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V.04-20-09 v.3 0 <br /> Electronic Aoplication <br /> E. Maximum Allowable Return on Gquity <br /> (15%of owner cash,Line VII.A2,plus I S%of syndication proceeds Line VII.A.3, <br /> plus 1.5%of(TMC,Line VI.D.,minus Developer Fee,Line VI.C.2.e.)) $1,117,135 <br /> F. Other Conditions: <br /> G.Regulatory Cost Avoidance/Cost Reduction <br /> 1.Regulatory Incentive-The following worksheet must be completed <br /> foreach projectthatincludes Reoulatorylncentives <br /> which reduce the cost of producing affordable housing. <br /> Incentive Cost Savings Total Cost <br /> Per Unit Savin s <br /> 2.Local Contributions-Value of donations that do not appear as a Cunding source. Sources must be <br /> listed below for inclusion in HTC scoring for L,ocal Contributions.Includes land donation,in-kind <br /> contributions and donations of labor,materials,serviccs,etc. <br /> Source Contact Type Value of <br /> Donation <br /> VIIL AFFIRMATIVE ACTION REQUIREMENT <br /> The Minnesota Human Ri�hts Act states that any person or organizalion having 40 or more employees in the last 12 months in[he Statc <br /> of Minnesota and involved in any transaction of$100,000 or more with state agency must have Affimiative Action Plan approved by the <br /> State Department of Human Rights. Therefore, no applications for$]00,000 or more will be accepted unless they include eidier: <br /> A. A Certificate of Compliance from the State Deparmient of Human Rights(For information call 651-296-5663) <br /> (for organizations with 40 or more employees);or <br /> B. A uotarized statement stating that the applying organization has had less than 40 employees in the State <br /> of Minnesota in the last 12 mondis. <br /> C. Provide inforniation on how you intend to make opportunities available for women-owned or minority- <br /> owned business enterprises. <br /> This application is submitted by the undersio ed widi the full knowledge and consen[of the governing body and is accurate in all details,to <br /> die undersigned's best knowled�e. <br /> Signature Dale <br /> The Minnesota Housing Finance Agency does not discriminate on the basis of race,color,national origin,sex,religion,age,or disabiliry <br /> in employment or die provision of services. <br /> Equal Opportunity Housing and Equal Oppor[unity Emplo}ment <br /> Comments <br /> Email the completed Minnesota Multifamily Rental Housing Common Application Form <br /> to MHFA at mhfa.app@state.mn.us. <br /> The MHFA will accept only one copy of the completed final Application Form. Do not <br /> IF YOU ARE NOT REQUESTING TAX CREDITS send incomplete or preliminary Application Forms. <br /> STOP AT THIS POINT. The Application Form that is e-mailed to the MHFA must be identical to the original <br /> signed Application Form submitted to the MHFA. <br /> Minnesota Multifamily Rental Housing Common Application forms will not be accepted <br /> after 5:00 pm on the application submission date. <br /> MHFA Application Form RFP/HTC1 10 4/22/2010 4:28 PM <br />