Prepurchase Signature


 

Tampa Bay Community Development Corporation d/b/a Suncoast Housing Connections– Disclosure Form NOTE: If you have an impairment, disability, language barrier, or otherwise require an alternative means of completing this form or accessing information about housing counseling, please talk to your housing counselor about arranging alternative accommodations. About Us and Program Purpose: Tampa Bay Community Development Corporation d/b/a Suncoast Housing Connections (SHC) is a nonprofit, HUD - approved housing counseling agency. We provide education workshops and a full spectrum of housing counseling services including pre-purchase, financial management, budget, credit repair, foreclosure prevention and non-delinquency post-purchase counseling. TBCDC, in partnership with Community Service Foundation, builds, rents and sells affordable housing. We serve all clients regardless of income, race, color, religion/creed, sex, national origin, age, family status, disability, or sexual orientation/gender identity. We administer our programs in conformity with local, state, and federal antidiscrimination laws, including the federal Fair Housing Act (42 USC 3600, et seq.). As a housing counseling program participant, please affirm your roles and responsibilities along with the following disclosures and initial, sign, and date the form on the following page. Counselor’s Roles and Responsibilities: • Reviewing your housing goal and your finances; which include your income, debts, assets, and credit history. • Preparing a Client Action Plan that lists the steps that you and your counselor will take in order to achieve your housing goal. • Preparing your household budget that will help you manage your debt, expenses, and savings. • Your Counselor is not responsible for achieving your housing goal, but will provide guidance and education in support of your goal. • Neither your counselor, nor SHC employees, agents, or directors may provide legal advice Client's Role and Responsibilities: • Completing the steps assigned to you in your Client Action Plan. • Providing accurate information about your income debts, expenses, credit, and employment. • Attending meetings, returning calls, providing requested paperwork in a timely manner. • Notifying SHC or your counselor when changing housing goals. • Attending education workshop (i.e. prepurchase counseling workshop) as recommended. • Retaining an attorney if seeking legal advice and/ or representation in matters such as foreclosure or bankruptcy protection. Termination of services: Failure to work cooperatively with your counselor and/ or SHC will result in the discontinuation of counseling services. This includes but is not limited to, missing three consecutive appointments. Agency Conduct: No SHC employee, officer, director, contractor, volunteer, 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 agency’s compliance with federal regulations and our commitment to serving the best interests of our clients. Agency Relationships: SHC has a financial affiliation with HUD, Neighborworks America, Florida Housing Finance Corporation, Pinellas County, Pasco County, The City of Clearwater, The City of Largo, The City of St.Petersburg, and banks including but not limited to Bank of America, Wells Fargo. I agree that SHC may release information about my membership, to the proper officials, in compliance with these contracts. Alternative Services, Programs, and Products & Client Freedom of Choice: You are not obligated to participate or use any programs and/ or services while you are receiving housing counseling from our agency. Your participation in a SHC program does not obligate or require you to use any series or products that may be suggested, offered, or recommended by SHC. You are entitled to choose whatever real estate professionals, lenders, and lending products that best meet your needs. Referrals and Community Resources: If asked for you will be provided a community resource list which outlines the county and regional services available to meet a variety of needs, including utilities assistance, emergency shelter, transitional housing, food bank, and legal aid assistance. This list also identifies alternative agencies that provide services, programs, or products identical to those offered by SHC and its exclusive partners and affiliates. 5 Privacy Policy: I/ We acknowledge that I/ We received a copy of SHC’s Privacy Policy. Errors, Omissions and Disclaimer of Liability: I/We agree SHC, its employees, agents and directors are not liable for any claims and causes of action arising from errors or omissions by such parties, or related to my participation in SHC counseling, and I hereby release and waive all claims of action against SHC and its affiliates. I have read this document, understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. Quality Assurance: In order to asses client satisfaction and in compliance with grant funding requirements, SHC, or one of its partners may contact you during or after the completion of your housing counseling service. You may be requested to complete a survey asking you to evaluate you client experience. You survey data may be confidentially shared with SHC’s grantors such as HUD OR Neigborworks America. Authorization to Release Information: I/we hereby authorize SHC to obtain all information necessary, including a credit report, to assist me/us in an evaluation of our capacity to successfully accomplish, or maintain homeownership I authorize TAMPA BAY COMMUNITY DEVELOPMENT CORP. I understand that depending on the type of service received, the information may be shared with realtors and/or lenders in an effort to determine eligibility for mortgage financing, and develop a plan to correct qualification deficiencies in the pursuit of a mortgage approval. I/we further authorize our first mortgage lender Closing Title Company and/or realtor to provide SHC with copies of any documents from my/our mortgage or real estate file that would assist SHC in the completion of my file. Home Inspection Materials: (Home Buyer Education and/ or Pre-Purchase Counseling Only). By signing below I/ We certify that I/ We received the following materials: “For Your Protection Get a Home Inspection” and “Ten Important Questions to Ask a Home Inspector” Unless seeking services other than Home Buyer Education or Pre-Purchase counseling in which case these materials are not applicable. By Signing below, I/ We acknowledge that I/We received, reviewed and agree to SHC’s Program Disclosures as provided herein.

 

 

 

Leave this empty:

Signature arrow sign here

Signed by Sean McKenna
Signed On: June 10, 2025


Signature Certificate
Document name: Prepurchase Signature
lock iconUnique Document ID: d7e58d4828c09f53a51e488efe83031f1bd840f4
Timestamp Audit
April 5, 2021 11:14 am EDTPrepurchase Signature Uploaded by Sean McKenna - admin@suncoasthousingconnections.org IP 47.202.108.243
April 16, 2021 11:40 am EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
April 16, 2021 11:40 am EDTTheresa Quiroga - theresa@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
April 27, 2021 10:37 am EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
April 27, 2021 10:37 am EDTJennifer Rhodes - jennifer@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
April 29, 2021 11:25 am EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
April 29, 2021 11:25 am EDTJennifer Rhodes - jennifer@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
August 10, 2021 10:12 am EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
August 10, 2021 10:12 am EDTJennifer Rhodes - jennifer@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
August 10, 2021 10:12 am EDTKeisha Hutton - keisha@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 1, 2021 3:41 pm EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 1, 2021 3:41 pm EDTJennifer Rhodes - jennifer@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 1, 2021 3:41 pm EDTKeisha Hutton - keisha@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
December 13, 2021 11:59 am EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
December 13, 2021 11:59 am EDTSean McKenna - sean@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
January 11, 2022 10:43 am EDTRoger Rayburn - roger@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
January 11, 2022 10:43 am EDTSean McKenna - sean@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
January 11, 2022 10:43 am EDTJasmin Ray - jasmin@suncoasthc.org added by Roger Rayburn - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
February 22, 2022 3:48 pm EDTSean McKenna - sean@suncoasthc.org added by Fran Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
February 22, 2022 3:48 pm EDTJasmin Ray - jasmin@suncoasthc.org added by Fran Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
February 22, 2022 3:48 pm EDTRoger Rayburn - roger@suncoasthc.org added by Fran Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:11 am EDTSean McKenna - sean@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:11 am EDTJasmin Ray - jasmin@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:11 am EDTRoger Rayburn - roger@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:27 am EDTRoger Rayburn - roger@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:27 am EDTSean McKenna - sean@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:27 am EDTJasmin Ray - jasmin@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:27 am EDTRoger Rayburn - roger@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:27 am EDTSean McKenna - sean@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 1, 2022 10:27 am EDTJasmin Ray - jasmin@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 11, 2022 11:07 am EDTRoger Rayburn - roger@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 11, 2022 11:07 am EDTSean McKenna - sean@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 11, 2022 11:07 am EDTJasmin Ray - jasmin@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
June 3, 2022 1:26 pm EDTRoger Rayburn - roger@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.205.69.40
June 3, 2022 1:26 pm EDTSean McKenna - sean@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.205.69.40
June 3, 2022 1:26 pm EDTJasmin Ray - jasmin@suncoasthc.org added by Frances Pheeny - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.205.69.40
September 22, 2022 10:41 am EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
September 22, 2022 10:41 am EDTKaren Nunes - karenn@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 3, 2022 1:22 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 3, 2022 1:22 pm EDTKaren Nunes - karenn@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 3, 2022 1:22 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 3, 2022 1:22 pm EDTKaren Nunes - karenn@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 27, 2023 2:53 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 27, 2023 2:53 pm EDTEllen Stoffer - ellen@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
March 28, 2023 1:56 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 131.148.90.2
March 28, 2023 1:56 pm EDTEllen Stoffer - ellen@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 131.148.90.2
August 7, 2023 9:17 am EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 35.140.121.37
August 7, 2023 9:17 am EDTEllen Stoffer - ellen@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 35.140.121.37
August 7, 2023 9:17 am EDTLinda O'Connor - linda@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 35.140.121.37
August 7, 2023 2:21 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 35.140.121.37
August 7, 2023 2:21 pm EDTEllen Stoffer - ellen@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 35.140.121.37
August 7, 2023 2:21 pm EDTLinda O'Connor - linda@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 35.140.121.37
October 23, 2023 11:04 am EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 23, 2023 11:04 am EDTEllen Stoffer - ellen@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
October 23, 2023 11:04 am EDTLinda O'Connor - linda@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 24.129.137.226
December 5, 2024 9:07 am EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.104.99
December 5, 2024 9:07 am EDTHousing Office - housing@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.104.99
May 30, 2025 6:21 am EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
May 30, 2025 6:21 am EDTHousing Office - housing@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 9, 2025 11:41 am EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 9, 2025 11:41 am EDTHousing Office - housing@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 9, 2025 11:41 am EDTHousing Office - suncoasthc@catchspam.com added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 9, 2025 2:49 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 9, 2025 2:49 pm EDTHousing Office - housing@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 10, 2025 5:09 pm EDTSean McKenna - sean@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 10, 2025 5:09 pm EDTHousing Office - housing@suncoasthc.org added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243
June 10, 2025 5:09 pm EDTHousing Officetest - suncoasthc@catchspam.com added by Sean McKenna - admin@suncoasthousingconnections.org as a CC'd Recipient Ip: 47.202.108.243