pre-Purchase Counseling
This session will typically include the Financial Management/Credit Counseling and reviewing and discussing the mortgage readiness; taking a group homebuyer education class, shopping for a mortgage, sources of down payment and closing costs, and Fair Housing Law. The HUD Home Inspection Guide link will be provided if the client has not attended a group education yet. This session will typically last for one-two hours. Counselor and client will discuss the home buying process, mortgage readiness, mortgage products, and fair lending/housing laws.
Assists individuals in developing a personalized plan that explores options and resources to achieve homeownership. We review all aspects of purchasing a home as well as reviewing their budget, debt, and credit reports.
Pre-Purchase Homebuyer Education Workshops
8-hour homebuyer education workshops are conducted by CAPI USA staff and topic experts covering the following topics: the steps to becoming a Homeowner, what toprepare financially and affordable monthly housing payments, the importance of credit,and how it affects homeownership, the basics of mortgage loans, comparison and the loan application process, the importance of having a home inspection, and the responsibilities of homeownership. The link to HUD Home Inspection Guide is provided at this group session. Each client has access to a one-on-one counseling session. Housing counselors will make reasonable efforts to conduct a verbal (via phone and email) follow-up session 15,30,60 days after the class and encourage the client to get a one-on-one session.
By signing below (typing in your first and last name), you agree that you understand the terms described above; please indicate your approval with your signature:
First Name
Last Name
Date
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Combined Privacy Act Notice and Tennessen Warning
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We at CAPI USA 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 state, federal government agencies and local agencies:
Financial Coaching/Financial Wellness Counseling;
Homeownership Capacity;
Homebuyer Education;
Homebuyer Counseling;
Home Equity Conversion Mortgage Counseling or Reverse Mortgage Counseling;
Post Purchase and/or Refinance Counseling;
Foreclosure Counseling.
These agencies receive the information described below.
Social Security Numbers
The Privacy Act of 1974 makes it unlawful for any Federal, State, or local government agency to deny your participation in the above referenced programs if you refuse to provide your social security number. If you do not voluntarily provide your social security number services to you may be more limited, but you will continue to be eligible to receive the services we can provide without a social security number.
Other Private Data
Under Minnesota Statutes, your name and address may be 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 above referenced programs. 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 data for the purposes of service delivery, program management, compliance, monitoring, research, and program evaluation.
We collect your private information from the following sources:
Information we receive from you on applications or other forms,
Information about your transactions with us, and
Information we receive from a consumer credit reporting agency.
We may disclose private information about you which may include your name, address, social security number, employer, assets, debts, income, credit bureau reports, your credit history and your creditworthiness.
We may disclose your private information to the following entities or their representatives identified
below or to other entities properly authorized under law to review it:
Staff at this organization and its partners operating in this program who need it to work on your
case;
Staff of the HECAT funders: Minnesota Housing Finance Agency, Family Housing Fund, Greater
Minnesota Housing Fund, and the Minnesota Homeownership Center;
Staff of the United States Department of Housing and Urban Development (HUD);
Staff of the Homeownership Capacity funder: Minnesota Housing Finance Agency.
By signing below (typing in your first and last name), you agree to allow us to collect and share information as described above; please indicate your approval with your signature:
First Name
Last Name
Date
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Credit Reporting Authorization
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In connection with my request to receive Financial Services and housing counseling and my pursuit to (a) evaluate my financial readiness to purchase real property and/or obtain a mortgage loan, and/or (b) receive mortgage delinquency counseling and/or post-purchase and refinance counseling, and (c) rental counseling, and (d) for review purposes lasting up to 5 years from the date of the initial counseling session, I (we)… Please indicate whether or not you authorize a credit check by selecting one of the checkboxes below:
I Authorize CAPI to obtain a copy of my/our credit report
I DO NOT Authorize CAPI to obtain a copy of my/our credit report
Credit Report Privacy Choice
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CAPI USA may share your credit report and any information you have provided, including any computations and assessments based upon such information, with potential mortgage lenders, governmental agencies, and/or other non-profit agencies. If authorized, these lenders may contact you to discuss loans for which you may be eligible, and these non-profit and governmental agencies may contact you for program evaluation purposes or to offer other services. You may revoke consent to these disclosures at any time by notifying CAPI USA Financial Services & Homeownership Program in writing.
Please indicate your choice:
I Authorize
I DO NOT Authorize
FINANCIAL CAPABILITY – HOUSING COUNSELING PROGRAM CLIENT AGREEMENT/DISCLOSURE
About Us and Program Purpose
CAPI USA is a non-profit that serves immigrant refugee and U.S.-born communities in the local Twin Cities metro. We serve all clients regardless of income, race, color, religion/creed, sex, national origin, age, familial status, marital status, disability status, public assistance, sexual orientation, or gender identity. We administer our programs in conformity with local, state, and federal anti-discrimination laws, including the Federal Fair Housing Act (42 USC 3600, et sew.), title VIII of the Civil Rights Act, and the Human Rights Act.
Financial Capability / Housing Counseling Agreement
CAPI USA is pleased to offer our programs and services to help your current finance and housing needs. By participating in our Financial Services, Homeownership, and Education program, you are agreeing to receive counseling, education, information, and application assistance, including computations, assessments, and procurement of services, in connection with your pursuit of (a) a home purchase, (b) credit and asset building (c) budgeting or (d) preventing a home foreclosure. While you are welcome and encouraged to do so, you are not obligated to participate in our home partner services, grant programs, or other services. CAPI USA is also not obligated to enroll you in any other program because of your participation in any homeownership education program. Each CAPI USA program is administered separately, and you should seek application information about your program of interest.
Funding Sources
CAPI USA receives/will receive grants from Federal government agencies, including the Department of Housing and Urban Development (HUD), State and Local government agencies, National Intermediaries, Financial Institutes, foundations, non-profits, and individual Donors. CAPI USA currently does not have a “fees for services” arrangement with any lending institution.
Non- Discrimination Policy
We at CAPI USA not and shall not discriminate based on race, creed, color, religion, gender, age, national origin, physical or mental health, sexual orientation, or any characteristic protected by the law, and is following all requirements of law and regulations concerning the provision of services, employment decisions, and volunteer participation.
Organization Conduct
No CAPI USA employee, director, volunteer, contractor, or agent shall undertake any action that might result in, or create the appearance of, administering counseling operations for personal or private gain, provide preferential treatment for any person or organization, or engage in conduct that will compromise our organization’s compliance with federal, state, or local regulations and our commitment to serving the best interests of our clients.
Organization Relationships
CAPI USA has a financial or professional affiliation with the Minnesota Housing Finance Agency, Minnesota Homeownership Center, National Coalition of Asian Pacific American Community Development (CAPACD), United Way, and banks, including Wells Fargo Home Mortgage.
Alternative Services, Programs, Products, and Referral Service Disclosure
CAPI USA, as appropriate, refers clients to other community service organizations. These organizations provide emergency shelter, financial assistance, utility assistance, and access to other locally available resources. While you may learn about the advantages/disadvantages of specific services, programs, and products during the education or
Financial Capability & Housing Counseling Program
counseling sessions, you are free to choose the services, programs, and products of your choosing regardless of the recommendations made by the educator/counselor. As a client of CAPI USA, you can utilize the services of licensed real estate brokers, lenders, attorneys, and other service experts on our referral lists. However, you are not obligated to receive, purchase, or utilize any services that CAPI USA or its partners offer or refer to. It is your responsibility, and based on decisions of your own free will to determine which services, programs, or products best meet your needs. From time to time, CAPI USA does receive grants or donations from various institutions to provide free services to the public. However, CAPI USA does not endorse or recommend any institutions. CAPI USA offers a list of services to inform clients and provide starting points for clients that may need it.
CLIENT PRIVACY POLICY DISCLOSURE AND TENNESSEN WARNING
We at CAPI USA value your trust and are committed to the responsible management, use, and protection of personal information. This notice describes our policy regarding collecting and disclosing personal information and our policies regarding conflict of interest. As used in this notice, personal information is information that identifies an individual personally and is not publicly available. It includes personal financial information such as credit history, income, employment history, financial assets, bank account information, and financial debts. It also includes your social security number and other information you have provided us on any applications or forms you have completed. The following programs are funded by Minnesota State entities Minnesota Homeownership Center (MN HOC) and Minnesota Housing, City of Minneapolis, Old National Bank, Wells Fargo, Bank of America, National CAPACD, and private foundations such as Target Foundations, United Way, and Allianz.
Financial Coaching/ Financial Wellness Counseling.
Homebuyer education.
Pre-purchase Counseling.
Information We Collect
We collect personal information to
learn about your current finance issue, including obtaining demographic information, the reason for financial difficulty and situation, housing objective, credit status, home value, and loan documentation,
support our financial counseling, assessing your financial capacity to meet your monthly obligations,
assist in qualification for our affordable home development projects
perform a mortgage affordability assessment.
assist you in shopping for and obtaining a home mortgage from a lender.
We collect personal information about you from the following sources:
Information we receive from you on applications or other forms,
Information we receive from a consumer credit reporting agencies,
Information we receive from independent third parties authorized by you to provide us with your information.
Information We Disclose
We may disclose the following kinds of personal information about you:
Information we receive from you on applications or other forms, such as your name, address, social security number, employer, occupation, assets, debts, and income.
Information we receive from consumer credit reporting agencies, such as your credit reports, credit history, and creditworthiness.
To Whom Do We Disclose
We may disclose your personal information to the following types of unaffiliated third parties:
Financial service providers, such as companies engaged in providing a home mortgage or home equity loans, and other nonprofit and governmental organizations involved in community development, but only for program review auditing, research, and oversight purposes.
We may also disclose personal information about you to third parties as permitted by law.
Before sharing personal information with unaffiliated third parties, except as described in this policy, we will allow you to direct that such information not be disclosed. If you want to opt out, that is to require us not to make disclosures about your personal information (other than disclosures permitted by law) as described in this notice.
Confidentiality and Security
We restrict access to personal information about you to those of our employees who need to know that information to provide products and services to you and to help them do their jobs, including making loan decisions, aiding you in obtaining loans from others, and financial counseling. We maintain physical and electronic security procedures to safeguard the confidentiality and integrity of personal information in our possession and guard against unauthorized access. We used locked files, user authentication, and detection software to protect your information. Our safeguards comply with federal regulations to guard your personal information.
Social Security Numbers
The Privacy Act of 1974 makes it unlawful for any Federal, State, or local government agency to deny your participation in the above-referenced programs if you refuse to provide your social security number. Suppose you do not voluntarily provide your social security number. In that case, your services may be more limited, but you will continue to be eligible to receive the services we can provide without a social security number.
Other Private Data
Under Minnesota Statutes, your name and address may be public data. All other data we may ask about you is private data on individuals. Agreeing to share your shared data is mandatory for participation in the referenced programs. Sharing your data is not compulsory for participation in the program. However, your services may be more limited if you do not provide private information (income, debts, and assets). We collect personal data for service delivery, program management, compliance, monitoring, research, and program evaluation.
Quality Assurance
To assess client satisfaction and comply with grant funding requirements, CAPI USA or one of its partners may contact you during or after completing your counseling service. You may be requested to complete a survey asking you to evaluate your client experience. Your survey data may be confidentially shared with CAPI USA funders HUD, the Minnesota Homeownership Center, Minnesota Housing Finance Agency, Twin Cities LISC FOC, HECAT, NATIONAL CAPACD, and or other Grantors.
Privacy Choices
If you want to opt-out, that is to direct us not to make disclosures about your personal information (other than disclosures permitted by law or by counseling agreement) as described in this notice, check the box below to indicate your privacy choices. This authorization is effective immediately.
Limit disclosure of personal information about me to unaffiliated third parties except nonprofit organizations involved in my case or government entities that required my information and the referred agency/company that I agreed to
Limit disclosure of personal information about me to unaffiliated third parties except nonprofit organizations involved in my case or government entities that required my information and the referred agency/company that I agreed to.
Financial Capability & Housing Counseling Program Acknowledgement
I/We understand that CAPI USA provides information and education on numerous loan products and housing programs. I/We further understand that the finance/housing counseling I/we receive from CAPI USA in no way obligates me/us to choose any of these particular loan products or housing programs.
Homeownership Advisor Roles & Responsibilities
Providing services confidentially, honestly, and respectfully.
Reviewing your housing goal and finances, including income, debts, assets, and credit history.
In partnership with you, develop a household budget to assist you with managing your debt, expenses, and savings.
In partnership with you, create a client action plan with steps that you and your Financial Coach/Homeownership Advisor will take to achieve your housing goal.
Presenting reasonable options available based on your current situation.
Offering referrals to needed resources. However, you are under no obligation to utilize the provided resources.
Providing guidance and education in support of your goal.
Neither your Financial Coach/Homeownership Advisor nor CAPI USA, employees, agents, contractors, or directors may provide legal advice.
Client Roles & Responsibilities
Providing accurate information about your income, debts, expenses, credit, and employment.
Attending meetings, returning calls, and promptly providing requested paperwork.
Being an active participant in creating and completing steps on your Action Plan.
Notifying CAPI USA or your Financial Coach/Homeownership Advisor if your housing situation or goal changes.
Attending educational workshops (i.e., Homebuyer Education) as recommended.
Retaining an attorney if seeking legal advice and representation in matters such as foreclosure or bankruptcy protection.
Termination Of Servicers
You or the advisor may terminate counseling services at any time. Reasons the advisor may terminate services include, but are not limited to, no progress on the agreed-upon Action Plan steps, not responding to an advisor’s attempt to contact you, or missing scheduled appointments.
By signing below (by typing your first and last name), I/We agree to allow CAPI USA to collect and share information as described above.
First Name
Last Name