Owner Occupied Repair Application

Owner Occupied Repair Application

Marquette County Habitat for Humanity Home Repair Program
Applicant Name*

First NameLast Name
Co-applicant Name

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Applicant's address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you owned and resided at the above address?*
Is the home a mobile home?

YesNo
If yes, do you own the land the mobile home is on?

YesNo
Did you or are you (or anyone in your household) currently serving in the US Armed Forces?*

YesNo
Where did you hear about our program?*
Facebook, newsletter, word of mouth, tv or radio, etc

List below the names of all people who are living in your home, including yourself.*

	Name	Birthday	Age	Sex	Disability Y/N	Relationship
Person 1
Person 2
Persion 3
Person 4
Person 5
Person 6

Please describe the repairs you are requesting assistance with.*
Financial Information

Current Earned Income - For each working person living in your house, please give the following. If not applicable to you, please fill in Person 1 and/or Asset 1 boxes with N/A.

Income*

	Name	Employer	Employer's Address	Monthly Income
Person 1
Person 2
Person 3

Assets*

	Name	Account Number	Address City, State & Zip	Balance
Asset 1
Asset 2
Asset 3
Asset 4

Other Income (Include AFDC, Food Stamps, SSI, SS, Disability, Child Support, Alimony. If not applicable to you, please fill in Income 1 boxes with N/A.*

	Name	Kind of Income	Monthly Income
Income 1
Income 2
Income 3

Any information you couldn't fit from charts above?
Program Guidelines
The Owner-occupied repair program is a no-interest loan through Marquette County Habitat for Humanity. The family must own and occupy the home. The family must meet all program criteria for Marquette County Habitat for Humanity:
1. House repair needed
2. Ability to pay and/or put in required "sweat equity" hours.
3. Willingness to partner with Marquette County Habitat for Humanity
All program recipients must complete "sweat equity". Sweat equity generally means working on your home project or on another Habitat project and is geared for your physical abilities. Sweat equity can also be completed in the ReStore, the Habitat office or at another qualified area non-profit agency.
Marquette County Habitat for Humanity is an equal opportunity program and therefore shall make housing equally available to all qualified families without discrimination. With the scope of their application process, MCHFH will not consider the following factors: sex, marital status, race, color, religion, national origin, age, receipt of public assistance income, physical handicap or family status.

I understand that by signing this application, I am authorizing Habitat for Humanity to evaluate my home and the need for repairs, my ability to repay the no interest loan (if applicable) and other expenses of homeownership, and my willingness to be a partner family. I understand that the evalution may include personal visits and income verification. I have answered all questions on this application truthfully. I understand that if I have not answered the questions truthfully, my application may be denied, and that even if I have already been selected to receive a home repair, I may be disqualified from the program. The original or copy of this application will be retained by Habitat for Humanity even if the application is not approved.
Required Documentation (check off after uploading)

Proof of homeownership (deed or title)Copy of home insuranceDocumentation of all sources of income including government sources; if paystubs, most recent two months are requiredCurrent bank statement(s)Proof from lender showing that mortgage is currentProof that property taxes are current
File Upload

Cancelof
Applicant Signature*

Clear
Co-applicant Signature

Clear

Owner Occupied Repair Application

Financial Information

Program Guidelines

Information for Government Monitoring Purposes

Applicant

Co-applicant