New Hampshire Capital Region Habitat for Humanity Homeownership Application
2024 - Dear Applicant: Please complete this application to determine if you qualify for the Habitat for Humanity homeownership program. Please fill out the application as completely and accurately as possible. All information you include on this application will be kept confidential in accordance with the Gramm-Leach-Bliley Act
Applicant & Co-Applicant Information
Applicant's Name
*
First Name
Last Name
Social Security Number
Cell Phone Number
*
Please enter a valid phone number.
Age
*
Email
*
example@example.com
Marital Status
*
Married
Separated
Unmarried (Including single, divorced, windowed)
Co-applicant's Name
First Name
Last Name
Social Security Number
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
Marital Status
Married
Separated
Unmarried (including single, divorced, widowed)
Dependents and others who will live with you (Name, Age, Gender), N/A if not applicable:
*
Present Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of years at present address
*
Address Type
*
Rent
Own
If you have lived at your present address for less than two years, complete the following: Last Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Willingness to Partner
To be considered for Habitat homeownership, you and your family must be willing to complete 70 hours of “sweat-equity”. Your help in building your home and the homes of others is called “sweat equity” and may include clearing the lot, painting, helping with construction, working in the Habitat office, attending homeownership classes or other approved activities.
I am willing to complete the required sweat-equity hours:
*
Applicant - Yes
Applicant - No
Co-applicant - Yes
Co-applicant - No
Present Housing Conditions
Number of bedrooms
*
1
2
3
4
5
Other rooms in the place where you are currently living (select all that apply):
*
Kitchen
Bathroom
Living Room
Dining Room
Other
If you rent your residence, what is your monthly payment?
Name, Address, and Phone Number of Current Landlord:
Describe the condition of the house or apartment where you live. Why do you need a Habitat home?
*
Property Information
If you own your residence, what is your monthly mortage payment?
Unpaid Balance?
Do you own land?
*
Yes
No
If you own land, what is your monthly payment and unpaid balance?
Applicant Employment Information
Name of Applicants Current Employer
*
First Name
Last Name
Address of Applicants Current Employer:
Years on this Job
*
Monthly (gross) wages:
*
Type of Business
*
Business Phone Number
Please enter a valid phone number.
Co-Applicant Employment Information
Name of Co-applicants Current Employer
First Name
Last Name
Address of Co-applicants Current Employer:
Years on this job:
Monthly (gross) wages:
*
Type of Business:
*
Business Phone Number
Please enter a valid phone number.
Applicant: If working at current job less than one year, complete the following information - Name and address of last employer, ears on this job, monthly (gross) wages, type of business, business phone.
Co-applicant: If working at current job less than one year, complete the following information - Name and address of last employer, ears on this job, monthly (gross) wages, type of business, business phone.
Monthly Income
Monthly Income
Applicant
Co-Applicant
Others in the Household
Total
Wages
TANF
Alimony
Child Support
Social Security
SSI
Disability
Section 8 Housing
Other
Other
Other
Total
Household Members whose income is listed above: (Note: Self-employed applicants may be required to provide additional documentation such as tax refunds and financial statements.)
Name
Income Source
Monthly Income
Date of Birth
1
2
3
4
Source of Down Payment and Closing Costs
Where will you get the money to make the down payment or pay for closing costs? (For example, savings or parents) - If you borrow the money, whom will you borrow it from, and how will you pay it back?
*
Assets
Assests
Name of bank, savings and loan, credit union, etc.
Address
City, State
ZIP
Account Number
Current Balance
1
2
3
4
5
6
7
8
9
Debt
Applicant Debt: To whom do you owe money?
Monthly payment
Unpaid Balance
Months left to pay
Vehicle Loans
Boat
Furniture, appliance, TV's (Includes rent-to-own)
Alimony
Child Support
Credit Card
Credit Card
Credit Card
Total medical (un-paid bills)
Other
Other
Total
Co-Applicant Debt: To whom do you owe money?
Monthly payment
Unpaid Balance
Months left to pay
Vehicle Loans
Boat
Furniture, appliance, TV's (Includes rent-to-own)
Alimony
Child Support
Credit Card
Credit Card
Credit Card
Total medical (un-paid bills)
Other
Other
Total
Monthly Expenses
Applicant
Co-Applicant
Total
Rent
Utilities
Insurances
Child Care
Internet Service
Cell Phone
Land Line
Business Expenses
Union Dues
Other
Other
Other
Total
Declarations
Please answer yes or no to the following questions for applicant and co-applicant
*
Applicant
Co-Applicant
A. Do you have any outstanding judgements becaus of a court decision against you?
B. Have you been declared bankrupt within the past seven years?
C. Have you had property foreclosed on or deed in lieu of foreclosure in the past seven years?
D. Are you currently involved in a lawsuit?
E. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?
F. Are you currently delinquent or in default on any federal debt or any other loan, mortgage, financial obligation or loan guarantee?
G. Are you paying alimony or child support or separate maintenance?
H. Are you a co-signer or endorser on any loan?
I. Are you a U.S. citizen or permanent resident?
If you answered "yes" to any question A-H above, or "no" to question I, please explain here.
Authorization and Release
I understand that by filing this application, I am authorizing Habitat for Humanity to evaluate my actual need for the Habitat homeownership program, my ability to repay an affordable loan and other expenses of homeownership, and my willingness to be a partner through sweat equity. I understand that the evaluation will include personal visits, a credit check and employment verification. I have answered all the 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 Habitat home, I may be disqualified from the program and forfeit any rights or claims to a Habitat home. The original or a copy of this application will be retained by Habitat for Humanity even if the application is not approved. I also understand that Habitat for Humanity screens all applicants on the sex offender registry. By completing this application, I am submitting myself to such an inquiry. I further understand that by completing this application, I am submitting myself to a criminal background check.
Signature
*
Date
-
Month
-
Day
Year
Date
Co-applicant Signature
Date
-
Month
-
Day
Year
Date
Right to Receive Copy of Appraisal
This is to notify you that we may order an appraisal in connection with your loan and we may charge you for this appraisal. Upon completion of the appraisal, we will promptly provide a copy to you, even if the loan does not close.
Applicant and Co-applicant Name:
*
Information for Government Monitoring Purposes
PLEASE READ THIS STATEMENT BEFORE COMPLETING THE BOX BELOW: We are requesting the following information to monitor our compliance with the federal Equal Credit Opportunity Act, which prohibits unlawful discrimination. You are not required to provide this information. We will not take this information (or your decision not to provide this information) into account in connection with your application or credit transaction. The law provides that a creditor may not discriminate based on this information, or based on whether or not you choose to provide it. If you choose not to provide the information, we may note it by visual observation or surname.
Applicant Race:
Native Indian of Alaska Native
Native Hawaiin or other Pacific Islander
Black/African American
White
Asian
Co-Applicant Race:
Native Indian of Alaska Native
Native Hawaiin or other Pacific Islander
Black/African American
White
Asian
Applicant Ethnicity:
Hispanic or Latino
Non-Hispanic or Latino
Co-Applicant Ethnicity:
Hispanic or Latino
Non-Hispanic or Latino
Applicant Sex:
Female
Male
Other
Co-Applicant Sex:
Female
Male
Other
Applicant Date of Birth
-
Month
-
Day
Year
Date
Co-Applicant Date of Birth
-
Month
-
Day
Year
Date
Applicant Marital Status
Married
Separated
Unmarried (Single, Divorced, Windowed)
Co-Applicant Marital Status
Married
Separated
Unmarried (Single, Divorced, Windowed)
Equal Credit Opportunity Act (ECOA) Notice
Purpose and background: Because Habitat for Humanity homeownership and loan programs qualify as Special Purpose Credit Programs under the Equal Credit Opportunity Act, Habitat can request and consider certain information about income that other lenders may not be allowed to request and consider in connection with their loan programs without providing certain disclosures and options for the applicant to decline to provide that information. Although federal law allows Special Purpose Credit Programs to request and consider this information to determine eligibility for their programs, the law does not explicitly provide an exemption from the disclosure. Accordingly, in order to avoid any confusion by Habitat applicants about their rights and obligations to provide this information, we recommend that Habitat affiliates provide the customary disclosure together with the explanation for Habitat’s right to consider that information in evaluating applications for the Habitat program. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status or age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that monitors compliance with this law concerning this company is the Federal Trade Commission, with offices at FTC Regional Office for the NHCRHFH or Federal Trade Commission, Equal Credit Opportunity, Washington DC, 20580. You need not disclose income from alimony, child support or separate maintenance payment if you choose not to do so. However, because we operate a Special Purpose Credit Program, we may request and require, in order to determine an applicant’s eligibility for the program and the affordable mortgage amount, information regarding the applicant’s marital status; alimony, child support and separate maintenance income; and the spouse’s financial resources. Accordingly, if you receive income from these sources and do not provide this information with your application, your application will be considered incomplete, and we will be unable to invite you to participate in the Habitat program.
Applicant Signature
*
Applicant Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Co-Applicant Signature
Co-Applicant Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
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