Housing Counseling Intake Form

  • Housing Counseling Intake Form

    LCHA is HUD Approved Housing Counseling Agency # 80113
  • Format: (000) 000-0000.
  • What type of Counseling are you seeking?*
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  • The following information is requested by our funders and/or the federal government to monitor compliance with the federal statutes that prohibit discrimination in housing.

  • Are you (check all that applies):*
  • Do you consent to sharing your experiences with LCHA's Housing Counseling with our funders or board of commissioners?*
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  • Please read the following Disclosure to Client and Privacy Policy

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  • LCHA's Privacy Policy

    Please read LCHA's Privacy Policy regarding your nonpublic personal information:
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  • Regarding your nonpublic personal information:*

  • For Your Protection, Get a Home Inspection

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  • Credit Report Authorization and Privacy Disclosure Form

    Credit Report Authorization and Privacy Disclosure Form

  • I hereby authorize and instruct Lake County Housing Authority (hereinafter “LCHA”) to obtain and review my credit report/s. My credit report/s will be obtained from credit reporting agencies chosen by LCHA. I understand and agree that LCHA intends to use my credit reports only for the purpose of evaluating my financial circumstances, to engage in counseling activities and/or to establish my readiness to purchase a home.*
  • My signature below authorizes the release of personal and financial information that I have supplied to LCHA in connection with such evaluation. Authorization is further granted to LCHA to use a copy of this form to obtain any information the LCHA deems necessary to complete my financial evaluation or create my personalized action plan.*
  • I understand that any debt management or spending plans suggested by an LCHA counselor are voluntary programs which serve to assist in the repayment of debts. These are not formal or binding agreements with debt holders, lenders, or creditors. LCHA maintains no formal agreement or affiliation with any debt holder, lender, or creditor.*
  • I understand that LCHA is not a lender and does not issue loans or credit.*
  • I understand that LCHA will be executing a "soft pull". A soft pull allows authorized parties to review your credit but these inquiries but do not allow associated lending decisions. A soft pull will not affect my credit score.*
  • I understand that I may revoke my authorization to these provisions at any time by contacting LCHA in writing.*
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