Home Repair Application

Dear Homeowner: This application provides Habitat for Humanity Calaveras with the basic information we need to determine your eligibility for the home repair program. This application also serves as a certification that the information you are providing is correct and authorizes Habitat for Humanity Calaveras to verify the information required to determine your elegibility. Please fill out the application as completely and accurately as possible. 

Habitat for Humanity Calaveras is unable to address repairs not directly related to health and safety such as routine maintenance, appliance repairs or replacement, repairs to garages or other spaces not considered living quarters and not required to access living quarters, luxury and/or cosmetic improvements (including interior and exterior paint), and various landscaping needs such as tree removal.

Upon application approval, a member of the Habitat for Humanity staff will conduct a site visit to determine the scope of work. Please note the scope of work may differ from the requested repairs. 

Homeowner and any additional able-bodied household members (16 or older) residing at the property agree to contribute to the work at the property also known as "Sweat Equity".

I acknowledge that Sweat Equity is a requirement of the Program and understand that no compensation will be paid to me and other members of my household for performance of Sweat Equity under any circumstances. 

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 Western Region, Federal Trade Commission 901 Market Street, Suite 570 San Francisco, CA 94103 or Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580. The law does not require you to 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 do 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 our Home Repair program.

• I/We certify that the information provided on this application is true and accurate and that I/We own the property at the address given.

• I/We grant permission to Habitat for Humanity Calaveras to check any and all references and to take any and all actions reasonably necessary to substantiate the information contained in this application or otherwise establish my/our suitability as an applicant(s) for the Habitat for Humanity Calaveras' Home Repair Program, including without limitation, contacting or otherwise attempting to confirm my/our (1) employment status and credit history, (2) personal references, including all parties listed in this application and/or any other parties which Habitat for Humanity Calaveras desires to contact, (3) family composition and marital status and related issues, (4) credit worthiness, (5) immigration status, (6) background check and other information relative to criminal charges and/or convictions, (7) any additional information that Habitat for Humanity of Calaveras deems necessary to evaluate this application. I/We understand that Habitat for Humanity Calaveras may reject this application based upon the results of these inquiries.

• I/We agree that if Habitat for Humanity Calaveras selects my/our home to be repaired, photos of me/us, my/our household members and my/our home may be taken and a biographical summary about me/us and my/our project may be written and shared with the general public or utilized for public relations, promotional or program development purposes. Additionally, certain details, including homeowner name, address,and demographic characteristics may be published publicly.

• I/We understand and agree that if Habitat for Humanity Calaveras selects my/our home to be repaired, I/We must participate as partners with Habitat for Humanity Calaveras which includes completing Sweat Equity hours or another qualifying volunteer opportunity.

• I/We understand that there is no monetary or other form of compensation for Sweat Equity.

• I/We understand that Habitat for Humanity Calaveras makes no guarantees as to the start or completion dates or length of repairs.

• I/We understand that Habitat for Humanity Calaveras is a nonprofit corporation with limited resources and cannot afford to provide or guarantee assistance for each applicant. Consequently, I/We agree that Habitat for Humanity Calaveras, its staff, whether voluntary or compensated, and its board of directors will not be liable in any way or otherwise be held responsible by me/us or anyone acting on my/our behalf in connection with my/our application for Habitat for Humanity Calaveras or any claims of any nature associated herewith.

• I/We understand that copies of any and all documentation provided to determine my/our program eligibility will not be distributed to a third-party without my/our authorization and may only be returned upon request.

• I/We understand that if I/We receive the maximum assistance from Habitat for Humanity Calaveras' Home Repair Program, I/We may not receive additional assistance for 3 years from Habitat for Humanity Calaveras after the completion of my/our repairs.

• I/We understand that submission of this Home Repair Program application and any supporting documentation does not guarantee assistance from Habitat for Humanity Calaveras' Home Repair Program.

• I/We understand that selection is based on submitting all required documentation, meeting the eligibility criteria and the availability of program funding, and that not all applicants may be serviced.

• I/We understand that program policies are subject to change at any time without prior notice. Any changes will be provided in writing.

If you need assistance, we are happy to help facilitate the completion of the application and gathering supplemental documents. 

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 the 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.

Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Please read this notice carefully to understand what Habitat for Humanity Calaveras, here in referred to as HFHC, does with your personal information. 

We collect nonpublic personal information about you from the following sources:

• Information we receive from you on applications or other forms;
• Information about your transactions with us or others; and
• Information we receive from a consumer reporting agency. 

We may disclose the following kind of nonpublic personal information about you

•  Information we receive from you on application or other forms, such as your name, address, social security number, assets, income, etc. 
• Information about your transactions with us or others such as your loan balance, payment history, etc.; and
• Information we receive from a consumer reporting agency such as your creditworthiness and credit history. 

All financial companies need to share customer's personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers' personal information; the reasons HFHC chooses to share; and whether you can limit this sharing. 

At Habitat for Humanity Calaveras, we are committed to keeping your information private. We recognize the importance applicants, program families, tenants, and homeowners place on the privacy and confidentiality of their information. While new technologies allow us to serve our customers more efficiently, we are
committed to maintaining privacy standards that are synonymous with our established and trusted name.

When collecting, storing, and retrieving applicant, program family, and homeowner data-such as tax returns, pay stubs, credit reports, employment verifications and payment history-internal controls are maintained throughout the process to ensure security and confidentiality. 

Habitat for Humanity Calaveras employees and volunteers are subject to a written policy regarding confidentiality, and access to applicant data is restricted to staff and volunteers on an as-needed basis. Information is used for lawful business purposes and is never shared with third parties without your consent, except as permitted by law. As permitted by law, we may disclose nonpublic personal information about you to the following types of third parties:

• Financial service providers, such as mortgage servicing agents.
• Nonprofit organizations, government entities, or other subsidy providers.

If you prefer that we do not disclose nonpublic personal information about you to nonaffiliated third parties, you may opt out of those disclosures; that is, you may direct us not to make those disclosures (other than disclosures permitted by law). If you wish to opt out of disclosures to nonaffiliated third parties, you may contact Habitat for Humanity Calaveras at admin@habitatcalaveras.org.

It is illegal to discriminate in the provision of or in the availability of financial assistance because of the consideration of:

• Trends, characteristics or conditions in the neighborhood or geographic area
  surrounding a housing accommodation or whether or not such composition is
  undergoing change, or is expected to undergo change, in appraising a housing accommodation or in determining whether or not, or under what terms and conditions, to provide financial assistance.
• Race, color, religion, sex, marital status, national origin or ancestry. It is illegal to consider the racial, ethnic, religious or national origin composition of a neighborhood or geographic area surrounding a housing accommodation or whether or not such composition is undergoing change, or is expected to undergo change, in appraising a housing accommodation or in determining whether or not, or under what terms and condition, to provided financial assistance.

These provisions govern financial assistance forthe purpose of the purchase, construction, rehabilitation or refinancing of one-to-four family residence occupied by the owner and for the purpose of the home improvement of any one-to-four family residence.

If you have questions about your rights, or if you wish to file a complaint, contact the management of this financial institution or:

California Department of Real Estate

Complaint Intake Unit

320 W. 4th Street, Ste 350

Los Angeles, CA 90013-1105

or

California Department of Real Estate

General Mail

P.O. Box 137000

Sacramento, CA 95813-7000

That I/we am/are currently occupying as my/our principal place of residence the real property commonly known as:

I/We delcare under penalty of perjury that the foregoing is true and correct.

Signature(s) of all occupants (over 18):