FORECLOSURE PREVENTION COUNSELING INTAKE FORM CLIENT #1

Save this PDF as:
Size: px
Start display at page:

Download "FORECLOSURE PREVENTION COUNSELING INTAKE FORM CLIENT #1"

Transcription

1 ML-4909 FORECLOSURE PREVENTION COUNSELING INTAKE FORM CLIENT #1 Name: Address: Mailing address (if different): First Middle Last Street City State Zip Code Street City State Zip Code Home/Cell Phone: ( ) Work Phone: ( ) Primary Language: How did you hear about us? Race (please circle all that apply): White American Indian/Alaskan Native Asian Black or African American Native Hawaiian/Other Pacific Islander Other: Household Size: Are you a veteran? Yes Gender (please circle): Male Female Were you born outside the United States? (please circle): Yes Head of household? Yes Household Type (please circle the most accurate): Single Married w/o children Married w/ children Female Head of Household Male Head of Household Two or more unrelated adults Other: How many dependents (other than those listed by any co-borrower)? What ages are they?,,, Are there non-dependents who will be living in the home? Yes If yes, list below: Relationship Age Relationship Age Hispanic (please circle): Yes Birth Date / / Social Security Number: - - Do you have a disability? Yes Do you have disabled dependants? Yes Education: (please circle one): Below High School Diploma High School Diploma or Equivalent Two-Year College Bachelors Degree Masters Degree Above Masters Degree Marital Status (please circle): 1. Single 2. Married 3. Divorced 4. Separated 5. Widowed Annual Household Income (gross): $ Current Housing Arrangement (please check one): Rent Does not pay rent Homeless Homeowner with mortgage Homeowner with mortgage paid off Are you a First Time Buyer? Yes (you do not currently own a home and have not owned a home in the past 3 years) Page 1 of 5

2 CLIENT #1 EMPLOYMENT Primary Employer: Secondary Employer: CLIENT #2 INFORMATION (other household member) Name: Last First MI Same Address as Client #1? Yes How Long at Address with Client #1? Preferred Contact Type (circle one): Home Phone Cell Phone Work Phone Home: ( ) Work: ( ) ext. Mobile/Cell: ( ) Fax: ( ) Social Security Number: Birth Date: / / Race (please circle one): White Black or African American American Indian/Alaskan Native & White Asian Black/African American & White American Indian/Alaskan Native & Black Asian & White Native Hawaiian/Other Pacific Islander American Indian/Alaskan Native Other: Hispanic: Yes Foreign Born:.. Yes Gender:. Male Female Are you a Veteran:.. Yes Are you disabled?. Yes Education (please circle one): Below High School Diploma Two-Year College Masters Degree High School Diploma or Equivalent Bachelors Degree Above Masters Degree Marital Status (circle one): Single Married Divorced Separated Widowed Relationship to Borrower (circle one): Spouse/Partner Child Sibling Parent Other Relative Relative by Marriage Do you have separate dependants? Yes What ages are they?,,,,,,, Page 2 of 5

3 CLIENT #2 EMPLOYMENT Primary Employer: Secondary Employer: MONTHLY INCOME Client #1 Gross Monthly Income $ Net Monthly Income $ Income: Job 1 - $ Job 2 - $ Job 3 - $ Client #2 Gross Monthly Income(s) $ Net Monthly Income $ Income: Job 1 - $ Job 2 - $ Job 3 - $ OTHER INCOME Alimony/Child Support Social Security Pension Income Public Assistance Dependent SSI Income Disability Income Rental Income CLIENT #1 CLIENT #2 Type Monthly Gross Monthly Gross SAVINGS/INVESTMENTS Check if applicable and the approximate value for each of the following: Type of account Bank/Company Checking account $ Savings account $ Retirement account $ Cash $ LOAN INFORMATION 1 st Mortgage (Primary): Monthly payment: _Amount still owed on loan: _ tice of Default? (circle one) Yes Auction Date: Page 3 of 5

4 Loan TYPE - Please circle all that apply: Insured Conventional FHA USDA Mobile Home Loan Uninsured Conventional VA Assumed Contract for Deed Loan TERM in years (circle one): Are taxes and insurance included in your payment (escrow)?. Yes If not, are your taxes current?... Yes is your insurance current?.... Yes 2 nd Mortgage (Secondary): Monthly payment: _Amount still owed on loan: _ tice of Default? (circle one) Yes Auction Date: Association Dues or 3 rd Mortgage: Monthly payment: _Amount still owed on loan: _ tice of Default? (circle one) Yes Auction Date: DEBTS/EXPENSES TYPE TOTAL OWED MONTHLY PAYMENT Credit card 1 Credit card 2 Credit card 3 Credit card 4 Car 1 Car 2 Student Loan Family Loan Personal Loan Other TOTAL DEBTS/EXPENSES BRIEF DESCRIPTION OF YOUR SITUATION Page 4 of 5

5 Do you want to try to keep your home? Yes Unsure Have you had previous delinquencies? When? Have you had previous workout plans with your mortgage company? When? Have you talked to your mortgage company yet about your current situation? Outcome? AUTHORIZATION, VERIFICATION AND DISCLOSURE: - I understand that I will FULLY PARTICIPATE in the Loan Modification reprocess with my Lender and actively communicating with the Lender s Loss Mitigation Department. - I understand that IF I do not provide ALL requested documents in a timely manner; within 5 business days, the file will NOT be sent to the Lender as they do not accept incomplete packets. - I will NOT receive a follow-up call after my counseling session; unless I call with a question, or I have hit a roadblock with my lender and/or I have attained a loan modification. If WNHS should hear anything from your lender before hand WNHS will give you a call. I understand that when and if I leave a message, I will get a call back within 2 business days. Other concerns will be addressed according to urgency and receipt of message. - I understand that my point of contact will be my foreclosure prevention counselor at WNHS. - I understand that WNHS receives congressional funds through the National Foreclosure Mitigation Counseling (NFMC) program and, as such, is required to share some of my personal information with NFMC program administrators or their agents for purposes of program monitoring, compliance and evaluation. - I understand that the NFMC program administrators and/or their agents may follow-up with me between now and December 31, 2012 for the purposes of program evaluation. - I understand that WNHS provides foreclosure mitigation counseling after which I will receive a written action plan consisting of recommendations for handling my finances, possibly including referrals to other assistance agencies or other WNHS programs/services as appropriate. - I understand that a counselor may answer questions and provide information, but not give legal advice. If I want legal advice, I will be referred for appropriate assistance. - I understand that I may be referred to other services provided by the organization, another agency or agencies as appropriate that may be able to assist with my particular concerns that have been identified. I also understand that I am not obligated to use any of the services offered to me. - I understand WNHS reserves the right to update or change our service delivery model, and will do our best to keep you apprised of these changes. Some or all of the agencies that fund the Foreclosure Program at Willamette Neighborhood Housing Services (WNHS), include, but are not limited to, the Department of Housing and Urban Development (HUD), National Foreclosure Mitigation Counseling (NFMC), Oregon Housing & Community Services (OHCS), and NeighborWorks America. The organizations that fund this program may require WNHS to share my personal information including the information provided above, and all information collected hereafter with program administrators or their agents for purposes of program monitoring, reporting, compliance, and evaluation. WNHS is a community development corporation. WNHS offers many affordable housing products including: affordable rental housing, housing rehabilitation loans, housing development and property sales, housing counseling services, and micro business services. WNHS provides home buyer education, pre-purchase, foreclosure prevention counseling services, as well as mortgage financing. I understand that WNHS encourages me to choose mortgage financing that meets my needs and is in my best interest. I understand that I am under no obligation to utilize any of WNHS services. I further understand I am not obligated to use any services from WNHS partners, and I am free to seek services from other providers. Should you or anyone you are with require special assistance for mobility impairments, visual or hearing impairments or other disabilities, please let the WNHS staff know and arrangements will be made to accommodate those needs. I acknowledge receipt of the WNHS Privacy Policy and understand the privacy options regarding this information. I hereby verify this information to be true and accurate to the best of my knowledge, and if asked can prove accuracy of the information. I identify the person(s) signing the registration form to be the client(s) receiving services from WNHS. Client # 1 Date Client # 2 Date ML-4909 Page 5 of 5

There is NO fee for mortgage assistance counseling.

There is NO fee for mortgage assistance counseling. Supporting Document Checklist Mortgage Assistance Counseling NOTE: If you have an impairment, disability, language barrier, or otherwise require an alternative means of completing this form or accessing

More information

REVERSE MORTGAGE. because HOME is where it all starts.

REVERSE MORTGAGE. because HOME is where it all starts. REVERSE MORTGAGE COUNSELING MATERIALS because HOME is where it all starts. Follow us on: Neighborhood Housing Services of Waterbury 161 North Main St. Waterbury CT 06702 P: 203.753.1896 F: 203.757.6496

More information

Neighborhood Housing Services

Neighborhood Housing Services Neighborhood Housing Services Lizz Casey Reverse Mortgage Counselor 520 W. Grand Ave. Beloit, WI 53511 of Beloit, Inc. 608-362-9051 Fax: 608-362-7226 www.nhsofbeloit.org Thank you for inquiring about Reverse

More information

Privacy Policy. We may disclose the following kinds of personal non-public information about you:

Privacy Policy. We may disclose the following kinds of personal non-public information about you: Registration Congratulations on taking your first steps toward buying a home! The first thing to know is that you are registering for the HomeOwner Basics program not a specific class. NeighborWorks Anchorage

More information

COMPLETE AND MAIL BACK TO: SEAGO ATTN: Julie Packer 1403 W. Highway 92 Bisbee, AZ 85603

COMPLETE AND MAIL BACK TO: SEAGO ATTN: Julie Packer 1403 W. Highway 92 Bisbee, AZ 85603 COMPLETE AND MAIL BACK TO: SEAGO ATTN: Julie Packer 1403 W. Highway 92 Bisbee, AZ 85603 Name: APPLICATION/INTAKE FORM (updated 3/11) Name: Please fill out the Application/Intake form completely # in Household:

More information

Steps to a Home Retention Solution. Required Document Checklist Please verify that you have submitted the following items by checking the box:

Steps to a Home Retention Solution. Required Document Checklist Please verify that you have submitted the following items by checking the box: Steps to a Home Retention Solution Follow these easy steps! 1. Call BCL of Texas and discuss your homeownership situation 2. Have Counselor explain the guidelines, check list, eligibility, and requirements

More information

Metro Interfaith Housing Counseling. Tell Us About Yourself. General Information Primary

Metro Interfaith Housing Counseling. Tell Us About Yourself. General Information Primary Metro Interfaith Housing Counseling 21 New St, Binghamton, NY 13903 Phone: 607.723.0582 Fax: 607.722.8912 Tell Us About Yourself Print clearly. Use additional sheets if necessary. Information provided

More information

Currently Renting How long at this address? Own My Home How many in the household?

Currently Renting How long at this address? Own My Home How many in the household? A. Client Information INTAKE FORM Last Name First Name Middle Initial Street Address City, State & Zip Best Phone Number(s) to Reach You Email Address Currently Renting How long at this address? Own My

More information

Mortgage Intervention Checklist

Mortgage Intervention Checklist 105 14 th Avenue, Seattle, Washington 206.461.3792 Fax 206.461. 8425 Mortgage Intervention Checklist The following information is needed in order for the Urban League to effectively review your situation

More information

INTAKE PACKET CHECKLIST

INTAKE PACKET CHECKLIST Dear Homeowner, www. rupco.org Thank you for your interest in our foreclosure prevention program. We understand that this is a difficult time for your household and we are here to help. In order to be

More information

INTAKE FORM. Signature. Signature. Date. Property Address: City: State: CA Zip Code:

INTAKE FORM. Signature. Signature. Date. Property Address: City: State: CA Zip Code: 2560 W Shaw Lane #101 Fresno CA 93711 Ph 559-221-6919 Fax 559-256-1564 info@chcfresno.org INTAKE FORM HUD Approved Agency #84811 Date Property Address: City: State: CA Zip Code: County: Home Phone: Do

More information

Foreclosure Prevention Intake Form

Foreclosure Prevention Intake Form Foreclosure Prevention Intake Form PART 1 Date: Client Number: Reason for Visit: How Did You Hear About SCDHC? Applicant: Name: City: State: Age: Lender Realtor SCDHC Mail Website : Zip: Home #: Cell #:

More information

REBUILDING YOUR CREDIT

REBUILDING YOUR CREDIT REBUILDING YOUR CREDIT REGISTRATION FORM Pre-Registration is REQUIRED There is a $10 fee for the course per household and a $20 per person fee for the tri-merged credit report. You may also bring a copy

More information

Registration Form Portland Housing Center

Registration Form Portland Housing Center Registration Form Portland Housing Center PORTLAND HOUSING CENTER www.portlandhousingcenter.org 3233 NE Sandy Blvd., Portland, OR 97232 Phone: 503-282-7744 x 101 Fax: 503-736-0101 For office use only Date

More information

Housing Partnership is a HUD Approved Nonprofit Organization

Housing Partnership is a HUD Approved Nonprofit Organization Dear Homeowner: Congratulations for taking that tough first step and contacting the Housing Partnership about your mortgage. We understand how hard that can be and promise to work as hard as you do to

More information

First Time Homebuyers

First Time Homebuyers First Time Homebuyers Congratulations on your first step toward homeownership! Our program is designed to guide you from start; education, to the finish; closing on your new home. Please take note of some

More information

Neighborhood Housing Services of New York City, Inc. 307 West 36th Street, 12th Floor NY, NY 10018 Tel: 212-519-2500 Fax: 212-727-8171

Neighborhood Housing Services of New York City, Inc. 307 West 36th Street, 12th Floor NY, NY 10018 Tel: 212-519-2500 Fax: 212-727-8171 NHS of Bedford Stuvesant 1012 Gates Avenue Brooklyn NY 11221 Tel: 718-919-2100 Fax: 718-919-2725 NHS of East Flatbush 2806 Church Avenue Brooklyn, NY 11226 Tel: 718-469-4679 Fax: 718-469-4743 NHSNYC NeighborWorks

More information

HOME STRETCH WORKSHOP REGISTRATION

HOME STRETCH WORKSHOP REGISTRATION HOME STRETCH WORKSHOP REGISTRATION Organization: Workshop location: Workshop (s): Instructions: Please fill out as completely as possible. If you need additional space, please feel free to use the back

More information

Fax completed package to: 703-580-8842

Fax completed package to: 703-580-8842 Fax Cover Sheet/Check List Borrower Name: Please Print Co-Borrowers Name: Please Print Loan Number(s): Owner Occupied n-owner Occupied Required Documentation for Borrower and Co-Borrower If you are a Wage

More information

MORTGAGE DELINQUENCY AND DEFAULT RESOLUTION COUNSELING

MORTGAGE DELINQUENCY AND DEFAULT RESOLUTION COUNSELING MORTGAGE DELINQUENCY AND DEFAULT RESOLUTION COUNSELING INTAKE PACKAGE Housing Partnership is a HUD approved nonprofit organization 1 Dear Homeowner: Congratulations for taking that tough first step and

More information

City of Victorville Mortgage Assistance Program Application (80% AMI)

City of Victorville Mortgage Assistance Program Application (80% AMI) City of Victorville Mortgage Assistance Program Application (80% AMI) Congratulations on taking steps towards homeownership. The City of Victorville, through its Mortgage Assistance Program, offers up

More information

DATA INTAKE FORM. Email Address: Fax: Send authorization via: LOAN INFORMATION

DATA INTAKE FORM. Email Address: Fax: Send authorization via: LOAN INFORMATION DATA INTAKE FORM Date: Call In or Walk In CMAX #: Hud# Start Time: End Time: Borrower: DOB: Age: DOB: Age: Gender: M F Race Hispanic: Y N Gender: M F Race Hispanic: Y N Education level: Military Status:

More information

Neighborhood Housing Services of Green Bay, Inc. d/b/a NeighborWorks Green Bay Program Intake Form

Neighborhood Housing Services of Green Bay, Inc. d/b/a NeighborWorks Green Bay Program Intake Form Neighborhood Housing Services of Green Bay, Inc. d/b/a NeighborWorks Green Bay Program Intake Form Return Completed Form to: NeighborWorks Green Bay Today s : 437 S. Jackson St. www.nwgreenbay.org Green

More information

NEIGHBORHOOD STABILIZATION PROGRAM (NSP) APPLICATION FOR NSP LOAN. Program Guidelines

NEIGHBORHOOD STABILIZATION PROGRAM (NSP) APPLICATION FOR NSP LOAN. Program Guidelines APPLICATION FOR NSP LOAN Income limits per household Program Guidelines Maximum Income 1 48,150 2 55,000 3 61,900 4 68,750 5 74,250 6 79,750 7 85,250 8 90,750 Homebuyer Requirements Home Education Minimum

More information

FIRST TIME HOMEBUYERS PROGRAM APPLICATION 75 College Avenue, 4 th Floor, Rochester, NY 14607 585-546-3700 3019 fax 585-546-2946

FIRST TIME HOMEBUYERS PROGRAM APPLICATION 75 College Avenue, 4 th Floor, Rochester, NY 14607 585-546-3700 3019 fax 585-546-2946 FIRST TIME HOMEBUYERS PROGRAM APPLICATION 75 College Avenue, 4 th Floor, Rochester, NY 14607 585-546-3700 3019 fax 585-546-2946 Applicant 1: Applicant 2: Home Ph# ( ) Work Ph# ( ) Cell Ph# ( ) Social Security

More information

FORECLOSURE COUNSELING APPOINTMENT CHECKLIST. Completed Foreclosure Intake Forms Including Budget Sheet, Release of Information, & Privacy Statement

FORECLOSURE COUNSELING APPOINTMENT CHECKLIST. Completed Foreclosure Intake Forms Including Budget Sheet, Release of Information, & Privacy Statement FORECLOSURE COUNSELING APPOINTMENT CHECKLIST PLEASE BRING EACH OF THE FOLLOWING TO YOUR APPOINTMENT: Completed Foreclosure Intake Forms Including Budget Sheet, Release of Information, & Privacy Statement

More information

Foreign Born. Female Head of Household Female. Male. Native Hawiian/Pacific Islander Native American/Alaskan Native

Foreign Born. Female Head of Household Female. Male. Native Hawiian/Pacific Islander Native American/Alaskan Native MORTGAGE DELINQUENCY INTAKE FORM Please fill out this application as completely as possible. If you have questions or need assistance, please call Windham & Windsor Housing Trust's Brattleboro office at

More information

FLORIDA POST PURCHASE COUNSELING PROGRAM

FLORIDA POST PURCHASE COUNSELING PROGRAM Phone: (727) 442-7075 Fax: (727) 446-8727 FLORIDA POST PURCHASE COUNSELING PROGRAM Please find enclosed our Foreclosure Prevention and Intervention Program Application. It is important that you complete

More information

APPLICATION FOR TENANT DO YOU HAVE A LEAD POISONED CHILD IN YOUR HOUSEHOLD? YES NO YES YES YES YES

APPLICATION FOR TENANT DO YOU HAVE A LEAD POISONED CHILD IN YOUR HOUSEHOLD? YES NO YES YES YES YES *TE: Each rental unit must complete a form. TENANT'S NAME: Please print duplicates Community Development Block Grant CITY OF SHEBOYGAN DEPARTMENT OF CITY DEVELOPMENT 828 CENTER AVENUE, Suite 104 SHEBOYGAN,

More information

CREDIT & BUDGET COUNSELING CHECKLIST. Completed Housing Intake Forms Including Budget Sheet, Release of Information, & Privacy Statement

CREDIT & BUDGET COUNSELING CHECKLIST. Completed Housing Intake Forms Including Budget Sheet, Release of Information, & Privacy Statement CREDIT & BUDGET COUNSELING CHECKLIST PLEASE BRING EACH OF THE FOLLOWING TO YOUR APPOINTMENT: Completed Housing Intake Forms Including Budget Sheet, Release of Information, & Privacy Statement Copy of Pay

More information

Borrower Name: SSN: DOB: Co-Borrower Name: SSN: DOB: Property Address:

Borrower Name: SSN: DOB: Co-Borrower Name: SSN: DOB: Property Address: Homeowner Intake Form Please print clearly and fill out all fields. I am interested in : Mortgage Default Prevention or Counseling Refinancing Reverse Mortgage Who Referred You? Scheduled Sale Date (If

More information

INTAKE FORM FORECLOSURE / PREDATORY LENDING COUNSELING

INTAKE FORM FORECLOSURE / PREDATORY LENDING COUNSELING DATE: I. CLIENT INFORMATION INTAKE FORM FORECLOSURE / PREDATORY LENDING COUNSELING Borrower Name: How did you hear about us? Website Have you contacted another agency? Yes No Agency Name Social Security

More information

Tooele County HOMEOWNER HOUSING REHAB LOAN APPLICATION

Tooele County HOMEOWNER HOUSING REHAB LOAN APPLICATION ELIGIBILITY Income Eligibility: This program is available to households with a maximum of 80 percent of the median family income for Tooele County. If your household income is greater than the limits,

More information

CITY OF SHEBOYGAN COMMUNITY DEVELOPMENT BLOCK GRANT OWNER-INVESTOR REHABILITATION LOAN PROGRAM GUIDELINES AND APPLICATION

CITY OF SHEBOYGAN COMMUNITY DEVELOPMENT BLOCK GRANT OWNER-INVESTOR REHABILITATION LOAN PROGRAM GUIDELINES AND APPLICATION CITY OF SHEBOYGAN COMMUNITY DEVELOPMENT BLOCK GRANT OWNER-INVESTOR REHABILITATION LOAN PROGRAM 1 You must be the owner of the property to be rehabilitated. 2 The property must be located in the City of

More information

WESTERN DAIRYLAND HOUSING COST REDUCTION INITIATIVE AND NSP/FRESH START APPLICATION

WESTERN DAIRYLAND HOUSING COST REDUCTION INITIATIVE AND NSP/FRESH START APPLICATION WESTERN DAIRYLAND HOUSING COST REDUCTION INITIATIVE AND NSP/FRESH START APPLICATION Social Security No. Applicant(s) (First Name) (Middle Initial) (Last Name) Address_ (Street) (City) (County) (Zip code)

More information

MORTGAGE PRE-APPROVAL

MORTGAGE PRE-APPROVAL MORTGAGE PRE-APPROVAL THE FIRST STEP TO OWNING YOUR OWN HOME Welcome Before you start looking for a home, arm yourself with the knowledge of what you can afford to spend and borrow by obtaining a mortgage

More information

HOUSING OPPORTUNITIES MADE EQUAL OF VIRGINIA, INC. Ensuring equal access to housing for all people.

HOUSING OPPORTUNITIES MADE EQUAL OF VIRGINIA, INC. Ensuring equal access to housing for all people. HOUSING OPPORTUNITIES MADE EQUAL OF VIRGINIA, INC. Ensuring equal access to housing for all people. Dear Homeowner: 626 East Broad Street, Suite 400 Richmond, Virginia 23219 804.354.0641 Fax: 804.354.0690

More information

1 Cal-Home Owner Occupied Rehabilitation Program Guidelines

1 Cal-Home Owner Occupied Rehabilitation Program Guidelines 1 Cal-Home Owner Occupied Rehabilitation Program Guidelines Funds for this program are provided through the State of California's Housing and Community Development Department Introduction: Cal Home is

More information

Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program

Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program Program Overview Under the First Time Homebuyer Program, the Hallandale Beach CRA will provide up to $50,000 in assistance

More information

SOMERSET DISASTER RECOVERY APPLICATION FOR HOMEOWNER ASSISTANCE

SOMERSET DISASTER RECOVERY APPLICATION FOR HOMEOWNER ASSISTANCE SOMERSET DISASTER RECOVERY APPLICATION FOR HOMEOWNER ASSISTANCE Application # Applicant Name: Co-Applicant Name: Property Address: City: Zip Code: Home Phone: Work Phone: Cell Phone: Section 1 - Property

More information

Application for Free Home Repairs

Application for Free Home Repairs Application for Free Home Repairs Name of Homeowner: Date of Birth: Gender Male Female Is this a female headed household? Is this a grandparent headed household? Street Address: City: County: Zip Marital

More information

What to bring to your first appointment:

What to bring to your first appointment: Tampa Bay Community Development Corporation Housing Counseling Services 2139 N.E. Coachman Road, Suite 1, Clearwater, FL 33765 Phone: (727) 442-7075 (866) 608-3220 (813) 849-1121 Fax: (727) 446-8727 www.tampabaycdc.org

More information

Foreclosure Prevention Process

Foreclosure Prevention Process NHS of the Fox Valley One American Way Elgin, IL 60120 Phone: (847) 695-0399 Fax: (847) 695-7011 Foreclosure Prevention Process How to OBTAIN a one-to-one consultation with a HUD-certified counselor please

More information

H.E.L.P. COMMUNITY DEVELOPMENT CORP. Foreclosure Counseling Program DOCUMENT CHECKLIST

H.E.L.P. COMMUNITY DEVELOPMENT CORP. Foreclosure Counseling Program DOCUMENT CHECKLIST H.E.L.P. COMMUNITY DEVELOPMENT CORP. Foreclosure Counseling Program DOCUMENT CHECKLIST PLEASE COMPLETE ITEMS 1 AND 2 BELOW AND FAX OR MAIL BACK TO OUR OFFICE. Complete the INTAKE FORMS as thoroughly as

More information

HOMEOWNER REHABILITATION LOAN

HOMEOWNER REHABILITATION LOAN City of Mobile COMMUNITY & HOUSING DEVELOPMENT DEPARTMENT DEADLINE: Friday, February 27, 2015 at 4:00 p.m. CITYWIDE IV HOMEOWNER REHABILITATION LOAN APPLICATION Please Return the Completed Application

More information

H O M E FOR HOMEOWNERS IN DISTRICT 3

H O M E FOR HOMEOWNERS IN DISTRICT 3 H O M E R E H A B L O A N P R O G R A M FOR HOMEOWNERS IN DISTRICT 3 Are You Having Problems with Your Plumbing? Do You Need a New Roof? Are Your Windows Old and Seeping Air? How About Other Over Looked

More information

PRE-PURCHASE HOMEOWNERSHIP PLANNING PROCESS

PRE-PURCHASE HOMEOWNERSHIP PLANNING PROCESS Helping Overcome Poverty s Existence, Inc. P.O. Box 743 Wytheville, Va. 24382; (276) 228-6280, Fax (276) 228-0508 Toll Free Phone: 1-877-818-8680 PRE-PURCHASE HOMEOWNERSHIP PLANNING PROCESS STEP 1 - Complete

More information

Main Office: Fax: (585) 243-4143 Tel: (585) 243-1500 Fax: (585) 243-4143 4621 Millenium Drive Geneseo, NY 14454

Main Office: Fax: (585) 243-4143 Tel: (585) 243-1500 Fax: (585) 243-4143 4621 Millenium Drive Geneseo, NY 14454 Main Office: Fax: (585) 243-4143 Tel: (585) 243-1500 Fax: (585) 243-4143 4621 Millenium Drive Geneseo, NY 14454 Dear Member, Thank you for your interest in our Home Equity Line of Credit. We appreciate

More information

RICE COUNTY ENVIRONMENTAL SERVICES RICE COUNTY SUBSURFACE SEWAGE TREATMENT SYSTEM LOW INCOME FIXUP GRANT PROGRAM

RICE COUNTY ENVIRONMENTAL SERVICES RICE COUNTY SUBSURFACE SEWAGE TREATMENT SYSTEM LOW INCOME FIXUP GRANT PROGRAM (507) 332-6113 RICE COUNTY ENVIRONMENTAL SERVICES 320 Northwest Third Street Suite 9 Faribault, Minnesota 55021-6145 Toll free from Northfield (507) 645-9576 Toll free from Lonsdale (507) 744-5185 TDD

More information

Our Mission. Promoting Independence by Providing Car Care

Our Mission. Promoting Independence by Providing Car Care Check List Douglas County Residents Only Our Mission Promoting Independence by Providing Car Care Please Submit the Following: FOR ALL APPLICANTS Fill out application completely and sign Sign the attached

More information

Dear Client, Photo ID Driver s license or Maryland State issued photo ID PLEASE COMPLETE/SIGN AND RETURN THESE ENCLOSED FORMS

Dear Client, Photo ID Driver s license or Maryland State issued photo ID PLEASE COMPLETE/SIGN AND RETURN THESE ENCLOSED FORMS Dear Client, Thank you for choosing Neighborhood Housing Services of Baltimore, Inc. for your homeownership retention and financial needs. To schedule an individual counseling appointment with a Homeownership

More information

Neighborhood Housing Services of New York City, Inc. 307 West 36th Street, 12th Floor NY, NY 10018 Tel: 212-519-2500 Fax: 212-727-8171

Neighborhood Housing Services of New York City, Inc. 307 West 36th Street, 12th Floor NY, NY 10018 Tel: 212-519-2500 Fax: 212-727-8171 Neighborhood Housing Services of New York City, Inc. 307 West 36th Street, 12th Floor NY, NY 10018 Tel: 212-519-2500 Fax: 212-727-8171 NHS of Bedford Stuvesant 1012 Gates Avenue Brooklyn NY 11221 Tel:

More information

First Time Homebuyer Program Application Package

First Time Homebuyer Program Application Package First Time Homebuyer Program Application Package Program Services The Homeownership Program's objective is to assist in all aspects of homeownership. Services provided by our home ownership counseling

More information

CalHome Homeowner Rehabilitation Loan Program Information

CalHome Homeowner Rehabilitation Loan Program Information CalHome Homeowner Rehabilitation Loan Program Information 333 W Ocean Blvd., 3rd Floor Long Beach CA 90802-4430 (562) 570-6949 Fax (562) 570-6215 lbcic.org Thank you for your interest in the Cal-Home Homeowner

More information

COMMUNITY ACTION PROGRAM OF EVANSVILLE Serving Gibson, Posey, Vanderburgh & Warrick Counties 27 Pasco Avenue Evansville, IN 47713 (812) 425-4241

COMMUNITY ACTION PROGRAM OF EVANSVILLE Serving Gibson, Posey, Vanderburgh & Warrick Counties 27 Pasco Avenue Evansville, IN 47713 (812) 425-4241 COMMUNITY ACTION PROGRAM OF EVANSVILLE Serving Gibson, Posey, Vanderburgh & Warrick Counties 27 Pasco Avenue Evansville, IN 47713 (812) 425-4241 FORECLOSURE PREVENTION COUNSELING APPLICATION Thank you

More information

CONGRATULATIONS! To get your approval letter

CONGRATULATIONS! To get your approval letter CONGRATULATIONS! Congratulations on your decision to make an offer on a Bank of America Foreclosure! As you may be aware, our REO Properties require a Bank of America approval letter before the listing

More information

Overview. Our Programs» Strengthening Norfolk s Neighborhoods. One person, one home, one dream at a time.

Overview. Our Programs» Strengthening Norfolk s Neighborhoods. One person, one home, one dream at a time. Overview HomeNet, a component of the Norfolk Redevelopment and Housing Authority (NRHA) is a full-service homeownership center who partners with local lending institutions, attorneys, housing developers,

More information

FIRST-TIME HOMEBUYER EDUCATION PROGRAM

FIRST-TIME HOMEBUYER EDUCATION PROGRAM FIRST-TIME HOMEBUYER EDUCATION PROGRAM The Center for Affordable Homeownership is committed to empowering potential homebuyers with the ability to make educated and informed decisions regarding the process

More information

Home Equity Loan Application

Home Equity Loan Application LCMS Rostered Church Worker Home Equity Loan Application INSTRUCTIONS: This is an interactive form that allows you to enter information in each field by using the tab key to move through the form. The

More information

SOMERSET DISASTER RECOVERY APPLICATION FOR BUSINESS ASSISTANCE

SOMERSET DISASTER RECOVERY APPLICATION FOR BUSINESS ASSISTANCE SOMERSET DISASTER RECOVERY APPLICATION FOR BUSINESS ASSISTANCE Application # Applicant Name: Co-Applicant Name: Business Name: Business Address: City: Zip Code: Home Phone: Work Phone: Cell Phone: Section

More information

Transportation Assistance Program Verification Checklist

Transportation Assistance Program Verification Checklist Please submit the following to the 2 nd floor reception desk at the Blaine Human Services Center, or via fax, or mail (see fax/address at bottom of the page): Car Repair, Insurance, or Vehicle Registration

More information

Lee County Central Point of Coordination Application Return Application Requested By: HIPPA Yes NO. Date of Application: / / Phone: #( )- -

Lee County Central Point of Coordination Application Return Application Requested By: HIPPA Yes NO. Date of Application: / / Phone: #( )- - Lee County Central Point of Coordination Application Return Application Requested By:_ HIPPA Yes NO Date of Application: / /Phone: #()-- Name of Applicant: Last First M.I. Current Address: City State Zip

More information

Foreclosure Prevention/Loan Modification Packet

Foreclosure Prevention/Loan Modification Packet Foreclosure Prevention/Loan Modification Packet Visionary Home Builders of California, Inc. (VHB) is a non-profit agency and is approved by the U.S. Department of Housing and Urban Development (HUD) to

More information

Rialto Housing Authority Mortgage Assistance Program Application

Rialto Housing Authority Mortgage Assistance Program Application Rialto Housing Authority Mortgage Assistance Program Application Congratulations on taking steps towards homeownership. The Rialto Housing Authority, through its Mortgage Assistance Program, offers up

More information

Pre-Purchase Counseling Application

Pre-Purchase Counseling Application Pre-Purchase Counseling Application Guidance on purchasing a home and qualifying for downpayment assistance Pre-purchase counseling helps prepare the first-time homebuyer for the home purchase process

More information

We Do Business in Accordance to the Federal Fair Housing Law

We Do Business in Accordance to the Federal Fair Housing Law PLEASE COMPLETE IN FULL Housing Authority of the City of Fort Myers Public Housing Application SOUTHWARD VILLAGE APTS. 3040 Franklin Street, Fort Myers, FL 33916 Telephone (239) 332-6635 Fax (239) 344-3273

More information

EMERGENCY REHAB APPLICATION GENERAL INFORMATION

EMERGENCY REHAB APPLICATION GENERAL INFORMATION EMERGENCY REHAB APPLICATION GENERAL INFORMATION 1 The City of Huntington Community Development Block Grant (CDBG) will make available no interest loans that you will have to repay monthly for minor home

More information

GUIDELINES FOR ACCEPTANCE IN THE HABITAT FOR HUMANITY OF PULASKI COUNTY PROGRAM

GUIDELINES FOR ACCEPTANCE IN THE HABITAT FOR HUMANITY OF PULASKI COUNTY PROGRAM GUIDELINES FOR ACCEPTANCE IN THE HABITAT FOR HUMANITY OF PULASKI COUNTY PROGRAM 6700 S. University Ave. Little Rock, AR 72209 501.376.4434 Apply for a Home 1. You will be considered for a Habitat home

More information

Bridge Closing Cost Assistance Loan Program Application

Bridge Closing Cost Assistance Loan Program Application Bridge Closing Cost Assistance Loan Program Application Congratulations on taking the steps towards Bridging" the Gap to Sustainable Homeownership. NPHS, through its partnership with the High Desert Association

More information

Loss Mitigation Pre-Foreclosure Sale Request Instructions & Disclosures

Loss Mitigation Pre-Foreclosure Sale Request Instructions & Disclosures Loss Mitigation Pre-Foreclosure Sale Request Instructions & Disclosures Member Name: Loan Number: If you have received a valid, reasonable, offer to purchase your home prior to a foreclosure and you would

More information

HOMEBASE AFFORDABLE HOMES PROGRAM

HOMEBASE AFFORDABLE HOMES PROGRAM HOMEBASE AFFORDABLE HOMES PROGRAM INCOME ELIGIBILITY APPLICATION Revised April 2013 Please provide ALL applicable information on this form. It will be used to determine your eligibility; HomeBase Income

More information

NFMC Client Level Data and Quarterly Reporting Requirements

NFMC Client Level Data and Quarterly Reporting Requirements NFMC Client Level Data and Quarterly Reporting Requirements The following data points will be collected for each draw request. If, upon implementation of the National Foreclosure Mitigation Counseling

More information

Alix Desulme District 4 Council Representative 2015 Single Family Home Beautification Program

Alix Desulme District 4 Council Representative 2015 Single Family Home Beautification Program Councilman Alix Desulme District 4 Council Representative 2015 Single Family Home Beautification Program The City of North Miami 2015 Single Family Home Beautification Program is a repair and rehabilitation

More information

Car Repair, Insurance, Vehicle Registration Requests:

Car Repair, Insurance, Vehicle Registration Requests: Transportation Assistance Program Please keep this page for your records. Car Repair, Insurance, Vehicle Registration Requests: Anoka County Minnesota Residents Only VERIFICATION CHECKLIST: Please submit

More information

Foreclosure Intervention Client Counseling Session Packet

Foreclosure Intervention Client Counseling Session Packet Foreclosure Intervention Client Counseling Session Packet IMPORTANT CLIENT NOTICE All Clients must complete all pages in this packet and provide all requested documents before an appointment can be scheduled.

More information

Uniform Residential Loan Application Washington Federal Savings

Uniform Residential Loan Application Washington Federal Savings Uniform Residential Loan Application Washington Federal Savings This application is designed to be completed by the Applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower"

More information

LIVE NEWARK DEPARTMENT OF ECOMONIC AND HOUSING DEVELOPMENT DIVISION OF HOUSING AND REAL ESTATE HOME FACADE PROGRAM (HFP) APPLICATION

LIVE NEWARK DEPARTMENT OF ECOMONIC AND HOUSING DEVELOPMENT DIVISION OF HOUSING AND REAL ESTATE HOME FACADE PROGRAM (HFP) APPLICATION LIVE NEWARK DEPARTMENT OF ECOMONIC AND HOUSING DEVELOPMENT DIVISION OF HOUSING AND REAL ESTATE HOME FACADE PROGRAM (HFP) APPLICATION Please PRINT and complete ALL pages of this application in its entirety

More information

Uniform Residential Loan Application

Uniform Residential Loan Application This application is designed to be completed by the applicant(s) with the Lender s assistance. Applicants should complete this form as Borrower or Co-Borrower, as applicable. Co-Borrower information must

More information

Northern Arizona Council of Governments

Northern Arizona Council of Governments Northern Arizona Council of Governments 119 EAST ASPEN AVENUE FLAGSTAFF, ARIZONA 86001-5222 (928) 774-1895 FAX (928) 773-1135 E-MAIL: khaislet@nacog.org KENNETH J. SWEET EXECUTIVE DIRECTOR Dear Homeowner,

More information

Homeowner Assistance Form

Homeowner Assistance Form Homeowner Assistance Form Before you complete this form, contact us for assistance. Mortgage loan number: I/We want to: Keep the property Sell the property The property is my/our: Primary residence Second

More information

Orlando Housing Authority

Orlando Housing Authority Orlando Housing Authority Orlando Housing Authority Primary Business Address Your Address Line 2 Your Address Line 3 Your Address Line 4 Phone: 555-555-5555 Fax: 555-555-5555 E-mail: someone@example.com

More information

PREQUALIFICATIONS RESULTS OF THE PREQUALIFICATION ARE UNOFFICIAL AND MAY CHANGE WHEN ALL ESTIMATED INFORMATION IS VERIFIED.

PREQUALIFICATIONS RESULTS OF THE PREQUALIFICATION ARE UNOFFICIAL AND MAY CHANGE WHEN ALL ESTIMATED INFORMATION IS VERIFIED. CENTRAL APPALACHIA EMPOWERMENT ZONE OF WEST VIRGINIA P.O. Box 176 Phone: 304/587-2034 Fax: 304/587-2027 PREQUALIFICATIONS The Prequalification process gives the Central Appalachia Empowerment Zone of WV

More information

BANKWEST MORTGAGE MANUFACTURED HOUSING CREDIT APPLICATION

BANKWEST MORTGAGE MANUFACTURED HOUSING CREDIT APPLICATION BANKWEST MORTGAGE MANUFACTURED HOUSING CREDIT APPLICATION DATE OF APPLICATION: SALES PRICE: DOWN PAYMENT (10% Minimum)*: PURPOSE OF LOAN: PURCHASE CONSTRUCTION REFINANCE LOAN AMOUNT: HOME WILL BE: PRIMARY

More information

Carroll College Matched Education Savings Account Application

Carroll College Matched Education Savings Account Application PERSONAL INFORMATION Name: Social Sec. No. (last four digits): Gender: Female Male Date of Birth: / / Ethnicity: African American Caucasian Latino or Hispanic Asian, Pacific Islander Native American Other

More information

PRINCE GEORGE S COUNTY My HOME LOAN PROGRAM APPLICATION

PRINCE GEORGE S COUNTY My HOME LOAN PROGRAM APPLICATION 9200 Basil Court Suite 504 Largo, Maryland 20774 301.883.5456 301.883.5291 fax PRINCE GEORGE S COUNTY My HOME LOAN PROGRAM APPLICATION My HOME LN#: APPLICANT NAME(S): Projected Settlement Date: DTI: (max

More information

Please note: We are accepting applications for 1-4 bedroom apartments only.

Please note: We are accepting applications for 1-4 bedroom apartments only. Page 1 Gardens at SouthBay Preliminary Application 6720 S. Louis Ave, Tampa, FL 33616 PLEASE RETURN APPLICATION MONDAY THURSDAY 9AM 6PM POR FAVOR DE REGRESAR LA APLICACIÓN DE LUNES A JUEVES DE 9AM A 6PM

More information

First-Time Homebuyers Training Assistance Program Application

First-Time Homebuyers Training Assistance Program Application Dear Prospective First Time Home Buyer: Thank you for your recent inquiry regarding the City of Kenner Department of Community Development s First Time Home Buyers Training Assistance Program. The purpose

More information

Dear Resident, Sincerely, Neighborhood Services Staff. Rehabilitation Program. Purchase/Workforce Program. Completed Application Form

Dear Resident, Sincerely, Neighborhood Services Staff. Rehabilitation Program. Purchase/Workforce Program. Completed Application Form City of Delray Beach Neighborhood Services Division Dear Resident, Thank you for your interest in the City of Delray Beach Neighborhood Services Programs. We are required to document your eligibility for

More information

Purchase Pre-qualify Primary Residence Secondary Residence or Investment. Current Address: # of Dependents Age(s)

Purchase Pre-qualify Primary Residence Secondary Residence or Investment. Current Address: # of Dependents Age(s) Pre-Approval Application A Program of Greater Metropolitan Housing Corporation (GMHC) In partnership with Dayton s Bluff Neighborhood Housing Services (DBNHS) *** PLEASE PRINT OR TYPE ALL INFORMATION CLEARLY***

More information

GreenStreet Home Equity Loan

GreenStreet Home Equity Loan GreenStreet Home Equity Loan In an effort to give you the best possible service, we would like to make you aware of the information that you will need to provide the Bank, in addition to the enclosed documents.

More information

JVS CLIENT INFORMATION SHEET. Primary concerns

JVS CLIENT INFORMATION SHEET. Primary concerns JVS CLIENT INFORMATION SHEET Note: If you have an impairment, disability, language barrier, or otherwise require an alternative means of completing this form or accessing information about housing counseling,

More information

City of Wausau Homeowner Rehabilitation Program APPLICATION FOR DEFERRED PAYMENT LOAN

City of Wausau Homeowner Rehabilitation Program APPLICATION FOR DEFERRED PAYMENT LOAN Date Time City of Wausau Homeowner Rehabilitation Program APPLICATION FOR DEFERRED PAYMENT LOAN To the applicant: The information on this form will be used to determine your eligibility for a Homeowner

More information

Thank you for considering a grant from Homes Are Possible, Inc. (HAPI)!

Thank you for considering a grant from Homes Are Possible, Inc. (HAPI)! Thank you for considering a grant from Homes Are Possible, Inc. (HAPI)! Home rehabilitation work may include but is not limited to: Roof repairs/shingles Siding Windows/Door Plumbing Electrical Foundation

More information

Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS

Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS Frederick County Department of Housing and Community Development Neighborhood Conservation Initiative (NCI) Program LENDER CHECKLIST for NCI/AG APPLICATION PACKAGE Homebuyer(s) Property Address 8-30-13

More information

FAMILY ASSETS FOR INDEPENDENCE IN MINNESOTA (FAIM) FAIM New Participant Application Form AGENCY USE ONLY : Agency Name:

FAMILY ASSETS FOR INDEPENDENCE IN MINNESOTA (FAIM) FAIM New Participant Application Form AGENCY USE ONLY : Agency Name: FAMILY ASSETS FOR INDEPENDENCE IN MINNESOTA (FAIM) AGENCY USE ONLY : FAIM New Participant Application Form Revised 05/23/14 Agency Name: Bank Account Number of 1 st Deposit Asset Grant First Name MI Last

More information

strengthening businesses and communities, one entrepreneur at a time

strengthening businesses and communities, one entrepreneur at a time BACKGROUND Micro Enterprise Services of Oregon (MESO) seeks to provide technical and financial assistance to low income & small existing and new businesses whose owners reside and/or have businesses in

More information

DURHAM REGIONAL FINANCIAL CENTER. Mortgage Default/Delinquency Program APPLICATION FOR SERVICE

DURHAM REGIONAL FINANCIAL CENTER. Mortgage Default/Delinquency Program APPLICATION FOR SERVICE DURHAM REGIONAL FINANCIAL CENTER Mortgage Default/Delinquency Program APPLICATION FOR SERVICE Appointments 919.688.3381 Fax - 919.287.2457 Email - info@drfcenter.org 1 Prescreening Questionnaire The N.C.

More information

Application for Vocational Rehabilitation Services

Application for Vocational Rehabilitation Services Strong Families Make a Strong Kansas Application for Vocational Rehabilitation Services Is Vocational Rehabilitation the right program for you? Some brief information about the Vocational Rehabilitation

More information

Housing Rehabilitation Program Preliminary Application City of Arlington 501 W. Sanford Street, Suite 20 Arlington, Texas 76011

Housing Rehabilitation Program Preliminary Application City of Arlington 501 W. Sanford Street, Suite 20 Arlington, Texas 76011 Date of Application (Office Stamp Only) Housing Rehabilitation Program Preliminary Application City of Arlington 501 W. Sanford Street, Suite 20 Arlington, Texas 76011 The information collected below will

More information

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below):

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below): UNIFORM RESIDENTIAL LOAN APPLICATION This application is designed to be completed by the applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower",

More information