Community Septic Management Program Application

2% Interest Rate Betterment Loan Application

Note to owner(s): This application is to be submitted to the Harvard Board of Health. Note, income information is considered confidential. For purposes of this program, "Owner" is defined as a person, or persons, who has or have, legal title to residential facilities served by an on-site system, including, but not limited to, any agent, executor, administrator, trustee, or guardian of the estate for the holder of legal title. Please provide all of the following information and be sure to sign the application. Use full legal names only.

Financial Information: Please include a signed and dated copy of all owners most recent Federal Tax Return [1040] with this application. For applicants not required to file a Federal Tax return, evidence of source(s) of income, (e.g. Social Security, pension benefits, unemployment benefits, veteran benefits, public assistance benefits, etc.), indicating the monthly amount you presently receive from each source, should be included for documentation purposes.

Submitting this form indicates that I agree with the terms below:
Certification by Owner(s): I/We agree to sign a betterment loan agreement with the Town of Harvard for the amount of eligible project costs for the purpose of septic system repair or replacement, pursuant to the Title 5 definition of septic system failure, and am/are aware that any such loan would be secured by a betterment assessment, recorded on my property title, on the property identified above, with a repayment term to the County not to exceed fifteen (15) years. I/we understand that the loan carries a 2% per annum interest rate and is payable quarterly to the Town of Harvard. I/we also understand that the Town may obtain a first priority lien on the homeowner's property if the repayments are not made on time. Interest at the rate of 14% per annum will accrue on overdue payments from the due date until payment is made. I/we also understand that should payments not be made, the Town, in addition to the proceeding, has statutory authority to take title to the property and, subsequently, to undertake proceedings to foreclose the owner's right to redeem the property from tax title. Furthermore, I/we understand that the Town of Harvard reserves its rights under available statutes to recover any and all costs incurred for this project in the event my/our application to this program proves to be fraudulent. This information provided is true and complete to the best of my/our knowledge and belief. I/we consent to the disclosure of such information of income and verification related to my/our application for financial assistance. I/we understand that any willful misstatement of material fact will be grounds for disqualification.