CDFI 0007 CDE Institutional Level Report

CDFI Program and NMTC Program Annual Report including CIIS

Blank 2012 CDE ILR

CDFI Program and NMTC Program Annual Report including CIIS

OMB: 1559-0027

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CDE Institution Level Report (2012)
I.
A.

ORGANIZATIONAL INFORMATION
BASIC INFORMATION
Date of Organization's Fiscal Year End

-2012

Organization Type
Organizational Structure
Year of Organization's Incorporation
Year Organization Began Financing Activities
Street Address
City
State
Zip
Website Address (if available)
1

Name of Person Responsible for Completing the ILR

2

Telephone Number of Person Responsible

() - Ext:

(including Extension if applicable)

3

E-mail Address of Person Responsible
B.

ORGANIZATIONAL STRUCTURE / AFFILIATION

4

Is the Organization a "Faith-Based" Organization?

5

Did any QLICIs Made During the Reporting Period Finance or Provide Services to any
Religious Institution(s) or Faith-Based Organization(s)?

6

Has or Does the Organization Intend to Use Any Other Tax Credit Programs in
Conjunction With Its NMTC Program Strategy?
* Historic Tax Credit
* Empowerment Zone, Enterprise Community or Renewal Community Tax Credits
* Other Federal Tax Credit Program
-- Name of Other Federal Tax Credit Program (if yes above)
* State Tax Credit Program
-- Name of Other State Tax Credit Program (if yes above)
* Local Tax Credit Program

Page: 1

CDE Institution Level Report (2012)
I.
C.
7

ORGANIZATIONAL INFORMATION
GEOGRAPHIES FINANCED DURING THE REPORTING PERIOD
Which of the Following Geographic Areas were Financed by the Allocatee's QEI Proceeds During the Reporting
Period?
* Appalachia
* Colonias
* Hot Zones
* Lower Mississippi Delta
* Native American Areas
* Rural Areas
* Major Urban Area
* Minor Urban Area

D.

HUMAN RESOURCES DEDICATED TO THE ALLOCATEE'S NMTC PROGRAM
Total Staff and Consultant Activity Breakout

8

FTEs Dedicated to Lending/Investing

9

FTEs Dedicated to FCOS

10

FTEs Dedicated to Administration and Other Activities

11

Total FTEs

12

Consultant/Contractor FTEs

Staff and Consultants

=

II. FINANCIAL POSITION
A. LENDING/INVESTING POOL
13 QEI Distribution Table
Please Check Here to Confirm That the Table Below is Complete

14

Non-QEI Investment Capital Table

15
16

Investment Capital Summary Table

B.
17
C.
18
D.

Off-Balance Sheet Resources Committed to the Organization for NMTC-Related
Lending/Investing.

$

ADDITIONAL FUNDS LEVERAGED BY THE ORGANIZATION
Additional Funds the Organization Was Able to Attract Because of Its QEIs.

$

QLICI COMMITMENTS
Total Financing Committed for QLICIs (Except FCOS) at Reporting Period End

$

REPORTING PERIOD SUMMARY FINANCIAL INFORMATION
Please Check Here to Confirm That the Table Below is Complete

19

Non-QEI Contributions for Operating Expenses Table

Page: 2

CDE Institution Level Report (2012)
III.

LOAN PURCHASES
Please Check Here to Confirm That the Table Below is Complete

20

Loan Purchase Table
Sector Breakout for All Loans Purchased During the Reporting Period
Total Amount and Number from the Loan Purchase Table

21

22

IV.

$

Sector Breakout for all Loans Purchased
Real Estate Business
Non-Real Estate Business
Other/Unknown Loans
Totals

$ Paid

# Loans

=

=

Did the Organization Require Each of the CDEs from which it Purchased Loans to Reinvest
at least the Designated Percent of the Proceeds (the Percentage Indicated in the Allocation
Agreement) of Such Loan Sales in the Form of QLICIs?
FINANCIAL COUNSELING AND OTHER SERVICES (FCOS)
Please Check Here to Confirm That the Table Below is Complete

23

QEI Used for FCOS Table
FCOS Provided Using QEI Funds

24
25

Entrepreneurs and Businesses Receiving Group-Based Training
Entrepreneurs and Businesses Receiving One-on-One Technical Assistance

26

Amount of Non-QEIs Used for FCOS, If Any
FCOS Provided Using Non-QEI Funds

27
28
V.
29

Number of Clients

Hours
Provided

Number of Clients

Hours
Provided

$

Entrepreneurs and Businesses Receiving Group-Based Training
Entrepreneurs and Businesses Receiving One-on-One Technical Assistance
BETTER RATES & TERMS
What is the Allocatee's Comparable for Determining Better Rates & Terms?
* CDE's Non-NMTC transaction
* CDE's Parent/Affiliate
* Banks

30

* Other
Allocatees Comparable Comments

Page: 3

CDE Institution Level Report (2012)
VI.
31
32
VII.
33
34
35

IMPACTS
Lending/Investing with Other CDEs
Lending/Investing with Certified CDFIs
DATA COLLECTION SYSTEMS
Loan Portfolio Software
Other
Borrower Characteristics Software
Other
Community Development Impact Software
Other

VIII. CREDIT REPORTING AGENCIES USED
36

Credit Scores

37

Reporting Agency
* Equifax
* Experian
* TransUnion

IX.

ILR FEEDBACK

38

Success Story

39

Comments

Page: 4

CDE Institution Level Report (2012)
X.

IRS COMPLIANCE QUESTIONS

1

For each Qualified Equity Investment received during the fiscal year have you notified the investor
that their investment qualifies for the New Markets Tax Credit?

2

At any time during the fiscal year did the total dollar amount of QEIs received exceed the amount of
the NMTC allocation awarded by the CDFI Fund?
a. If yes, what was the amount of QEIs received that exceeded the amount authorized in
the Allocation Agreement?

3

$

During the fiscal year was there a recapture event, as described in 26 CFR section 1.45D-1T(e)(2)
that was not corrected in accordance with the IRS regulations?
Please Check Here to Confirm That the Table Below is Complete

a. If yes, complete the following chart for each QEI subject to recapture.
4

For QLICIs made during the fiscal year, was each QLICI made within 12 months of originally
receiving the QEI in accordance with the IRS regulations including allowable corrections?
a. If no, what was the aggregate dollar amount of QLICIs not made within the required
timeframe?

5

Did you receive any principal repayments on a QLICI (equity or debt), for which these amounts
were not reinvested that resulted in the organization failing the substantially-all requirement?
a. If yes, what was the aggregate dollar amount of QLICI repayments not reinvested
within the required timeframe?

6

$

$

For any QLICIs that you made during the fiscal year to Qualified Active Low-Income Community
Businesses, did the businesses qualify as QALICBs (per 26 CFR section 1.45D-1T(d)(4)) at the
time of the initial investment?
a. If NO, please describe below.

7

If you invested in or lent to other CDEs, did you ensure that these entities:
a. Were in fact certified as CDEs by the CDFI Fund?
b. Invested the funds received into eligible QALICBs?

8

If you purchased loans from other CDEs, did those loans meet the loan purchasing criteria (per 26
CFR section 1.45D-1T(d)(1)(ii))?

9

Did you establish reserves in accordance with 26 CFR section 1.45D-1T(d)(3)?
a. If yes, what was the aggregate amount of reserves established?

10

$

Did you use the direct tracing or safe harbor method for determining substantially all?
Please Check Here to Confirm That the Table Below is Complete

IRS Question 10 Table
11

Please use the narrative box below to provide any further information regarding your responses to Question 1-10
of this IRS compliance survey:

Page: 5

CDE Institution Level Report (2012)
CERTIFICATION STATEMENT
Prior to the CDFI Fund accepting the data submitted by an Awardee/Allocatee, the user must certify, on behalf of the organization,
to the following:

CIIS DATA SUBMISSION
1

The person(s) entering the data and making these certifications has been authorized, by the organization for which the data
is input, to enter the data and make the certifications.

2

The institution-level and transaction-level data to be submitted to the CDFI Fund through CIIS is true, accurate, and
complete, and accurately represents the activities and/or performance of the organization for which data is input.

ASSURANCES
1

If the Awardee received a 2003 or 2004 Native American Technical Assistance (NATA), Native American CDFI
Development (NACD) award, or Native American CDFI Assistance (NACA) award, 50 percent or more of the Awardee's or
the Awardee's Partner's activities primarily serve Native American, Alaska Native and/or Native Hawaiian communities.

2

If the Awardee has received an award from the CDFI Fund, none of the proceeds of said award has been used to engage in
the lobbying of the Federal Government or in litigation against the United States unless authorized under existing law.

3

If the organization has transferred any portion of its NMTC allocation authority to a subsidiary Allocatee and said subsidiary
Allocatee has issued a Qualified Equity Investment (QEI), the Allocatee hereby certifies that said subsidiary Allocatee has
obtained an unqualified opinion on its most recently completed audited financial statement. The certification applies to the
year in which the subsidiary Allocatee issued the QEI and each year thereafter until termination of the Allocation
Agreement.

REPRESENTATIONS AND WARRANTIES
The Awardee/Allocatee hereby represents and warrants to the CDFI Fund the following, as applicable:
1

Organization, Standing and Powers. The Awardee is a validly existing Tribal Government or Alaska Native Village
Government, or an entity validly existing and in good standing under federal law or the laws of the state or Tribe of its legal
formation, and has all requisite power and authority to own and operate its assets and properties, to carry on its business as
it is now being conducted and to carry out its proposed, hereby authorized use(s) of the Assistance provided pursuant to an
Assistance Agreement.

2

Qualification. The Awardee is duly qualified, in good standing and authorized to transact business in each jurisdiction where
the conduct of the Awardee's business, the carrying out of its authorized use(s) of the Assistance or the ownership of its
assets and properties requires such qualification, or, if not so qualified, the Awardee's failure to so qualify shall not have a
material adverse effect on the Awardee, its financial condition or operations and will not impair the Awardee's ability to carry
out its authorized use(s) of the Assistance or its right to enforce any material agreement to which it is a party.

3

Litigation. The Awardee has neither actual nor constructive knowledge of any suit, action, proceeding or investigation
pending or threatened that questions the validity of the Assistance Agreement including, but not limited to, the carrying out
of the authorized use(s) of the Assistance.

4

Disclosure. Neither the Assistance Agreement nor any attachment thereto, nor any certification or other document
referenced or incorporated therein and furnished to the CDFI Fund by the Awardee contains any untrue statement of a
material fact or omits to state a material fact necessary in order to make the statements contained herein or therein, in light
of the circumstances under which they were made, not misleading. The Awardee has disclosed, in writing, to the CDFI
Fund all facts that might reasonably be expected to result in a material adverse effect upon the Awardee_s ability either to
conduct its principal business or to carry out its authorized use of the Assistance. The Awardee has not knowingly and
willfully made or used a document or writing containing any false, fictitious or fraudulent statement or entry as part of its
correspondence or communication with the CDFI Fund. The Awardee acknowledges, under 18 U.S.C. section 1001, that if
it knowingly and willfully makes or uses such document or writing it or its employee(s) or agents shall be fined or imprisoned
for not more than five years, or both.

Page: 6

CDE Institution Level Report (2012)
E
CERTIFICATION STATEMENT
REPRESENTATIONS AND WARRANTIES
5

Taxes; Debts; Bankruptcy. The Awardee is not delinquent on any debts owed to Federal, State, local or Tribal governments
including, but not limited to, amounts due under the Internal Revenue Code, and has never filed for bankruptcy nor had a
conservator appointed. The Awardee has neither actual nor constructive knowledge of any pending or anticipated
bankruptcy filings or conservatorship appointments on its behalf.

6

Debarment, Suspension and Other Responsibility Matters. Pursuant to 31 C.F.R. 19.335, neither the Awardee nor any of its
principals (as defined by 31 C.F.R. 19.995): (a) are presently excluded or disqualified from covered transactions by any
Federal department or agency; (b) within the three-year period preceding the date of the Assistance Agreement, have been
convicted of or had a civil judgment rendered against them for any of the offenses listed in 31 C.F.R. 19.800(a); (c) are
presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with
commission of any of the offenses listed in 31 C.F.R. 19.800(a); or (d) within the three-year period preceding the date of the
Assistance Agreement, have had one or more public transactions (Federal, State, or local) terminated for cause or default.

COVENANTS AND AGREEMENTS OF THE AWARDEE
Until the termination of the Assistance Agreement, the Awardee shall duly perform and observe each and all of the following
covenants and agreements:
1

Compliance with Government Requirements. In carrying out its responsibilities pursuant to the Assistance Agreement, the
Awardee shall comply with all applicable Federal, State, local and Tribal laws, regulations, ordinances, Office of
Management and Budget (OMB) Circulars, and Executive Orders.

2

Fraud, Waste and Abuse. If the Awardee becomes aware at any time of the existence or apparent existence of fraud, waste
or abuse of Assistance provided pursuant to the Assistance Agreement, the Awardee shall promptly report such
incidence(s) to the Office of Inspector General of the U.S. Department of the Treasury and/or the CDFI Fund.

3

Retention of Records. The Awardee shall comply with all record retention requirements set forth in OMB Circular A-110,
Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other
Non-Profit Institutions, and OMB Circular A-102, Grants and Cooperative Agreements with State and Local Governments.
Pursuant to this Circular, the Awardee shall retain all financial records, supporting documents, statistical records and any
other records pertinent to the Assistance for a period of three years after the conditions for termination have all been met.

4

Equal Credit Opportunity Act. The Awardee shall provide its products and services in a manner that is consistent with the
Equal Credit Opportunity Act (15 U.S.C. section 1691), to the extent that the Awardee is subject to the requirements of such
Act.

5

Certain Insider Activities. The Awardee shall comply with the restrictions on Insider activities set forth in the CDFI Program
Regulations (at 12 CFR section 1805.807).

6

Certification. If the Awardee is a certified CDFI, the organization continues to meet the eligibility requirements for
certification as a CDFI. If the Allocatee is a certified CDE, the organization continues to meet the eligibility requirements for
certification as a CDE. The term "Organization" shall include the Allocatee and all of its subsidiary Allocatees, if applicable.
As applicable, the Awardee/Allocatee maintains its existence as an Insured Credit Union, an Insured Depository Institution,
or a Depository Institution Holding Company, as defined by the Appropriate Federal Banking Agency.

7

Applicability of Criminal Provisions. The criminal provisions of 18 U.S.C. section 657 regarding embezzlement or
misappropriation of funds are applicable to all Awardees and Insiders.

8

Compliance with Non-Discrimination Statutes. The Awardee shall comply with all Federal statutes relating to
non-discrimination, including, but not limited to: Title VI of the Civil Rights Act of 1964; Title IX of the Education
Amendments of 1972; Section 504 of the Rehabilitation Act of 1973; the Age Discrimination Act of 1975; the Drug Abuse
Office and Treatment Act of 1972; the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970; section 523 and 527 of the Public Health Service Act of 1912; and Title VIII of the Civil Rights Act
of 1968.

If the Awardee / Allocatee is unable to comply with all applicable certifications, the organization must advise the CDFI Fund as
such in writing in reasonable detail. Such correspondence should be addressed to the CDFI Fund's Grants Manager at
[email protected].

Page: 7

CDE Institution Level Report (2012)
13

QEI Distribution Table
QLICI USAGE($$)
Award
Control
Number

QEI
Identifier

Date QEI
Issued

Amount of
Loans and
Loan
QEI at
QALICB
Investments Purchases
Original
Loans and
in Other
from Other
Issue
Investments
CDEs
CDEs

Other Eligible Usages

FCOS

Original
Reserves for
Term of
Additional
Reserves for
QEI
Operations Investments
Loan Losses
(months)
in Existing
QLICIs

TOTALS

Page: 8

CDE Institution Level Report (2012)
14 Non-QEI Investment Capital Table
Source of Capital

Type of Capital

Amount

Interest
Rate

Remaining
Term (in
months)

Debt Subtotal
Grand Total

Page: 9

CDE Institution Level Report (2012)
15 Investment Capital Summary Table

Type of Capital

Amount

Percentage of
Total Capital

Weighted
Average Interest
Rate of Debt

Weighted
Average Term
(months) for
Debt

Debt Subtotal
Grand Total

Page: 10

CDE Institution Level Report (2012)
19 Non-QEI Contributions for Operating Expenses Table
Type of Contributor

Amount

TOTAL

Page: 11

CDE Institution Level Report (2012)
20 Loan Purchase Table
Purchase
#

Purchase Date

Seller Organization

Total $ Paid

Total #
Loans

Presale Book Value

TOTALS

Page: 12

CDE Institution Level Report (2012)
20 Loan Purchases (Source of Funds) Table

Page: 13

CDE Institution Level Report (2012)
23 QEIs used for FCOS Table
QEI

Amount Set Aside for
FCOS

Amount Used for FCOS
During Reporting Period

Page: 14

CDE Institution Level Report (2012)

31 Lending/Investing with Other CDEs

Page: 15

CDE Institution Level Report (2012)

32 Lending/Investing with Certified CDFIs

Page: 16

CDE Institution Level Report (2012)

38 Success Story

Page: 17

CDE Institution Level Report (2012)
IRS 3

Recapture Event Table

QEI

Date Recapture
was Triggered

Reason for Recapture

Amount Subject to
Recapture

Did you Inform the
Appropriate
Investors of the
Recapture Event?

Page: 18

CDE Institution Level Report (2012)
IRS 10

Substantially All Methodology Table
Name of the CDE

Substantially All Methodology
Used

Page: 19

CDE Institution Level Report (2012)
Notes
Question
No.

User

Date

Note

Page: 20


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