Closing Cost Assistance Grant Program
Not attaching documents may delay your request being reviewed in a timely manner.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about this program?
Mailing Address same as above?
Yes
No
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Telephone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Telephone
Please enter a valid phone number.
Format: (000) 000-0000.
Birth date
-
Month
-
Day
Year
Date
Email
example@example.com
Social Security Number
Diver License Number & State
Marital Status
Single
Married
Divorced
Separated
Widowed
Spouse Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Spouse Email
example@example.com
Spouse Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Disability/ Special Need
Yes
No
Veteran
Yes
No
Branch of the Military (If applicable)
First Time Homebuyer
Yes
No
Foreign Born
Yes
No
Primary Language
Total Houshold Size
Military & Hero Details
Branch of Service/Hero Affiliation
Police
Fireman
First Responder
Military
Military Status
Military / Active Duty
Veteran
Non Applicable
Pay Grade
Job Title
Command
Years of service
When will you deploy
-
Month
-
Day
Year
Date
Location of deployments
Section 1: Employment Information
Current Employer
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Fax
Please enter a valid phone number.
Format: (000) 000-0000.
Employers Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been at your current employer
Your Hire Date
-
Month
-
Day
Year
Date
Email
example@example.com
Title/Position
Supervisors Name
Supervisors Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Compensation (Yearly)
Hourly Rate
Hours Worked Per Week
Self Employed P&L (YTD gross)
Self Employed P&L (YTD net)
Section2: Housing Arrangement and History
Homeowner with a Mortgage $______________Per Month
Rent: $__________________Per Month
Does not pay rent
No pay rent
How long have you lived at your current residence
Have you or any other person listed on this application, purchased or had ownership interest in a residential unit within the last 3 years:
Yes
No
Section3: Home Ownership Information
Have you or any other person listed on this application, purchased or had ownership interest in a residential unit within the last 3 years:
Yes
No
Have you or your co-applicant filed for bankruptcy or foreclosed on a property in the past 3 years:
Yes
No
What is maximum housing payment you are comfortable making?
Section 4: Household Type Information
Status
Single with Dependents
Married with Dependents
Married without Dependents
Single Adult
Household Size
Number of Dependents
Ages of Dependents
Section5: Assets
Borrower
Rows
Balance
Checking Account
Savings Account
Money Market
Other (stocks, bonds, ext.)
401K and Retirement
TOTAL
Co-Borrower
Rows
Balance
Checking Account
Savings Account
Money Market
Other (stocks, bonds, ext.)
401K and Retirement
TOTAL
How much do you have for your down payment
Section 6: Liabilities
Borrower
Rows
Name
Unpaid Balance
Monthly Payment
1
2
3
4
5
6
7
8
TOTAL
Co-Borrower
Rows
Name
Unpaid Balance
Monthly Payment
1
2
3
4
5
6
7
8
TOTAL
Are all debts listed?
Yes
No
Is any debt past due?
Yes
No
How many months?
Have you or your co-applicant filed for bankruptcy or foreclosed on a property in the past 3 years?
Yes
No
Section 7: Lender Information
I have been pre-approved for a first mortgage
Yes
No
I am in contract to buy a house and have a closing date for my loan
Yes
No
If yes, please enter the closing date
-
Month
-
Day
Year
Date
Name of Loan Officer
Name of Bank
Telephone of Loan Officer
Please enter a valid phone number.
Format: (000) 000-0000.
Email of Loan Officer
example@example.com
Co - Applicant Information
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Telephone
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Cell Telephone
Please enter a valid phone number.
Format: (000) 000-0000.
Birth date
-
Month
-
Day
Year
Date
Social Security Number
Diver License Number & State
Marital Status
Single
Married
Divorced
Separated
Widowed
Name
First Name
Last Name
Disability/ Special Need
Yes
No
Veteran
Yes
No
Brach of Military (If applicable)
First Time Homebuyer
Yes
No
Foreign Born
Yes
No
Primary Language
Section 1: Employment Information
Current Employer
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Fax
Please enter a valid phone number.
Format: (000) 000-0000.
Employers Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been at your current employer
Your Hire Date
-
Month
-
Day
Year
Date
Email
example@example.com
Title/Position
Supervisors Name
Supervisors Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Compensation (Yearly)
Hourly Rate
Hours Worked Per Week
Gross Monthly Income (before taxes)
Net Monthly Income (after taxes)
Self Employed P&L (YTD gross)
Self Employed P&L (YTD net)
Section2: Housing Arrangement and History
Describe your current housing arrangement:
Rows
Amount
Homeowner with a Mortgage
Rent
Does Not Pay Rent
TOTAL
How long have you lived at your current residence
Have you or any other person listed on this application, purchased or had ownership interest in a residential unit within the last 3 years
Yes
No
What is maximum housing payment you are comfortable making?
Section3: Home Ownership
Have you or any other person listed on this application, purchased or had ownership interest in a residential unit within the last 3 years:
Yes
No
Have you or your co-applicant filed for bankruptcy or foreclosed on a property in the past 3 years
Yes
No
What is maximum housing payment you are comfortable making?
Section 4: Relation to Applicant
Grandfather/Grandmother
Father/Mother
Father/Mother
Sister/Brother
Uncle/Aunt
Girl Friend/ Boy Friend
Niece/Nephew
Domestic Partner
Son/Daughter
Section5: Assets
Borrower
Rows
Balance
Checking Account
Savings Account
Money Market
Other (stocks, bonds, ext.)
401K and Retirement
TOTAL
Co-Borrower
Rows
Balance
Checking Account
Savings Account
Money Market
Other (stocks, bonds, ext.)
401K and Retirement
TOTAL
How much do you have for your down payment
DD214
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VA Disability Letter
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Paystubs / LES (for active duty)
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Saving statement
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