Application for homeownership

Application for Homeownership

Please complete the following 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 will be kept confidential in accordance with the Gramm Leach-Bliley Act.

If you have any questions please contact us at 401.213.6711 x305 for assistance.

Click "save" at the bottom of each section at any point to finish the application at a later time (a link will be emailed to you).

South County Habitat for Humanity is an equal opportunity, fair housing provider and does not discriminate on any basis protected by state or federal law in its selection process.

South County Habitat for Humanity

1555 Shannock Road, Charlestown, RI 02813 Mailing: PO Box 68, Shannock, RI 02875
Phone: 401.213.6711 | Fax: 401.213.6715 Email: housing@southcountyhabitat.org

Need for Housing
Please briefly describe your need for housing in the space below.

How did you hear about this application round?
Your feedback helps us improve our outreach efforts

Household Members

Please use the following section to list those who would be living in the home with you, aside from the applicant(s)

Rows	Name	Date of birth	Does this person have income? (Y/N)
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Dependent 6
Dependent 7
Dependent 8

Income Information

Employment income: List all current sources of employment for household members, including applicant(s).

Rows	Employer name	Start Date (MM/YYYY)	Monthly gross wages	Whose income is this?
Employer 1
Employer 2
Employer 3
Employer 4
Employer 5
Employer 6

Non-Employment Income: List all current non-employment income for household members, including applicant(s). (eg - SSI, SSDI, child support, retirement or veteran benefits)

Rows	Income source	Description	Monthly amount	Whose income is this?
Source 1
Source 2
Source 3
Source 4
Source 5
Source 6

Applicant and co-applicant - please list the past 5 years of employment (if not included above).

Rows	Employer name	Dates of employment (MM/YYYY - MM/YYYY)	Applicant or Co-Applicant?
Source 1
Source 2
Source 3
Source 4
Source 5

Use the space below to share any details about your employment income (e.g., seasonal work, fluctuating hours, per diem
Asset Information

Applicant and Co-Applicant - Enter all financial accounts - savings, checking, CD, Money Market, cryptocurrency, Venmo, etc.

Rows	Name of Company or Institution	Account type	Last 4 digits of acct	Current balance
Account 1
Account 2
Account 3
Account 4
Account 5
Account 6

Debt Information

Applicant and Co-Applicant enter all debts - car loans, student loans, child support, credit cards, payday, personal loans, etc.

Rows	Name of Company or Institution	Type of Debt	Monthly payment	Remaining balance
Account 1
Account 2
Account 3
Account 4
Account 5
Account 6

Willingness to Partner
Willingness to partner: To qualify for Habitat for Humanity’s homeownership program, applicants must show a strong willingness to partner with SCHH. This includes completing required "Sweat Equity" hours—non-monetary contributions such as helping build homes, volunteering at the SCHH ReStore, attending events, or completing workshops.

Applicants are also expected to maintain good communication with SCHH, keep finances and credit in good standing, and speak positively about the organization.
Applicant: I have read and understand the Willingness to Partner and agree to complete the required hours of Sweat Equity and other program requirements
Co-Applicant: I have read and understand the Willingness to Partner and agree to complete the required hours of Sweat Equity and other program requirements

Notices and Agreements

Please review this notice carefully and sign below to acknowledge your understanding.
Privacy Notice:

At Habitat for Humanity for Rhode Island, South County Inc., 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 more efficiently serve our customers, 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 verification and payment history – internal controls are maintained throughout the process to ensure security and confidentiality.

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 kinds of nonpublic personal information about you:
- Information we receive from you on applications 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 or payment history;
- and Information we receive from a consumer reporting agency such as your creditworthiness and credit history.
Habitat for Humanity for Rhode Island, South County Inc. 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, other subsidy providers;
- Habitat legal representatives.
If you prefer that we do not disclose nonpublic personal information about you to non-affiliated 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 call Habitat for Humanity for Rhode Island, South County Inc. at (401) 213-6711.

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, 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: Northeast Region Federal Trade Commission, 1 Bowling Green, New York, NY 10004 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.
Please enter your full name and today's date below to acknowledge you agree and understand the following:
- By submitting this application I am authorizing South County Habitat for Humanity (SCHH) to evaluate my eligibility for the homeownership program.
- I understand that the evaluation will include a credit check and income verification.
- I have answered all questions on this application truthfully. I understand that if I have not answered questions truthfully, my application may be denied, and that even if I have already been selected for the program, I may be disqualified from the program and forfeit any rights or claims to a Habitat home.
- I understand SCHH screens all applicants on the sex offender registry as well as running a criminal background check. By completing this application, I am submitting myself and all persons listed, to such an inquiry.
- I have read and understand the Privacy Notice
- I have read and understand the Equal Credit Opportunity Act Notice
Applicant Name

First NameLast Name
Applicant: Today's Date

MonthDayYear
Co-Applicant Name

First NameLast Name
Co-Applicant: Today's Date

MonthDayYear

Application Submission
Submit Application

By selecting below you are submitting your application and documentation. Applications cannot be modified once submitted.
Should be Empty:

Rows	Yes	No
1. Do you have any outstanding court-ordered judgments against you?
2. Have you declared bankruptcy in the past 3 years?
3. Have you had property foreclosed on or deed-in-lieu of in the past 7 years?
4. Are you currently involved in a lawsuit?
5. Are you a co-signer or endorser on any loan?
6. Are you a US citizen or permanent resident?

Rows	Yes	No
1. Do you have any outstanding court-ordered judgments against you?
2. Have you declared bankruptcy in the past 7 years?
3. Have you had property foreclosed on or deed-in-lieu of in the past 7 years?
4. Are you currently involved in a lawsuit?
5. Are you a co-signer or endorser on any loan?
6. Are you a US citizen or permanent resident?

Applicant* Information

Co-Applicant Information

Need for Housing

How did you hear about this application round?

Demographic information

Household Members

Income Information

Asset Information

Debt Information

Declarations

Willingness to Partner

Notices and Agreements

Submit Application