I certify that I have owned this property at the address above for a minimum of 12 months and use it as my primary residence. I will continue to occupy my home for at least 5 years. If I must relocate, I understand I may be responsible for a prorated portion of the project cost. (20% of the project cost will be forgiven yearly.) I agree to sign the release and waiver of liability, which will not affect the coverage provided by the required homeowners insurance. I certify that I understand that Habitat for Humanity may not be able to provide all the repairs I have requested on this application. I certify that I understand that the priority for Habitat for Humanity Critical Home Repair project is primary homes of residence and that repairs to any auxiliary buildings (garages, sheds) will only be considered after this priority is met. I certify that I will provide all household income to Habitat for Humanity, and I will allow Habitat for Humanity to conduct a certification of household income, pull my credit report, verify people on the deed, and make personal visits to my home. I understand that by filing this application, I am authorizing Habitat for Humanity to evaluate my actual need for the Habitat Home Repair Program, my ability to repay an affordable loan, and my willingness to be an advocate for Habitat for Humanity. I understand that the evaluation may 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 funds through a Habitat Home Repair Program, I may be disqualified from the program and forfeit any rights or claims to Habitat funding. The original or a copy of this application will be retained by Habitat for Humanity even if the application is not approved. I understand Habitat for Humanity may require a down payment to start any repair project(s). This will depend on the repair program you qualify for and/or is available at the time of application. I understand Habitat for Humanity will obtain a Deed of Trust on your property for the amount of the repair minus your financial contribution (if any) to the project. A Claim of Lien will be registered with the County Register of Deeds until financial obligation is paid in full. At which time, a Discharge of Claim of Lien will be registered. If you are approved for a grant, then the Claim of Lien will be for any amount over the grant funded amount. Habitat for Humanity assumes all homes contain some lead from lead-based paint and Habitat for Humanity is a certified firm for lead-based paint renovations. As such I agree to allow Habitat to mitigate and dispose of lead-based paint according to EPA regulations. I certify that I will notify Habitat for Humanity of any changes to my financial or living situation as soon as they occur. I certify that I understand that this application and all copies of supporting documents will become the property of Habitat for Humanity and will not be returned to me, and that Habitat for Humanity will keep the original application on file for three years, whether or not it is approved. I certify that I will communicate program information and requirements, an explanation of repairs to be made, and any property lien information with all other titleholders (if any) of the property listed on this application. I also understand that Habitat for Humanity reserves the right to screen all applicants on the sex offender registry and conduct a criminal background check. By completing this application, I am submitting myself to such an inquiry. I certify that the information on this application is accurate.