FAIM Coordinator Forms
The grant a FAIM client is enrolled in can be found in the "Intended Use" field on the FAIM account statement you pull from VistaShare. The four digits represent the grant number they are enrolled in.
FAIM enrollment forms below have been updated for State Grant 2086. Other forms will be updated as time allows. Always use the current forms posted on this site.
Grant 2086 enrollment closed on September 30, 2024. Pre-screen clients for potential eligibility and place them on your local wait list in the event of future funding.
FAIM Enrollment and Account Opening Forms
- FAIM Local Agency Wait List Form
- 2025 Federal Poverty Guideline - use "FPG" if your agency receives CSBG funding
- 50% AMI by MN County - effective 5/1/2024 - if CSBG funds support FAIM, the FPG must be used.
- FAIM Saving Affordability Calculator - updated 3/6/2024 - Send to FAIM Admin. Complete with client at screening.
- FAIM Pre-Enrollment Screening Tool - 2/22/2024 - Send to FAIM Admin. Pre-screen before completing an application.
- FAIM Coach Checklist - Application & Account Opening - updated 3/5/2024- checklist for coach reference.
- FAIM Application -Grant 2086 - Core 4 Assets - 3/6/2024 - Send to FAIM Admin.
- FAIM Core 4 Assets - Contract Agreement & Beneficiary Form - updated 4/26/2024 - Send to FAIM Admin.
- FAIM Application - Grant 2086 - 6 Assets - NEW 4/26/2024 - Send to FAIM Admin.
- Contract Agreement - 6 Assets - and Beneficiary Form - NEW 4-26-2024 - Send to FAIM Admin.
- FAIM - Self-Employment Income Worksheet - Feb 2022 - Send to FAIM Admin.
- FAIM - Declaration of No Income Form - created 6-27-2024
- FAIM - Employment Verification Letter - created 9/19/2024
Bremer Bank does NOT accept electronic signatures from outside their system - forms must be physically signed where indicated.
- FAIM-Bremer Account Opening Forms Packet - 3/6/2024 - Send to FAIM Admin & Bremer.
- Optional: Bremer - Automatic Transfer Authorization Form 1-30-2024 - Send to FAIM Admin & Bremer.
- Optional FAIM Account Info - Direct Deposit / Auto Transfer Setup 1/30/2024 - Give to client for direct deposit.
Pre-Post Enrollment Assessment Tools / Budget Form
- Wheel of Finance Worksheet
- Household Budget Estimate Form - March 2021
- Assessment - Financial Knowledge at Application or Exit
- Assessment - Self Efficacy
- Assessment - Financial Practices
- Assessment - Financial Products and Services
- Assessment - Financial Knowledge Pre-Post Training
FAIM Training Hours Tracking Forms and Completion Certificates
- Financial wellness curriculum located within the FAIM Coordinators - Training
- FAIM Financial Management Training Hours Tracking Form - created 6/5/2024
- Financial Management Training Certificate 2-23-2024
- Asset-specific Training Hours Tracking Form - updated 6/5/2024
- Asset-specific Training Certificate 2-23-2024
FAIM Payout Request Forms
- Coach Payout Checklist - PS Education or Business Development - updated 12/16/2024 - for coach reference.
- Coach Payout Checklist - Home or Vehicle Purchase - updated 12/16/2024 - for coach reference.
- Coach Payout Checklist - 529 or Emergency Savings - created 12/16/2024 - 1st draft - for coach reference
- FAIM Payout Request Forms Packet - Core 4 Asset Tracks - UPDATED 12/16/2024 - Send to FAIM Admin
- Packet Includes: Matched Withdrawal, Education Notes and Savings Transfer Request forms
- FAIM Payout Request Forms Packet - 529 or Emergency Saving Asset Tracks - created 12/16/2024
- Packet Includes: Matched Withdrawal, Education Notes and Savings Transfer Request forms
- W9 Form - Send to FAIM Admin - required if vendor is not in WCMCA's fiscal system or inactive for 12 months.
- See below for additional documents required with the payout request based on asset track
- If this will be the final payout for the client, also complete the Exit forms at time of payout request.
Business Asset Forms and Templates
- FAIM - Guide to Business Development Requirements - Updated 4-26-2022 - share with business asset clients
- FAIM Business Plan - 2020 Template Send in - share with business asset clients
- FAIM Use of Funds & Budget Projection Spreadsheets March 2022 - Template Send in - share with business asset clients
- FAIM Business Plan Approval Form - Fillable -March 2022 - Send in Send in - share with business asset clients
- W9 Form - Send in - Business must have an EIN even if operating as sole proprietor. Do not list SSN on the W9 for business asset
- Send with business payout request: copy of EIN assignment letter from IRS, registration of business with MN Secretary of State, and documentation of business checking account opened at an insured bank or credit union
- Business Asset Online Resources - Share with business asset clients for free help with business plan creation and approval
- Locate a Small Business Development Center (SBDC) in MN: https://mn.gov/deed/business/help/sbdc
- SBDC Resource: A Guide to Starting a Business in Minnesota
- SCORE: Find Your Business Mentor | SCORE
- Sales Tax Resources: www.thestc.com or www.zip2tax.com
- Vehicle purchase guidance - for business asset
- Market Research and Pricing
- Small Business Marketing
Education Asset Forms
- FAIM - Third Party Billing Form - updated 12/16/2024 Send in with payout request. Send to the college PRIOR to drop/add date.
- Send with payout request: Student must provide an itemized college bill, class list, and bookstore receipt (if applicable)
- Career Assessment Tool
- Education Tracking Form
- Sample - College Fee Statement
Home Purchase Asset Forms
- FAIM Guidance for Home Purchase Asset Track - created 7-12-2024 - share with client
- Loan Estimate - send with payout request forms
- Closing Disclosure (CD) - send final, signed copy after closing date. Also required for principal reduction payout - if home was purchased after enrolling in FAIM but before meeting the minimum enrollment requirement.
- Current Mortgage Statement - send with copy of final CD if doing a principal reduction payout. Another copy is required within 30 days of the payout to document that the FAIM payment was applied to principal only.
- Household Budget Estimate Form - located in Financial Training/Assessment Tools section
- Mortgage Qualifier Form
- FAIM Letter to Mortgage Lender - Grants 2005 and 2085 - FAIM program details, share with lender
- FAIM Letter to Mortgage Lender - Grant 2086 - created October 2024 - FAIM program details - share with lender
Vehicle Purchase Asset Forms
- Household Budget Estimate Form - in Financial Training/Assessment Tools section. Participant's budget must support cost of vehicle ownership
- FAIM Guide for Vehicle Purchase - State Grant 2005 & 2086 - Updated 3/6/2024 - share with client
- FAIM Guide for Vehicle Purchase - State Grant 2085 - Updated 3/6/2024 - share with client
- Vehicle Training Material Options:
- "Car Handbook" from MN Attorney General's website: ag.state.mn.us/Office/Publications.asp
- Car Buying Education Material - Nov 2021
- Dealership List - Received FAIM Payout 3/4/2025
- How to pull KBB value - for used vehicle at a dealership
- Vehicle Research Comparison Spreadsheet - new 3/6/2024 - template for vehicle research and comparison
- FAIM - Used Vehicle Inspection Form - June 2022 - send with payout request
- Vehicle Service Record Tracking Template - template for clients to track their vehicle service record.
- Letter of Guarantee - dealership may request verification of pending FAIM payment:
- Coach must submit all vehicle documentation for the payout to FAIM Admin for review.
- If vehicle is approved, Admin will complete the form and send to the coach.
- Required with payout request forms:
- Copy of FAIM participant's valid Minnesota driver's license
- Copy of vehicle insurance quote from agent - for the vehicle being purchased.
- KBB or NADA market value printout for vehicle being purchased. Price must be under high retail value.
- Copy of Vehicle Inspection Report - AND - Repair Estimate for anything noted on the inspection.
- Copy of Vehicle Purchase Agreement (PA)
- After payment - final copy required with FAIM funds listed.
- If the FAIM payment is not clearly noted on the PA, an itemized receipt is required from dealership.
- Copy of vehicle title (both sides) - AND lien release (if applicable)
- After payout - copy of title transfer document showing the FAIM participant as sole owner.
- If applicable, a copy of client's loan document showing terms.
FAIM Exit Forms
- FAIM Exit - Account Closing Checklist 2019 for reference
- FAIM Exit Form - updated 3/6/2024 - Send to FAIM Admin
- FAIM Savings Account Closure Form - updated 3/6/2024 - Send to FAIM Admin - wait for okay to send to Bremer
- FAIM Education Notes Form - Six Assets - Updated 5-21-2024 - Send in if client exits without a payout
- FAIM Participant Survey 2018 - Send in optional client survey
FAIM Program Forms
- How to pull FAIM Account Statements or Individual Transaction Record
- FAIM Release/Consent to Share Story/Photo 10-11-2024
- FAIM Brochures:
- FAIM - Client Contact Log keep in local client file.
- FAIM - Local Client File Cover Sheet - updated March 2021
- FAIM Now What Brochure - Updated 2-7-2022
- FAIM Timeline - Updated 3-3-2022
- FAIM Contract Amendment Request Form - Jan 2022 Fillable - send in
- FAIM Contract Extension Request Form - Jan 2022 Fillable - send in
- FAIM Waiver of Odd Cents Form - Jan 2022 Fillable - Send in
- FAIM One-Time Emergency Withdrawal Form and Excess Savings Withdrawal Form - Coach must contact FAIM Admin to request completion.
- Enrollment Denial Letter - March 2021 Fillable
- Enrollment Termination Letter - April 2021 Fillable
Cornerstone Advocacy Service - Forms for CAS Private Match Enrollees
- Cornerstone Coach - Private Match Payout Request Checklist - 5-5-2022 - CAS Payout Checklist
- Cornerstone Exit Form Fillable May 2022 - Send in - CAS Exit form