PRE HOMEOWNERSHIP APPLICATION

PRE HOMEOWNERSHIP APPLICATION

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 keep it confidential in accordance with the Gramm-Leach-Bliley Act.
APPLICANT INFORMATION
Applicant's name

First NameLast Name
Home phone
Please enter a valid phone number.
Age
Legal Status

MarriedSeparatedUnmarried (lncl. single, divorced, widowed)
Dependents and others who will live with you (not listed by co-applicant)*
Present address (street, city, state, ZIP code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of housing

OwnRent
Number of years
lf you have lived at your present address for less than two years, complete the following:
Present address (street, city, state, ZIP code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of housing

OwnRent
Number of years

EMPLOYMENT INFORMATION
Your CURRENT employer information

lf working at current job MORE than one year, complete the following information:
Name of your employer
Years on this job
Address of your employer

Street Address

Street Address Line 2

CityState

Zip Code
Monthly (gross) wages
Business phone
Please enter a valid phone number.
Type of business
Your LAST employer information

lf working at current job LESS than one year, complete the following information:
Name of your employer
Years on this job
Address of your employer

Street Address

Street Address Line 2

CityState

Zip Code
Monthly (gross) wages
Business phone
Please enter a valid phone number.
Type of business

CO-APPLICANT INFORMATION
Applicant's name

First NameLast Name
Home phone
Please enter a valid phone number.
Age
Legal Status

MarriedSeparatedUnmarried (lncl. single, divorced, widowed)
Dependents and others who will live with you (not listed by co-applicant)*
Present address (street, city, state, ZIP code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of housing

OwnRent
Number of years
lf you have lived at your present address for less than two years, complete the following:
Present address (street, city, state, ZIP code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of housing

OwnRent
Number of years

EMPLOYMENT INFORMATION
Your CURRENT employer information

lf working at current job MORE than one year, complete the following information:
Name of your employer
Years on this job
Address of your employer

Street Address

Street Address Line 2

CityState

Zip Code
Monthly (gross) wages
Business phone
Please enter a valid phone number.
Type of business
Your LAST employer information

lf working at current job LESS than one year, complete the following information:
Name of your employer
Years on this job
Address of your employer

Street Address

Street Address Line 2

CityState

Zip Code
Monthly (gross) wages
Business phone
Please enter a valid phone number.
Type of business
Should be Empty:

APPLICANT INFORMATION