EH

eHome Session Form

Fill this out to complete your 1-hr session with a housing counselor!
Dear Future Homebuyer:

Thank you for choosing Clinch-Powell to complete your homebuyer education. Homebuyer Education program is for anyone who is interested in owning their own home and who realizes that such a significant undertaking is worth preparing for. Studies have shown that homeowners who completed homebuyer education and/or counseling were less likely to be delinquent on their mortgages and demonstrated better financial stability.

Clinch-Powell is a HUD-Approved counseling agency which utilizes the NCHEC Realizing the American Dream curriculum and complies with industry standards. This intake is for our online Homebuyer Education option through EhomeAmerica. EhomeAmerica is an online homebuyer education course approved by the state and government agencies. To register for the online course, go to ehomeamerica.org . *In the website, make sure that you select Clinch-Powell as your organization so that we receive your course information. You will be expected to pay for the course directly through the website; the cost will be $99.

As per the guidelines of the state housing finance agency (THDA), in addition to the online course content, participants must also complete a short budget counseling session before a Certificate of Completion will be provided. The specific content of what you discuss with your housing counselor in this session will be kept confidential, and will not affect your loan. Appointments can be done over the phone or in-person. We will need the listed information/documentation at least 24 hours before the appointment so that one of our housing counselors may complete an individualized financial analysis for your budget counseling session. **There are also FAQ’s at the end of the packet for your assistance.

*WHAT YOU WILL NEED TO PROVIDE US: (at least 24 hours before your budget counseling session)
- Proof of income for the household: a copy of at least one paystub/award letter from each source of income
- 1 months of bank statements (for all accounts)
- Or - Copy of most recent credit card statement (if applicable)
- Copy of the Loan Estimate
- Driver’s License (Required for all THDA mortgage Loans and down payment assistance)
*Note: The majority of people who participate in this program do so because they have already started the process with a specific lender who requires Homebuyer Education. You should make sure that the structure of Clinch-Powell’s online Homebuyer Education program meets all of the requirements to your lender’s satisfaction.

UPLOAD DOCUMENTS

Mail to PO Box 379; Rutledge, TN 37861

Fax to 865-828-5212
Borrower Information
First Name*
First Name
Last Name*
Last Name
Filename
Birthdate*

MonthDayYear
Last 4 of Social Security Number*
E-mail*
Phone Number*

Area CodePhone Number
Do you need to add a Co-Borrower?*

NoYes
Co-Borrower First Name
First Name
Co-Borrower Last Name
Last Name
Birthdate

MonthDayYear
Last 4 of Social Security Number
E-mail
Phone Number

Area CodePhone Number
Household Information
Address*

Street Address

Street Address Line 2

CityState

Zip Code
How long have you lived at current address?*
County*
Type of Current Residence
Household Size*
# of people living in house
Number of Dependents
Under 18 or Full-Time Student
Ages of Dependents

More borrower information
Are you a Veteran or Active Duty Military?*

VeteranActive DutyNo
Sex
Disabled
Race
Ethnicity
Highest Level of Education Obtained
Marital Status
Are you a Veteran or Active Duty Military?

VeteranActive DutyNo
Sex
Disabled
Race
Ethnicity
Highest Level of Education Obtained
Do the Borrower and Co-Borrower currently live together?

NoYes

Household Budget

Please complete this budget based on your CURRENT expenses BEFORE the new loan. This budget is a REQUIREMENT for your counseling session.
Housing Expenses*
Living Expenses*
Monthly Installment debt*
Etc. Monthly Expenses*
Note if any money is routinely set aside for Savings:
Ex: $100 per month
Do you have any upcoming changes in expenses or income?*

YesNo
If yes, please explain:

Electronic Signature and Submission

Please read Clinch-Powell's policies below. By signing, or selecting "Yes" you agree that you have read and fully understand our policies and agree to the terms of our policies.
Authorization + Terms & Conditions
I/we hereby authorize Clinch-Powell, when appropriate, to share information with USDA Rural Development, TN Housing Development Agency, Department of Housing & Urban Development, Federation of Appalachian Housing Enterprises, or another relevant third party or partnering agency for the purposes of program reporting, monitoring, compliance, and evaluation. And in furtherance of the aforementioned purposes, I authorize Clinch-Powell to contact me at a later date to request my Closing Disclosure and update the information in my housing file. I also authorize my lender(s) to provide relevant information/documentation to Clinch-Powell in order to assist with this program/process. I/We, certify that all the information I have provided is complete, correct and true to the best of my knowledge. I understand that providing false or misleading information may result in the rejection of my application and/or the withholding of a completion certificate. I have been made aware that the completion of a multi-hour Homebuyer Education course with additional financial counseling session is required. I also understand that the completion of this program in no way guarantees me a house or the loans/funds to purchase one. And further, that Clinch-Powell is an independent entity that does not have control or influence on the decisions of my (potential) lender.Fees for this service are paid directly to eHome America through their website, any discrepancies with the fee payment should be discussed directly with eHome America.The goal of Clinch-Powell’s Homebuyer Education program is to adequately prepare me for the challenges of buying/owning a home to the best of the instructor(s)’s abilities. While the program may strive to provide a variety of relevant information, the program does not assume the same level of expert knowledge available from professionals in their respective disciplines. As such, I understand that the information bestowed to me through this program in no way replaces or assumes comparability to that of: a tax professional/CPA, loan officer, financial/estate planner, contractor, psychologist, marriage counselor, real estate agent, lawyer (bankruptcy, property, divorce, tax, or otherwise). I also understand that it is my responsibility to provide Clinch-Powell and my (potential) lender with up to date contact information and accurate information. It is my responsibility to communicate with my lender directly regarding the status of my course process/completion. I authorize Clinch-Powell to contact me by any method I have provided. I understand Clinch-Powell has no control over the security of communication methods outside of its internally owned communication portals, and is therefore not responsible for external security breaches. Lastly, I acknowledge that this application is specifically for Homebuyer Education - and is NOT any type of loan application. The information provided within this application, or in my counseling sessions will only be provided to the loan officer(s) I have specified in this application.*

YesNo
Borrower Signature*

Clear
Co-Borrower Signature

Clear
Disclosure & Conflict of Interest
Clinch-Powell RC&D Council is a non-profit Community Housing Development Organization and a HUD-approved counseling agency (82394) that, among other activities, helps families with affordable housing goals. Most services are available in alternative formats and locations upon request.

Clinch-Powell receives funding for its housing programs through grants and loans from a number of sources, including but not limited to: USDA Rural Development, US Dept. of Housing & Urban Development [HUD], Corporation for National and Community Service, Federal Home Loan Bank, the Environmental Protection Agency, State of TN, THDA, Fahe/ Just Choice Lending, Citizens Bank & Trust Co. of Grainger County, Rural LISC, Fannie Mae, Freddie Mac, TVA, Ballad Health, East TN Foundation, United Way, public fundraising, and private donations.

As a housing counseling agency, Clinch-Powell offers the following services: 1) Pre-Purchase Homebuyer Education Workshops-- utilizing the Realizing the American Dream curriculum; 2) Pre-Purchase Counseling--financial readiness to purchase/own an affordable home; 3) Post-Purchase Counseling and Workshops-- non-delinquency home improvement, energy efficiency; 4) Foreclosure Prevention/Loss Mitigation Counseling—assisting to resolve mortgage defaults; 5) Rental Counseling--locating safe/decent rental housing; 6) Household Budgeting & Credit Repair Counseling and Workshops--financial literacy and personal money management; 7) High-Cost Mortgage Counseling-requirement of certain mortgage loans to ensure borrower’s understanding of the risk of the loan. Clinch-Powell, along with Clinch-Powell Construction Company develops affordable single-family homes to sell to low- to moderate- income families. In addition to coordinating the packaging and servicing of select loan products, subsidiary, TaCL, and Clinch-Powell itself occasionally offers low-interest loans and grants for various affordable housing activities. Clinch-Powell NMLS #195063; S. Karge NMLS#2403630. Please visit http://mortgage.nationwidelicensingsystem.org/ to find more information regarding history and profile as a mortgage lender. Lastly, Clinch-Powell is a property manager for multiple duplexes and single-family rental housing units which it also owns.

In providing counseling services, Clinch-Powell housing counselors will present to their clients several options in the furtherance of their housing goal/service, possibly including recommendations of some of the above listed services. The Clinch-Powell housing counselor will recommend only services that are in the best interest of the client, and will inform the client of any interests the organization has in any particular product or service. Within the agency, individual housing counselors may perform multiple affordable housing activities within the scope of their regular job duties, and as such, will not receive any additional funds or incentives specifically for those activities. Moreover, as per HUD guidelines, housing counselors will not simultaneously participate in specific housing activities.

As the client, you have the right to inquire as to specific relationships Clinch-Powell or its employees have with other entities. You also have the right to choose (or not) the products or services that you feel are right for your household, regardless of any option presented or recommendation made by the housing counselor. YOU ARE UNDER NO OBLIGATION TO UTILIZE/RECEIVE, OR EVEN CONTINUE WITH SERVICES THROUGH YOUR HOUSING COUNSELOR OR CLINCH-POWELL AS A WHOLE. Your decision to utilize or not utilize certain programs and products will not in any way affect your housing counseling service. If you decide to discontinue services with Clinch-Powell, or if your need is beyond the scope of the agency’s capabilities, Clinch-Powell staff will assist you locating a more suitable local agency.

If you/your housing situation meet certain criteria, we may collect personal information directly from you and enter into a computer system call HMIS (Homeless Management Information System). Many agencies that provide assistance use this computer system to gather information about clients that are homeless or at risk of homelessness. We only collect information that we consider to be appropriate. You are not required to provide this information. However, without your information we may not be able to fully assist your needs. All information provided to the HMIS system is safeguarded and held under tightest security.

Clinch-Powell is an equal opportunity provider, employer, and lender. Discrimination is prohibited by Federal law. Clinch-Powell Resource Conservation and Development Council is a 501(c)(3) non-profit organization. All programs of the RC&D are available without regard to race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, reprisal or retaliation for prior civil rights activity, in any program or activity conducted, or because the applicant has in good faith exercised any right under the Consumer Credit Protection act. The federal agencies that administer compliance with these laws are: U.S. Department of Justice, Civil Rights Division, 950 Pennsylvania Avenue, NW Washington, D.C. 20530-000;
Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington, D.C.
I/We have read and fully understand the above Disclosure and Conflict of Interest Policy.*

YesNo
Privacy Policy Notice
We may collect non-public personal information about you from the following sources: A) Information that you provide to us orally or written, such as on applications or other forms; B) Information about your transaction with us or others; and C) Information from others, such as credit bureaus, real estate appraisers, lenders and employers.

We do not disclose any non-public personal information about you without your consent to anyone, except:
- information provided to your lender as required to gain approval for a loan or protect your current home,
- to government agencies and grantors in compliance with their respective monitoring and reporting requirements,
- in broader forms to partnering agencies for reporting purposes, joint applications, and/or compilation of statistical data,
- as required by law.
To maintain security of customer information, we restrict access to your personal and account information to persons who need to know that information in order to provide you products and services requested with this application. We may disclose certain limited information to relevant third parties as part of a particular service as further described in the specific program authorization. We maintain physical, electronic and procedural safeguards that comply with federal standards to guard your non-public personal information. As a client, you have the right to opt-out and direct us to withhold non-public personal information from third parties, or to specify/limit to whom such information is provided. If you choose to opt-out, we will not be able to answer questions from third parties. To opt-out, you will need to make special note of this on this page, written separately, or explicitly stated to your counselor; not signing this page is not sufficient to opt-out. If at any time, you wish to change your decision with regard to your opt-out, you may call us at 865-828-5927 and do so.

If you decide to discontinue services through Clinch-Powell, we will still adhere to the policies and practices as described in this notice. The agency will continue to safely maintain your records for a period of time, of up to three (3) years, after which all digital files will be purged and paper documents will be shredded and destroyed.

I have been provided a copy of, fully read, and understand the information within this disclosure, as well as, Clinch-Powell RC & D’s policies regarding conflicts of interest and the confidentiality of client information as state above
I/We have read and fully understand the above Privacy Policy. *

YesNo
Upon submission of this form you will be emailed a link to HUD resources: "For your protection, get a home inspection!" (HUD form 92564-cn) and "Ten Questions to Ask Your Home Inspector". By clicking yes, you acknowledge those resources have been made available to you.*

I understand these resources will be made available to me.
By selecting the submit button I/we acknowledge, just as if I/we had signed a written contract, that all of the information stated in this application, to the best of my/our knowledge is true and accurate. *

YesNo
Should be Empty:

eHome Session Form

Borrower Information

Household Information

More borrower information

Household Income

Household Budget

Program Participation Questions

Electronic Signature and Submission

Authorization + Terms & Conditions

Disclosure & Conflict of Interest

Privacy Policy Notice