Preferred Homes of Iowa

Applicant #1
Applicant #1 Name

First NameLast Name
Cell Phone Number Applicant #1

Area CodePhone Number
Birthdate Applicant #1

MonthDayYear
Date
Email Address Applicant #1
example@example.com
Current Address Applicant #1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Landlord Name - Applicant #1

First NameLast Name
Current Landlord Phone Number - Applicant #1

Area CodePhone Number
How Long Have You Lived at your Current Residence? Applicant #1
Current Employer - Applicant #1
Employer Address - Applicant #1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name - Applicant #1

First NameLast Name
Supervisor Phone Number - Applicant #1

Area CodePhone Number
Typical Paycheck Amount - Applicant #1
Round to the nearest dollar. You will need to submit two paystubs to verify
How Often Are You Paid - Applicant #1

WeeklyEvery two weeksTwice Per MonthMonthlyOther
What other sources of Income do you have and how much net per month? Applicant #1
Include Child Support, Alimony, Social Security for you or your kids as well as the amounts for each. We will need verification of these amounts.
For married couples, or couples that hold debt jointly, answer the following monthly bills/ debt questions collectively under Applicant #1
What Monthly Bills/ Debt do you have? (Check all that apply) - Applicant #1

Car PaymentsCredit Card PaymentsStudent Loan PaymentsOther
List all cars owned and how much the monthly payment and total debt is on each: (Applicant #1)
List each vehicle and payment on a separate line
List all credit cards you have and how much the monthly payment and total debt is on each: (Applicant #1)
List each card on a separate line
List all student loans owed and how much the monthly payment and total amount is on each: (Applicant #1)
List each loan on a separate line
List all other loans owed and how much the monthly payment and total debt is on each: (Applicant #1)
List each loan on a separate line

Applicant #2
Applicant #2 Name

First NameLast Name
Cell Phone Number Applicant #2

Area CodePhone Number
Birthdate Applicant #2

MonthDayYear
Date
Email Address Applicant #2
example@example.com
Current Address Applicant #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Landlord Name - Applicant #2

First NameLast Name
Current Landlord Phone Number - Applicant #2

Area CodePhone Number
How Long Have You Lived at your Current Residence? Applicant #2
Current Employer - Applicant #2
Employer Address - Applicant #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name - Applicant #2

First NameLast Name
Supervisor Phone Number - Applicant #2

Area CodePhone Number
Typical Paycheck Amount - Applicant #2
Round to the nearest dollar. You will need to submit two paystubs to verify
How Often Are You Paid - Applicant #2

WeeklyEvery two weeksTwice Per MonthMonthlyOther
What other sources of Income do you have and how much net per month? Applicant #2
Include Child Support, Alimony, Social Security for you or your kids as well as the amounts for each. We will need verification of these amounts.
If you are married or hold debt jointly AND put all monthly bills/ debt under Applicant #1, move on to the next page.
What Monthly Bills/ Debt do you have? (Check all that apply) - Applicant #2

Car PaymentsCredit Card PaymentsStudent Loan PaymentsOther
List all cars owned and how much the monthly payment and total debt is on each: (Applicant #2)
List each vehicle and payment on a separate line
List all credit cards you have and how much the monthly payment and total debt is on each: (Applicant #2)
List each card on a separate line
List all student loans owed and how much the monthly payment and total amount is on each: (Applicant #2)
List each loan on a separate line
List all other loans owed and how much the monthly payment and total debt is on each: (Applicant #2)
List each loan on a separate line

Applicant #3
Applicant #3 Name

First NameLast Name
Cell Phone Number Applicant #3

Area CodePhone Number
Birthdate Applicant #3

MonthDayYear
Date
Email Address Applicant #3
example@example.com
Current Address Applicant #3

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Landlord Name - Applicant #3

First NameLast Name
Current Landlord Phone Number - Applicant #3

Area CodePhone Number
How Long Have You Lived at your Current Residence? Applicant #3
Current Employer - Applicant #3
Employer Address - Applicant #3

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name - Applicant #3

First NameLast Name
Supervisor Phone Number - Applicant #3

Area CodePhone Number
Typical Paycheck Amount - Applicant #3
Round to the nearest dollar. You will need to submit two paystubs to verify
How Often Are You Paid - Applicant #3

WeeklyEvery two weeksTwice Per MonthMonthlyOther
What other sources of Income do you have and how much net per month? Applicant #3
Include Child Support, Alimony, Social Security for you or your kids as well as the amounts for each. We will need verification of these amounts.
What Monthly Bills/ Debt do you have? (Check all that apply) - Applicant #3

Car PaymentsCredit Card PaymentsStudent Loan PaymentsOther
List all cars owned and how much the monthly payment and total debt is on each: (Applicant #3)
List each vehicle and payment on a separate line
List all credit cards you have and how much the monthly payment and total debt is on each: (Applicant #3)
List each card on a separate line
List all student loans owed and how much the monthly payment and total amount is on each: (Applicant #3)
List each loan on a separate line
List all other loans owed and how much the monthly payment and total debt is on each: (Applicant #3)
List each loan on a separate line

Applicant #4
Applicant #4 Name

First NameLast Name
Cell Phone Number Applicant #4

Area CodePhone Number
Birthdate Applicant #4

MonthDayYear
Date
Email Address Applicant #4
example@example.com
Current Address Applicant #4

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Landlord Name - Applicant #4

First NameLast Name
Current Landlord Phone Number - Applicant #4

Area CodePhone Number
How Long Have You Lived at your Current Residence? Applicant #4
Current Employer - Applicant #4
Employer Address - Applicant #4

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name - Applicant #4

First NameLast Name
Supervisor Phone Number - Applicant #4

Area CodePhone Number
Typical Paycheck Amount - Applicant #4
Round to the nearest dollar. You will need to submit two paystubs to verify
How Often Are You Paid - Applicant #4

WeeklyEvery two weeksTwice Per MonthMonthlyOther
What other sources of Income do you have and how much net per month? Applicant #4
Include Child Support, Alimony, Social Security for you or your kids as well as the amounts for each. We will need verification of these amounts.
What Monthly Bills/ Debt do you have? (Check all that apply) - Applicant #4

Car PaymentsCredit Card PaymentsStudent Loan PaymentsOther
List all cars owned and how much the monthly payment and total debt is on each: (Applicant #4)
List each vehicle and payment on a separate line
List all credit cards you have and how much the monthly payment and total debt is on each: (Applicant #4)
List each card on a separate line
List all student loans owed and how much the monthly payment and total amount is on each: (Applicant #4)
List each loan on a separate line
List all other loans owed and how much the monthly payment and total debt is on each: (Applicant #4)
List each loan on a separate line

Minor Children Information
Please add the names and ages of each minor child who will be living in the home:
If there are no minor children who will be living in the home write "None"

Signature Page
Signature Applicant #1

Clear
Signature Applicant #2

Clear
Signature Applicant #3

Clear
Signature Applicant #4

Clear
Should be Empty:

Preferred Homes of Iowa

Applicant #1

Applicant #2

Applicant #3

Applicant #4

Minor Children Information

Wrap Up

Signature Page