Critical Home Repair Application Process

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1 Critical Home Repair Application Process The Critical Home Repair (CHR) Program is a home preservation program that provides needed interior and exterior repairs for low-income homeowners, so that they may maintain a safe, decent, and affordable place to live. The CHR Program is designed to be a hand up, not a hand out, to low-income elderly, disabled, and families who are in need such that they may feel proud and dignified about the place they call home. The CHR Program focuses on safety, security, accessibility, weatherization, and keeping houses up to city and town codes. The first step in the CHR Process is to determine the need of the family. The family must fill out the CHR Application completely and provide any supporting documents that are needed to verify income and expenses. It will then be determined by the affiliate if the family meets the low-income qualifications set by HUD. This is determined by the number of family living in the home and all income for those that are 18 years of age and older living in the home. At this time there is a required deposit due to the affiliate. The deposit amount will be based on the extent of the CHR Project and how many hours it will take the Construction Supervisor to start the CHR planning. The deposit will be a minimum of 50 to a maximum of 200 and will be applied to the balance due once the CHR Project is complete. However, if the homeowner backs out of the CHR Project, the deposit will not be refunded. The next step is for our Construction Supervisor to come out for a home inspection to evaluate the home and assess whether repairs or construction modifications can be made to the home. Typically, Habitat does not provide CHR to a home when the repair to the home costs more than the value of the home. If the repair or construction modification can be done, the Construction Supervisor will put together a project quote to estimate the cost of the CHR. At this time, it will be discussed between the affiliate board, Executive Director and homeowner as to what monthly payments will be required by the homeowner to the affiliate to reimburse for costs incurred. If the CHR Project requires a builder s permit, it will be the responsibility of the homeowner to pay for that up front. The builders permit will range in price depending on the city the homeowner lives in. If the homeowner cannot afford to pay for the builders permit up front, a written request must be submitted to the affiliate and at that time the Executive Director will request approval from the board of directors. Once a monthly payment agreement has been reached, the homeowner will sign the CHR Project Quote acknowledging the agreement. Once the CHR Project is complete, the final cost will be put together in a Promissory Note the details the monthly payment amount and the due date as well as any late fees that are applied. If you have any questions about this process, please feel free to contact us directly at (5147) We look forward to receiving your application and providing assistance to your family! Page 1 of 6

2 Strengthening families and neighborhoods through partnership, house building and affordable homeownership Application for Critical Home Repair 954 E. Grand River, Williamston, MI Phone: (517) Fax: (517) Applicant: Please complete this application as part of the selection process to determine if you qualify for Habitat for Humanity critical home repair. Please use ink and fill out the application as completely and accurately as possible. All information on this application will be kept confidential. PLEASE TELL US WHO REFERRED YOU TO HABITAT, OR HOW YOU HEARD OF US SO WE MAY THANK THEM (CIRCLE) Friend or family (who) Newspaper Flyer Website Radio Presentation If other, please explain Today s Date: APPLICANT INFORMATION Applicant s name Birthdate Co-Applicant s name Birthdate Social Security Number Phone Age - - ( ) Address Married Separated Unmarried (circle one) Dependents and others who live with you Name Age Male/Female Social Security Number Phone Age - - ( ) Address Married Separated Unmarried (circle one) Dependents and others who live with you Name Age Male/Female Present Street Address Own or Rent Present Street Address Own or Rent Present Street Address If Living at Present Address for Less Than Two Years Complete the Following Own or Rent Present Street Address Own or Rent FOR OFFICE USE ONLY DO NOT WRITE IN THIS AREA Date Received Date Application Complete WILLINGNESS TO PARTNER Page 2 of 6

3 To be considered for a HFHGI Critical Home Repair, you and your family must be willing to complete a certain number of sweat equity hours. Your help in providing a Critical Home Repair for yourself and others is called sweat equity and may include clearing the lot, painting, helping with construction, working in the Habitat office, or other approved activities. I AM WILLING TO COMPLETE THE REQUIRED SWEAT-EQUITY HOURS Applicant Yes No Co-Applicant Yes No Please estimate the number of hours and likely time of day you will be able to work each week to complete your hours of sweat equity. For example: Monday 4-6, Wednesday 12-2, Saturday 10-5 Applicant Monday Tuesday Wednesday Thursday Friday Saturday Co-Applicant Monday Tuesday Wednesday Thursday Friday Saturday PROPERTY INFORMATION If you own your residence, what is your monthly mortgage payment, including taxes and insurance? Do you own land? Yes Have you ever experienced a foreclosure? Yes Applicant No (if yes, please describe, including location No (if yes, what was the date?) EMPLOYMENT INFORMATION Co-Applicant If working at Current Job Less Than One Year, Complete the Following Information MONTHLY INCOME AND COMBINED MONTHLY BILLS Gross monthly income Applicant Co-Applicant s in Monthly Bills Monthly Amount Page 3 of 6

4 Employment Income Food Assistance Cash Assistance Social Security SSI Disability Child Support VA Benefit Total Household Rent Car Payments Credit Cards Child Support Student Loans Total Self-employed applicant(s) are required to provide the last 2 Office use only: years federal income tax returns with schedule C. 30 day pay stub W2 Statements All applicants must submit income documentation for all sources of income. Most recent 30 days pay stubs, W2 statements, last Previous years income taxes year s income taxes, and documentation of any other income received. SOURCE OF DOWNPAYMENT AND CLOSING COSTS If down payment is requested, where will you be getting the money? If you are borrowing money to pay these costs, explain how and from whom? ASSETS LIST CHECKING AND SAVINGS ACCOUNT BELOW Name and Address of Bank, Savings & Loan, or Credit Union Name and Address of Bank, Savings & Loan, or Credit Union Page 4 of 6

5 REPAIR REQUEST What are you requesting to be repaired? Permanent Wheel Chair Ramp Roof Replacement/Repair Weatherization : What is the reason you are requesting the repair? SOURCE OF REPAIR COST Where will you be getting the money to pay for the repair of your home? If you are borrowing the money to pay these costs, explain how and from whom. DEBT To whom do you and the co-applicant owe money? Car Payment Alimony/Child Support Payment Furniture Payment Job-Related Expenses Payment Credit Card Payment Payment Medical Payment Payment DECLARATIONS Please check the box that best answers the following questions for you and the co-applicant Applicant Co-Applicant Do you have any debt because of a court decision against you? Yes No Yes No Have you been declared bankrupt within the past 7 years? Date of discharge Yes No Yes No Have you had property foreclosed on in the last 7 years? Date of foreclosure: Yes No Yes No Are you currently involved in a lawsuit? Yes No Yes No Are you obligated to pay child support of separate maintenance? Yes No Yes No Are you a U.S. citizen or permanent resident? Yes No Yes No Answering yes to these questions does not automatically disqualify you. If you answered yes to any question a through c, however, please explain on a separate sheet of paper. Additional Household Income (over 18 years of age) Name Age Monthly Income Employer Page 5 of 6

6 We are pledged to the letter and spirit of U.S. policy for the achievement of equal housing opportunity throughout the nation. We AUTHORIZATION AND RELEASE I understand that by filing this application, I am authorizing Habitat for Humanity to evaluate my actual need for a Habitat home, my ability to repay the no-interest loan and other expenses of homeownership and my willingness to be a partner family. I understand that the evaluation will include personal visits, a credit check, and rental 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 will be denied, and that even if I have already been selected to receive a Habitat home, I will be disqualified from the program. The original copy of this application will be retained by Habitat for Humanity, even if the application is not approved. Applicant Signature Date Co-Applicant Signature Date X X encourage and support an affirmative advertising and marketing program in which there are no barriers to obtaining housing because of race, color, religion, sex, handicap, familial status or national origin. ADDITIONAL AUTHORIZATION AND RELEASE The undersigned applicant(s) applied for the Habitat for Humanity Homeownership/Critical Home Repair program. The applicant(s) authorize Habitat for Humanity of Greater Ingham County to evaluate the applicant s actual need for the Homeownership/Critical Home Repair program, ability to repay the loan and other expenses of homeownership, and the willingness to participate in the Habitat partnership. The evaluation will include personal visits, credit check, criminal records check and contact references. The applicant(s) authorize Habitat to obtain records pertaining to them and their family as requested, including necessary records related to financial matters including State or Federal taxes, court proceedings, Family Independence Agency, medical care, and employment/income. The applicant(s) release Habitat and its member volunteers from any and all liability, which may arise in connection with the release of information. The original or a copy of this application will be retained by Habitat for Humanity of Greater Ingham County, even if the application is not approved. I also understand that my signatures on this application give Habitat for Humanity of Greater Ingham County and its partners in the program permission to use photos and family bio in appropriate publications. Any information found to be fraudulent causes the application to be denied. Applicant s Signature _ Date Co-Applicant s Signature _ Date Page 6 of 6

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