I certify that the information contained in this form is truthful and complete to the best of my knowledge and is provided in good faith. I understand that if I knowingly give false information, withhold information, or fail to report any changes promptly, I will be in violation of the terms of agreement and will become ineligible to receive housing services/assistance through HOMES, Inc.
My signature authorizes HOMES, Inc. and its agents to obtain information necessary to establish my eligibility for the possibility of housing assistance and to collect any verifications pertaining to thereto.
I understand and acknowledge that at this point HOMES, Inc. has not guaranteed assistance through any of their programs.
I understand that any assistance will be made with the understanding this will be my primary residence. If at any time the house is no longer my primary residence, I understand a mortgage and/or declaration of covenants and restrictions will contain a clause to recapture funds that would have been forgiven otherwise.
I understand that this is an intake and that it is valid for one year. If I do not renew or update the information within one calendar year this file will be moved to an inactive file and if I re apply the date I re-apply will be my new intake date.
HOMES, Inc. is an equal opportunity organization, we do not discriminate against individuals based on their race, color, religion, national origin, sex, disability, familial status, age, sexual orientation, gender identity, or marital status.
Clients will be selected on a first come, first serve, first qualify basis. “First Qualify” indicates the client has met all criteria necessary to qualify for program funding guidelines.