Deed Restriction Compliance

2024 Ridgway Wetterhorn Compliance Check Form

COMPLIANCE INSTRUCTIONS: PLEASE READ CAREFULLY PRIOR TO COMPLETING THIS FORM.

Reporting Period: Past full 12 months as of the date of compliance form submission.

Step 1. Employment Verification:

W2 Employees: Please have every employer you are currently employed with complete and sign the Employment Verification Form.
Self-Employed Individuals: Please complete and notarize the self-employment statement and provide Client Verification to verify work presence in the Ridgway School District (RSD) R-2. If self-employment is not completed in RSD R-2 the client verification form is not needed.

Step 2. Gather all the required documentation per employment type such as employment verification, most recent year’s taxes, W-2(s), 1099(s), most recent pay stub(s) reporting year-to-date earnings, business license(s), past 12 month profit and loss statement(s))

Step 3. Complete the online compliance form below and upload your documents.

****NOTE: Form progress cannot be saved. Please ensure you have all required materials complete and available prior to submitting the form.

Step 4. Submit the form. If additional information is required after review of your materials we will reach out via email.

If you have any questions please reach out to lottery@impactdf.org

Please enable JavaScript in your browser to complete this form.

UNIT OWNERSHIP

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Owner #1 Name *

First

Last

Owner #1 Email *

Owner #1 Phone *

Owner #2 Name

First

Last

Owner #2 Email

Owner #2 Phone

Deed Restricted Community *

Housing Unit Address *

Address Line 1

City

State

Zip Code

Is your mailing address the same as your Housing Unit Address? *

Mailing address

Address Line 1

City

State

Zip Code

HOUSEHOLD INFORMATION

Provide the name of all other members of the Unit's Household, excluding Tenants. Please provide Name, Age, and Relationship to Owner.

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Occupant Name #1

Occupant Name #2

Occupant Name #3

Relationship to Owner & Age of Occupant #1

Relationship to Owner & Age of Occupant #2

Relationship to Owner & Age of Occupant #3

TENANT DETAIL

Is the property, or part of the property, rented (excluding Household members listed above)? *

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Tenant Name #1

Tenant Name #2

Tenant Name #3

Tenancy Start Date #1

Tenancy Start Date #2

Tenancy Start Date #3

Tenancy End Date #1

Tenancy End Date #2

Tenancy End Date #3

Monthly Rent #1

Monthly Rent #2

Monthly Rent #3

Tenant Email Address(es)

RESIDENCY STANDARD

Number of months Property occupied as primary residence since closing *

Owner #1

Number of months Property occupied as primary residence since closing

Owner #2

Number of months Property occupied as primary residence since closing

Household Member #1

Number of months Property occupied as primary residence since closing

Household Member #2

Number of months Property occupied as primary residence since closing

Household Member #3

PROPERTY OWNERSHIP STANDARD

Does any member of the household have a direct or indirect ownership interest in ANY OTHER property/land within 150 miles of the Deed Restriction Housing Unit? *

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Property Address #1

Address Line 1

City

State

Zip Code

Type of Property #1

(Ex. Residential, Commercial, Vacant Land)

Property Address #2

Address Line 1

City

State

Zip Code

Type of Property #2

(Ex. Residential, Commercial, Vacant Land)

EARNED INCOME STANDARD

Please enter the cumulative gross household income (i.e. the total income for all household members and from all sources) earned over the last 12 months. This includes any income earned from renting the property, but should not include the gross income of a property tenant.

Wages - Total for all employment within Ridgway R-2 School District

Wages - Total for all employment outside Ridgway R-2 School District

Benefits - Total including, but not limited to Social Security, SSI, Workers Comp., Disability, Unemployment, Severance, Annuity, Pension, Retirement, Death Benefits

Alimony and/or child support

Investment and other income - Total including, but not limited to accrued interest; dividends from bonds, stocks and mutual funds; trust fund disbursements

Rental property income

Monetary gifts

Any other sources of income?

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Other Income Amount

Source of Other Income

Total Gross Household Income *

HOUSEHOLD GROSS ASSETS

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Cash / Cash Equivalents:

Other Liquid Income?

Cash on Hand

Money Market Funds

Checking Account

Other Income

Savings Account

Source of Other Income

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Real Estate:

Residential (including your home)

Land

Other

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Investments:

Other Investment?

Certificates of Deposit

Annuities

Mutual Funds

Stocks

Retirement Funds

Other Investment

Bonds

Funds in Names of Dependents

Source of Other Investment

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Personal Property:

Automobiles

Appliances / Furniture

Recreation Vehicles / Boats

Collections

Home Furnishings

Jewelry

Business Assets (if applicable)

Total Household Gross Assets *

HOUSEHOLD GROSS LIABILITIES

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Current Debts:

Other Debt?

Business Expenses Owed

Store Accounts Balances

Rent for Storage/Office Space Owed

Medical Expenses Owed

Legal Expenses Owed

Other Debt

Credit Card Balance(s)

Taxes Owed

Source of Other Debt

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Outstanding Loans:

Other loans?

Bank / Finance Company Loan

Education Loan

Business Loan

Automobile Loan

Life Insurance Loan

Other Loan

Recreational Vehicle / Boat Loan

Personal (Family/Friends) Loan

Type of Other Loan

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Current Mortgage Balance

Residential

Land

Other

Total Household Liabilities

HOUSEHOLD NET ASSET

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Total Assets

Total Liabilities

Net Assets

Document Uploads

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W2 Employees:

Upload one complete verification form and most recent W2 from each source of employment during the reporting period.

Employment Verification(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Most Recent W2(s)

Click or drag files to this area to upload. You can upload up to 10 files.

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Self-Employed:

Upload one current business license, prior 12 month profit and loss statement, verification of hours worked in the Ridgway R-2 school district (such as invoices, ledgers, etc.) and client verification of income and hours from each source of self-employment.

Current Business License(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Self Employment Statement(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Client Verification of Income and Hours Form(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Profit and Loss Statement(s) for the Reporting Period

Click or drag files to this area to upload. You can upload up to 10 files.

Verification of Hours Worked in the Ridgway R-2 School District

Click or drag files to this area to upload. You can upload up to 10 files.

Additional Supporting Documentation

Click or drag files to this area to upload. You can upload up to 10 files.

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Tenant(s)

Upload all pages of the current, signed lease/rental agreement.

Current, Signed Lease Agreement

Click or drag files to this area to upload. You can upload up to 5 files.

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All Owners/Tenants

PLEASE REDACT SOCIAL SECURITY NUMBERS. At the minimum please provide Form 1040 if no other schedules/forms are required to file. Self-employed individuals must upload appropriate business schedules (Schedule C, Schedule 1, etc.) as well as Federal business taxes (Form 1065, 1120, 1120s, Schedule K, etc.)

Most Recent Filed Federal Tax Returns with all pages, schedules, and forms

Click or drag files to this area to upload. You can upload up to 10 files.

Attestation *

I/We confirm understanding of the current Deed Restriction Community Regulations and Guidelines regarding Continuing Household Qualification and Compliance Verification

Signature Owner/Tenant #1 *

*By electronically signing this form you confirm your adherence to the Deed Restriction Regulations and Guidelines and attest the information provided on this form is true and accurate.

Signature Owner/Tenant #2

*By electronically signing this form you confirm your adherence to the Deed Restriction Regulations and Guidelines and attest the information provided on this form is true and accurate.

Phone

Compliance Form

Deed Restriction Compliance

2024 Ridgway Wetterhorn Compliance Check Form

If you have any questions please reach out to lottery@impactdf.org

UNIT OWNERSHIP

HOUSEHOLD INFORMATION

TENANT DETAIL

RESIDENCY STANDARD

PROPERTY OWNERSHIP STANDARD

EARNED INCOME STANDARD

HOUSEHOLD GROSS ASSETS

Cash / Cash Equivalents:

Real Estate:

Investments:

Personal Property:

HOUSEHOLD GROSS LIABILITIES

Current Debts:

Outstanding Loans:

Current Mortgage Balance

HOUSEHOLD NET ASSET

Document Uploads

W2 Employees:

Self-Employed:

Tenant(s)

All Owners/Tenants

ADDRESS

PHONE

EMAIL