Background

The Manufactured Home Relocation Trust Fund is available to eligible homeowners to assist in relocating a manufactured home to a new location within a 50-mile radius of the park that is being closed.

Relocation benefits are available in the amount of:
•	the actual costs of moving up to $7,000 for a single section home, or
•	the actual costs of moving up to $12,500 for a multi-section home.

If the home is unable to be relocated to a new location within 50 miles, the homeowner can tender the title of the home to the park owner and receive benefits of:
•	Single section home:
o	Minimum: $2,000, even if the verified value is less
o	Maximum: the verified value of the home up to $8,000.
•	Multi-section home:
o	Minimum: $4,000, even if the verified value is less
o	Maximum: the verified value up to $14,000.
NOTE: A manufactured homeowner is not entitled to payments under the Manufactured Home Relocation Trust Fund if the manufactured home park owner is not required to make a payment to the Fund under statute.

Instructions

Homeowner(s) to complete all sections and sign this form and submit to the appointed Neutral Third Party, along with all required documents. The Neutral Third Party must process applications within 14 days of receipt. Applications not processed within 45 days are deemed approved. Once the Neutral Third Party has approved the application, all materials will be submitted to Minnesota Housing for payment at MNHousing.ManufacturedHomes@state.mn.us.
NOTE: A list of required documents can be found on the Document Checklist form on the Minnesota Housing website. There are two different checklists, depending on whether the homeowner is relocating to another community or if the homeowner is unable to relocate. Please use the checklist that applies to either circumstance.

Homeowner Contact Information	
Name of Manufactured Homeowner(s)		
		
Name of Manufactured Home Park		
Current Address		
Lot Number		
City/State		
Zip Code		
County		
Phone Number		
Email Address		
		
Manufactured Home Type:	Single Section	Multi-Section	
Neutral Third Party Information	
Name of Neutral Third Party		
Neutral Third Party Address		
City/State/Zip Code		
Neutral Third Party Phone Number		
Neutral Third Party Email		
Date Form Submitted to Neutral Third Party		

Relocation Information

1.	What date did you receive a Park Closure Notice from the Park Owner notifying you that the manufactured housing park you reside in will be closing?

2.	What date is the manufactured housing park expected to close?

3.	If the park has not closed entirely, have you relocated to a new lot within the same manufactured housing park?

4.	Do you plan to relocate your manufactured home to another park within a 50-mile radius of the park that is closing?

a.	If the answer to Question 4 is yes, have you contracted with a mover to help relocate your manufactured home?

i.	What is the name of the moving company? 	
ii.	What is the contract price for moving your home? 	
b.	If the answer to Question 4 is yes, are there any additional costs related to relocating your home that must be paid to another party in order to relocate your home?

i.	If yes, what are the additional costs? 	
c.	If the answer to Question 4 is no, is the reason because of the age or condition of the manufactured home, or because there are no manufactured home parks willing or able to accept the home within a 50-mile radius? 	

d.	If the answer to question 4 is no, have you and the Park Owner agreed on an independent appraiser to determine the value of your manufactured home?

i.	If yes, what is the value determined by the appraiser? 	
ii.	If no, what is the average of the previous five years tax market value?

5.	Have you received any other monetary compensation for your manufactured home from any other entity or organization, related to the closure of the park?

a.	If yes, what source has provided you with compensation? 	
b.	What is the amount of compensation? 	

6.	What is the total dollar amount of benefits that you are requesting from the Manufactured Home Relocation Trust Fund?

Signature and Certification

This application and all other documents are submitted by the undersigned and are, to the undersigned’s best knowledge, accurate in all details. I understand that I may be asked for additional documentation to support this application.
I understand that providing false representations constitutes an act of fraud. False, misleading or intentionally incomplete information may result in the denial of my application, the repayment of any funds received, or other remedies available under law.
Note: The information requested in this application is legally required to determine if you
qualify for participation in this program. A portion of the data requested is classified as “private data on individuals” under Minnesota Statute 462A.065. Use of data obtained is limited to that necessary for the administration and management of this program by Minnesota Housing personnel, those under contract with Minnesota Housing, and other governmental agencies when authorized by state statute or federal law.

Signature	Date

Printed Name