Homeownership Application

HOMEOWNERSHIP PROGRAM APPLICATION
We are pledged to the letter and spirit of U.S. policy for the achievement of equal housing opportunity throughout the nation. We encourage and support an affirmative advertising and marketing program in which there are no barriers to obtaining housing because of race, color, religion, sex, handicap, familial status or national origin.
Please complete this application to determine if you qualify for the Habitat for Humanity homeownership program truthfully, completely and accurately. All information you include on this application will be maintained in accordance with our privacy policy.
Type of credit
I am applying for individual credit.
I am applying for joint credit. Total number of borrowers:
Each borrower intends to apply for joint credit. Your initials:
How did you hear about this program?
Applicant's Full Name

First NameMiddle NameLast Name
SSN*
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
E-mail
example@example.com
Photo ID

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Dependents and others who will live with you (not listed by co-applicant)

	Name	DOB	Male	Female
1.
2.
3.
4.
5.

Present Address

Street Address

Street Address Line 2

CityState

Zip Code
RentOwn
Number of Years
If you have lived at your present address for less than two years, complete the following:
Previous Home Address

Street Address

Street Address Line 2

CityState

Zip Code
RentOwn
Number of Years
Co-Applicant's Full Name

First NameMiddle NameLast Name
Co-Applicant's SSN
Co-Applicant's Age
Co-Applicant's Date of Birth

MonthDayYear
Date
Co-Applicant's Phone Number
Please enter a valid phone number.
Co-Applicant's E-mail
example@example.com
Co-Applicant's Photo ID

Cancelof
Co-Applicant's Present Address

Street Address

Street Address Line 2

CityState

Zip Code
RentOwn
Number of Years
If you have lived at your present address for less than two years, complete the following:
Co-Applicant's Previous Address

Street Address

Street Address Line 2

CityState

Zip Code
RentOwn
Number of Years
Willingness to Partner
To be considered for Habitat homeownership, you and your family must be willing to complete a certain number of "sweat-equity" hours. 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.
Applicant: I am willing to complete the required sweat-equity hours.

YesNo
Co-Applicant: I am willing to complete the required sweat-equity hours.

YesNo
Present Housing Conditions
Number of Bedrooms
Other rooms in the place where you are currently living

KitchenBathroomLiving RoomDining RoomOther
If you rent, what is your monthly rent payment ($)
Please supply a copy of your lease

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Name, address and phone number of current landlord
Describe the condition of the house or apartment where you live
Please provide a narrative of why you need a Habitat home in 1 or 2 paragraphs
Property Information
If you own your residence, what is your monthly payment? ($)
Unpaid Balance ($)
Do you own land?

YesNo
Monthly Payment ($)
Unpaid Balance ($)
If you wish your property to be considered for building your Habitat home, please attach land documentation.

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Applicant's Employment Information
Name of Current Employer
Address of Current Employer

Street Address

Street Address Line 2

CityState

Zip Code
Start Date

MonthDayYear
Date
Gross Monthly Income ($)
Type of Business
Business Phone
Please enter a valid phone number.
If you have a second job, complete the following information.
Name of Current Employer (Second)
Address of Current Employer (Second)

Street Address

Street Address Line 2

CityState

Zip Code
Start Date (Second)

MonthDayYear
Date
Gross Monthly Income ($) (Second)
Type of Business (Second)
Business Phone (Second)
Please enter a valid phone number.
If working at current job less than one year, complete the following information.
Name of Last Employer
Address of Last Employer

Street Address

Street Address Line 2

CityState

Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Business Phone
Please enter a valid phone number.
Gross Monthly Income ($)
Type of Business
If you have changed jobs in the past 6 months, have your employer complete the Employment Verification Form.
Co-Applicant's Employment Information
Co-Applicant's Name of Current Employer
Co-Applicant's Address of Current Employer

Street Address

Street Address Line 2

CityState

Zip Code
Start Date

MonthDayYear
Date
Gross Monthly Income ($)
Type of Business
Business Phone
Please enter a valid phone number.
If working at current job less than one year, complete the following information
Co-Applicant'sName of Last Employer
Co-Applicant's Address of Last Employer

Street Address

Street Address Line 2

CityState

Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Business Phone
Please enter a valid phone number.
Gross Monthly Income ($)
Type of Business
If you have changed jobs in the past 6 months, have your employer complete the Employment Verification Form.
MONTHLY INCOME

	Applicant	Co-Applicant	Others in Household
Wages
TANF
Alimony
Child Support
Social Security
SSI
Disability
Section 8 Housing
Unemployment Benefits
VA Compensation
Retirement (e.g. pension)
Military entitlements
Other
Total

Income Documents: (check stubs for the most recent 3 months, child support verification, social security/disability statements, if applicable - bankruptcy discharge papers)

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PLEASE NOTE: Self-employed applicants may be required to provide additional documentation such as tax returns and financial statements.
Tax Return Documents

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Household Members Whose Income is Listed Above

	Name	Income Source	Monthly Income	Date of Birth
1.
2.
3.
4.

Closing Costs
You will be required to pay for your first year of homeowners insurance at the time of closing (approximately $1,000-$1,500). You will also be required to pay for your costs to close (approximately $1,200- $1,500). Please tell us how you plan to cover these expenses.
Assets

	Name of Bank, Savings and Loans, Credit Union, Assets	Address, City, State Zip	Account Number	Current Balance ($)
1.
2.
3.
4.
Total

Bank Statements: (most recent 6 months)

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Debt

To whom do you and the co-applicant(s) owe money?

Applicant's Debts ($)

	Monthly Payment	Unpaid Balance	Months Left to Pay
Other Motor Vehicle
Boat
Furniture, Appliances, TV's (rent to own)
Allimony
Child Support
Credit Card
Credit Card
Credit Card
Student loan debts
Open 30 days (balance paid monthly, e.g travel card)
Medical debt
Other
Other
Total

Applicant: Provide a written explanation of any debts for which you have established payment plans.
Applicant: Provide documentation from the debtor of the arrangement you have made.

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Co-Applicant's Debts ($)

	Monthly Payment	Unpaid Balance	Months Left to Pay
Other Motor Vehicle
Boat
Furniture, Appliances, TV's (rent to own)
Allimony
Child Support
Credit Card
Credit Card
Credit Card
Student loan debts
Open 30 days (balance paid monthly, e.g travel card)
Medical debt
Other
Other
Total

Co-Applicant: Provide a written explanation of any debts for which you have established payment plans.
Co-Applicant: Provide documentation from the debtor of the arrangement you have made.

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Monthly Expenses ($)

	Applicant	Co-Applicant
Rent
Utilities
Insurance
Child Care
Internet Service
Cell Phone
Landline
Business Expenses
Union Dues
Other
Other
Other
Total

Declarations

Please select the word that best answers the following questions for you and the co-applicant

	Applicant	Co-Applicant
a. Do you have any outstanding judgments because 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 judgment?
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 through h, or "no" to question i, please explain
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
Do you wish to furnish this information?

YesNo
Race (applicant may select more than one racial designation)

American Indian or Alaska NativeNative Hawaiian or other Pacific IslanderBlack/African-AmericanWhiteAsian
Ethnicity

Hispanic or LatinoNon-Hispanic or Latino
Sex

FemaleMale
Marital status

MarriedSeparatedUnmarried (single, divorced, widowed)
Co-Applicant
Do you wish to furnish this information?

YesNo
Race (applicant may select more than one racial designation)

American Indian or Alaska NativeNative Hawaiian or other Pacific IslanderBlack/African-AmericanWhiteAsian
Ethnicity

Hispanic or LatinoNon-Hispanic or Latino
Sex

FemaleMale
Marital status

MarriedSeparatedUnmarried (single, divorced, widowed)
Authorization, Agreement 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.

If this application is created as (or converted into) an "electronic application," I consent to the use of "electronic records" and "electronic signatures" as the terms are defined in and governed by applicable federal and/or state electronic transaction laws. I intend to sign and have signed this application either using my: (a) electronic signature or (b) a written signature and agree that if a paper version of this application is converted into an electronic application, the application will be an electronic record, and the representation of my written signature on this application will be my binding electronic signature.

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.
This is to notify you that we may order an appraisal in connection with your loan. Upon completion of the appraisal, we will promptly provide a copy to you, even if the loan does not close.
Applicant's Signature*

Clear
Date

MonthDayYear
Month - Day - Year
Co-Applicant's Signature

Clear
Date

MonthDayYear
Month - Day - Year
Equal Credit Opportunity Act Notice
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 the Midwest region, Federal Trade Commission, 55 West Monroe Street, Suite 1825, Chicago, IL 60603 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's Signature*

Clear
Co-Applicant's Signature

Clear
Applicant's Full Name

First NameLast Name
Co-Applicant's Full Name

First NameLast Name
Date

MonthDayYear
Date
Date

MonthDayYear
Date
You will also have to submit a seperate Criminal History Form as part of the application process.
Should be Empty:

HOMEOWNERSHIP PROGRAM APPLICATION

Willingness to Partner

Present Housing Conditions

Property Information

Applicant's Employment Information

Co-Applicant's Employment Information

MONTHLY INCOME

Closing Costs

Assets

Debt

Declarations

Information for Government Monitoring Purposes

Applicant

Co-Applicant

Authorization, Agreement and Release

Equal Credit Opportunity Act Notice