2023 HFLA Loan Application Form

HFLA Loan Application Form
Thank you for your interest in applying for an HFLA loan.

Before you begin our application, please make sure that you meet the following eligibility requirements:
- You are Jewish
- You reside in British Columbia (exceptions made for students raised in B.C. that are temporarily studying out-of-province)
- You are a Canadian citizen, Permanent Resident or Convention Refugee
- You are 19 years of age or older
This loan application should take about 15 minutes or so to complete. If, however, you need to take a break, simply press the "Save" button and follow the instructions so that you can complete the application later. Please note that you DO NOT need to create a jotform account to save your work. Simply go to the bottom option that reads "skip create an account".

You will receive an email confirming your application submission. Our offices will then review your application for errors and omissions and be in touch with you if we have any questions or concerns.

Once your application is deemed complete, a volunteer board member will call you to arrange a virtual interview at a mutally agreeable time.

Please email jwaselhfla@gmail.com with questions or if you have any technical issues while completing this application.

CONTACT INFORMATION
What is your name?:*

First NameLast Name
If applicable, please list your maiden name or any other previous names:

First NameLast Name
What is your e-mail Address?*
example@example.com
What is your cell phone number?*
Please enter a valid phone number.
What is your home address? *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

BACKGROUND QUESTIONS
What is your Date of Birth:*

MonthDayYear
All loan applicants must be 19 years or older to apply for an HFLA loan. If you are a student who has not yet turned 19, a parent should submit the loan application in their name.
How old are you?*
Are you Jewish?*
You must be Jewish to apply for an HFLA loan
Please describe your involvement in the Jewish community:*
What is your citizenship status?*
In order to be considered for an HFLA loan you must be a Canadian Citizen or have Permenant Resident or Convention Refugee Status in Canada

If you do not meet these requirements, please email jwaselhfla@gmail.com to determine your eligability to apply for a loan with us.
What country/region were you born in (this is for statistical purposes only and will not effect your application)?*
If applicable, what year did you arrive in Canada?
Have you ever applied for an HFLA loan before?*
Have you ever served as a guarantor on an HFLA loan before?*
How did you hear about HFLA?*
Are you a current client of Jewish Family Services (JFS)*

YesNo

	Cost
Lease Deposit
Equipment
Website
Marketing
Legal
Accounting
Other
Total

Family Questions
What is your martial status?*
What is your spouse/partner's name?*

First NameLast Name
What is your spouse/partner's date of birth?*

MonthDayYear
What is your spouse/partner's citizenship status?*
Has your spouse/partner ever had an HFLA loan?*
Is your spouse/partner aware that you are applying for this loan (note that they will be required to sign a document if your loan application is approved?*

YesNo
Do you have any dependent children?*

YesNo

Housing Questions
Do you own or rent your home?*
What is your monthly rent on your home?
What year was this home purchased?*
What was the original purchase price of this home?*
What is the current value of this home?*
How much is owed on this home?*
Total equity in this home:*

Calculation - Borrower Job Title
Calculation - Borrower Gross Annual Income
Employment Questions

Please complete the following Employment chart for both yourself and your spouse/partner. If a question is not applicable, please input the word "N/A".*

	Applicant	Spouse/Partner
Job Title
Name of employer
Years at this job
Number of hours worked per week (if applicable)
Hourly wage BEFORE TAX DEDUCTIONS (if applicable)
Annual Income BEFORE TAX DEDUCTIONS (i.e. gross income)
Annual Income AFTER TAX DEDUCTIONS (i.e. net income)

Please complete the following MONTHLY income chart for both yourself and your spouse/partner. If a question is not applicable to you, please input the number "0"*

	Applicant	Spouse/Partner
Monthly Income AFTER TAX (i.e. net income)*
Monthly Canada Child Benefit (CCB) Income
Monthly Income from government programs (E.I., Income Assistance, PWD Assistance etc)
Monthly Income from pensions, Old Age Security (OAS) and Guaranteed Income Supplement (GIS)
Monthly Income from any other sources
Total

Borrower monthly net income:
Borrower's Spouse monthly net income:
Total combined monthly net income:

Financial Questions

Please complete the following ASSET chart for both yourself and your spouse/ partner. If a question is not applicable to you, please input the number "0". *

	Applicant	Spouse/Partner
Bank Balance
RRSP's
GIC's
Other Investments
Total

Total combined non-residential assets:

Please complete the following LIABILITY chart for both yourself and your spouse/partner. If a question is not applicable to you, please input the number "0".*

	Applicant	Spouse/Partner
Personal Loans
Student Loans
Outstanding Line of Credit
Credit Card Debt (please only complete if you maintain a balance on your cards)
Other Debts
Total

Total combined non-residential liabilities:
Non-residential assets - non-residential liabilities
Do you pay your credit card balance in full each month?*

YesNo
Have you ever had a loan or financial obligation sent to collections?*

YesNo
Have you ever declared bankruptcy?*

YesNo

If you drive an automobile, please complete the following chart:

	Applicant	Spouse
Car Brand
Car Model
Car Year

Monthly Expense Questions

Please complete the following MONTHLY expense chart for your family. If a question is not applicable to you, please input the number "0"*

	Monthly Cost
Monthly Rent or Mortgage Payment
Monthly Property Tax Payment
Monthly Strata/Maintenance Payment
Monthly Car Payment(s)
Monthly Cost of Auto Insurance
Monthly Cost of Car Gas
Monthly Cost of Public Transportation
Monthly Cost of Extended Medical Coverage
Monthly Cost of Utilities (heat & hydro)
Monthly Cost of TV, Phone(s) and Internet
Monthly Cost of Food
Monthly Cost of Clothing & Personal Care Items
Monthly Cost of Childcare/Summer Camp/Children's Activities
Monthly Cost of Tuition
Monthly Costs of Loan/Debt Payments
Monthly Cost of Other Expenses (synagogue dues, therapies etc)
Total

Total Combined Monthly Expenses*
Monthly Income - Monthly Expenses =*

Acknowledgment and Declaration
I,First Name Last Name, declare that the information provided in this application is true and correct.

I acknowledge and agree that the personal information collected from me may be disclosed to the employees and volunteers involved in the loan decision process, to persons retained by HFLA to administer the loan, the the guarantor(s) listed above and to the other persons deemed necessary by HFLA for the provision or enforcement of the loan.
Job Title
Signature

Clear
Date*

MonthDayYear
Date
Administrative Notes:
Should be Empty:

	Name of Child	Age of Child	Child's School Name	Annual Tuition Cost After Subsidy	Annual Jewish Camp Fees Cost After Subsidy	Annual Jewish Program Costs After Subsidy
Child 1
Child 2
Child 3
Child 4
Child 5

HFLA Loan Application Form

CONTACT INFORMATION

BACKGROUND QUESTIONS

LOAN REQUEST & GUARANTOR INFORMATION

Student/Skills Training Loan Information

New Business Information

Family Questions

Housing Questions

Employment Questions

Financial Questions

Monthly Expense Questions

Acknowledgment and Declaration