First Time Homebuyers

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1 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 important information you need before attending the First Time Homebuyers Education Workshop. The classes are from 5:30-9:30PM on the third Wednesday and Thursday of the month. You must arrive on time and stay for the full time to receive a certificate of completion You are required to bring a valid governmental issued Photo identification and your most current paystub to the workshop on the first night. These documents are required in order to receive a certificate of completion. After you have successfully completed the eight hour workshop, you will be awarded The Urban League Palm Beach County Certificate of Completion. A housing representative will contact you within 30 days thereafter to schedule your one-on-one counseling session with an Urban League Palm Beach County Certified Housing Counselor. At the one-on-one counseling session you will be provided guidance and given an action plan to put you on track toward achieving The American Dream, Buying Your Own Home. At the First Time Homebuyer s Workshop a checklist will be given to you. Please be aware that you must bring the required documents to your One-on-One counseling appointment. Failure to do so will cause your appointment to be rescheduled. Your cooperation is imperative to ensure a smooth process. Thank you for trusting The Urban League of Palm Beach County to assist you in your road to Homeownership Success. Once Again Congratulations Urban League of Palm Beach County, Inc. Housing Department HUD Certified Counseling Agency Revised mm 1

2 Please fully complete the attached Intake Forms and, bring all pertinent documents below to scheduled appointment First Time Homebuyer Checklist Please fully complete the attached Intake Forms and Bring all pertinent documents below to scheduled appointment Driver's License and/or government issued photo ID (All adults 18 years or over in Households) Notarized Affidavit of Proper Address (If address does not match the Driver's License) Social Security Cards for all household members Copy of Alien ID Cards (If applicable) Children's Birth Certificates Copy of all Utility Bills Most recent 30 consecutive days pay stubs for all working adults (18 years & older) & Other applicable income such as: Benefits Statements for Social Security, AFDC, TANF Food Stamps, Retirements, SSI, Proof of Child Support or Child Support Order, Unemployment or Worker s Compensation. Two (2) most recent consecutive Bank Statements (All pages) Two (2) years most recent signed Tax Return with W2 Tax Forms (All pages and schedules) Self-employed: Two (2) years Tax Returns signed with all schedules and Profit & Loss Financial Statements Most recent other assets such as: IRA s, Stocks, Bonds, etc. Credit Report (ULPBC will obtain for an $18.00 per person Credit Report Fee) Please bring Cash or Money Order to your appointment Pre-approval from Lender (If applicable) Homeowners Certificate Revised mm 2

3 HOMEBUYER INTAKE APPLICATION Client ID#: APPLICANT PLEASE PRINT CLEARLY Name: First MI Last Address: Street City State Zip Home: ( ) - Work: ( ) - Cell: ( ) Social Security Number - - of Birth Race (Please circle): (1) American Indian/Alaskan Native & White (2) Black or African American (3) American Indian/Alaskan Native (4) American Indian/Alaskan Native & Black (5) White (6) Asian (7) Asian & White (8) Native Hawaiian/Other Pacific Islander (9) Black/African American & White (10) Other: Ethnicity (Please select Yes or No for Hispanic Origin): English Proficiency: Hispanic: Yes No Is English Proficient Is Not English Proficient Marital Status (Please circle): (1) Single (2) Married (3) Divorced (4) Separated (5) Widowed Gender (Please circle): Male Female Disabled (Please circle)? Yes No Current Housing Arrangement (Please select one): (1) Rent (2) Homeless (3) Homeowner with mortgage (4) Living with family member and not paying rent (5) Homeowner with mortgage paid off Rural Status? Does Not Live In Rural Area Lives In Rural Area Chose Not To Respond (1) Female headed single parent household (2) Two or more unrelated adults (3) Single Adult (4) Male headed single parent household (6) Married without children (5) Married with children (7) Other Family/Household Size: How many dependents? What ages are they?,,,,,,,,, Are there non-dependents who will be living in the home? Yes No (if yes list below) Relationship Age Relationship Age Annual Household Income: $ (Annual Gross wages of all wage earners in the household). Active Military: No Yes N/A Veteran? Foreign Born? Housing Choice Voucher? Revised mm 3

4 Education (Please circle one): (1) High School Diploma or Equivalent - (2) Two-Year Degree - (3) Bachelor s Degree - (4) Master s Degree Referred to by (please select all that apply) UL Employee/Board Member Bank Walk-In TV Realtor Government Agency Advertisement Friend Radio Newspaper If you were referred by a bank, which one? CO-APPLICANT PLEASE PRINT CLEARLY Name: First MI Last Address: Street City State Zip Home: ( ) - Cell: ( ) Social Security Number Work: ( ) of Birth Race (Please circle): (1) American Indian/Alaskan Native & White (2) Black or African American (3) American Indian/Alaskan Native (4) American Indian/Alaskan Native & Black (5) White (6) Asian (7) Asian & White (8) Native Hawaiian/Other Pacific Islander (9) Black/African American & White (10) Other: Ethnicity (Please select Yes or No for Hispanic Origin): English Proficiency: Hispanic: Yes No Is English Proficient Is Not English Proficient Marital Status (Please circle) (1) Single (2) Married (3) Divorced (4) Separated (5) Widowed Gender (Please circle): Male Female Disabled (please circle)? Yes No Education (Please circle one): (1)High School Diploma or Equivalent (2) Some College (3) Bachelor s Degree (4) Master s Degree (5) No High School (6) Some High School Relationship to Applicant (Please circle one): Spouse Daughter Son Sister Brother Girlfriend Boyfriend Mother Father Other (please specify) Active Military: No Yes N/A Veteran? Foreign Born? Housing Choice Voucher? APPLICANT EMPLOYMENT PLEASE PRINT CLEARLY Primary Employer: Position / Title Hire Street City State Zip Phone: ( ) - Part-Time or Full-Time (Please Circle) Gross Income (before Taxes): $ Paid Weekly Bi-weekly Twice a Month Monthly Revised mm 4

5 Secondary Employment: Position / Title Hire Address City State Zip Phone: ( ) - Part-Time Full-Time (Please Circle) Gross Income (before Taxes): $ Paid Weekly Bi-weekly Twice a Month Monthly CO-APPLICANT EMPLOYMENT PLEASE PRINT CLEARLY Primary Employer: Position / Title Hire Address City State Zip Phone: ( ) - Part-Time or Full-Time (Please Circle) Gross Income (before Taxes): $ Paid Weekly Bi-weekly Twice a Month Monthly Secondary Employment: Position / Title Hire Address City State Zip Phone: ( ) - Part-Time or Full-Time (Please Circle) Gross Income (before Taxes): $ Paid Weekly Bi-weekly Twice a Month Monthly INCOME PLEASE PRINT CLEARLY Type of Income Customer Monthly Amount Co-Applicant Monthly Amount Salary Alimony/Child Support *Current Rent or Mortgage Payment Rental Income Social Security Pension Income Public Assistance Self-Employment Income Dependent SSI Income Disability Income Other Income *Landlord or Mortgage Company Name: Contact Phone No. for Landlord: Revised mm 5

6 Circle One APPLICANT CO-APPLICANT Can you document your child support/alimony Income? Yes No N/A Yes No N/A If yes, how long will it continue? If your child or family member receives SSI, Yes No N/A Yes No N/A How many more years will the payment continue? If you receive disability income, Is it for permanent disability Yes No N/A Yes No N/A Regarding other employment, have you worked in this field for two or more years? Yes No N/A Yes No N/A Are you currently in Chapter 13 Bankruptcy? Yes No N/A Yes No N/A If yes, when did it begin? If yes, when will it be paid in full? If yes, how much is the payment? Have your payments been made on time? Yes No N/A Yes No N/A Have you ever filed a Chapter 7 Bankruptcy? Yes No N/A Yes No N/A If yes, when was it discharged? LIQUID FUNDS/SAVINGS/INVESTMENTS Please list the appropriate value of the following: PLEASE PRINT CLEARLY Checking Account Savings Account Cash CDs Securities (stocks, bonds, etc.) Retirement Account APPLICANT CO-APPLICANT Are you about to receive additional funds (e.g., tax refunds, property sales, etc.)? Yes No If yes, how much? $ ADDITIONAL INFORMATION PLEASE PRINT CLEARLY APPLICANT CO-APPLICANT Have you owned a home in the last Three (3) years? Yes No Yes No Are you a Veteran? Yes No Yes No Do you have a contract on a home at this time? Yes No Yes No Are you currently working with a real-estate agent? Yes No Yes No What is the best time for an individual appointment? AM PM Revised mm 6

7 ALTERNATIVE DELIVERY OF SERVICES FOR IMPAIRED AND DISABLED INDIVIDUALS Urban League of Palm Beach County is sensitive to the special needs of all of our clients. If you have an impairment, disability, and/or language difficulty and need access to our services, please contact us so we may assist you accordingly. AUTHORIZATION PLEASE READ THE FOLLOWING BEFORE SIGNING I authorize the Urban League of Palm Beach County (a HUD certified Housing Counseling Agency) to: (a) Charge a credit report fee of $18. This will allow Urban League of Palm Beach County the ability to pull my/our credit report to review my/our credit file for housing counseling in connection with my pursuit on a loan to purchase real property (a new Home); Borrower Initial, Co-borrower initial (b) Obtain a copy of the HUD-1 Settlement Statement, Appraisal, and Real Estate Note(s) when I purchase a home, from the lender who made me/us a loan and/ or the title company that closed the loan. Borrower Initial, Co-borrower initial. By signing this application, I certify that the information given to the Urban League of Palm Beach County, Comprehensive Housing Counseling program of household composition income, net family assets and all allowances and deductions are accurate and complete to the best of my knowledge or belief. The information solicited on this application by the Urban League of Palm Beach County in order to assure that Federal Laws prohibiting discrimination against tenants and applicants on the basis of race, color, national origin, religion, sex, family status, age, and handicap are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used to discriminate against you in any way. Borrow Signature: Co-Borrow Signature: Counselor Signature: : : : Print Name of Counselor: Revised mm 7

8 Client Authorization for Counseling Agency I/We authorize the Urban League of Palm Beach County, Inc. to discuss with me/us any information related to my/our personal circumstances as may be necessary to help me/us to solve my/our housing problems. I/We further authorize the Urban League of Palm Beach County, Inc. to release to other firms, funders and other third parties agencies information related to our file. I/We understand that the information about our personal circumstances will be treated totally confidential and no information about me/us will be accessible to any party who is not directly involved in my/our situation. Signature of Head of Household Signature of Spouse ACKNOWLEDGEMENT OF COUNSELING PLAN I,, accept and agree to comply with the counseling Action Plan implemented to assist me in the resolution of my housing problem or meeting my housing need. Failure to comply with the counseling Action Plan could result in termination of counseling. Termination may occur under any of these conditions: 1. Failure to submit requested documentation no more than 10 working days after initial appointment. 2. Failure to appear at counseling appointment. 3. Failure to follow the agreed upon counseling Action Plan. 4. Failure to respond to phone calls or correspondence received by the Urban League. Signature DATA BECOMES THE PROPERTY OF THE URBAN LEAGUE OF PBC, INC. ALL documents copied during the screening process by the Housing Counselor to identify the housing need or problem shall become the property of the Urban League of Palm Beach County, Inc. Such documents shall include but not be limited to the following: pay stubs, bank statements, tax returns and W2 s, correspondence, social security cards, driver s license, property tax statements, warranty deed, financial documentation, social security documentation, etc. I/We authorize the agency to open my/our client file to be reviewed for program monitoring and compliance purposes. I/We also authorize the agency to conduct necessary activities related to these services. Signature Signature Revised mm 8

9 Conflict of Interest Policy Statement The Urban League of Palm Beach County provides the following housing counseling services: Pre/Post purchase counseling, foreclosure mitigation and default counseling, rental assistance, home buyer education and financial literacy education. I/We understand that it is my/our right and responsibility to decide whether to engage in any course of housing counseling with the Urban League of Palm Beach County and determine whether counseling is suitable for my/our housing issue. I/We understand that the Urban League of Palm Beach County has the discretion to charge reasonable fees for some counseling services, and that these fees will be explained to me prior to any counseling. I further understand that fees will not be charged if they create a financial hardship and that I will not be denied counseling if I cannot pay the fees. I/We understand that the Urban League of Palm Beach County provides information on a broad range of housing programs and products, and that the Urban League of Palm Beach County provides rental housing through its affiliate, New Urban Community Development Corporation. The Urban League of Palm Beach County partners with banks and mortgage providers, fair housing agencies, legal service providers, insurance providers, foundations, title companies, real estate agents and/or brokerages, and credit counseling service providers. I understand that I am not obligated to choose any particular loan product or housing program discussed in my counseling sessions. I/We understand that the Urban League of Palm Beach County does not guarantee that I/We will receive mortgage financing from any lender and/or other mortgage financing entity. I/We may be referred to other housing services of the organization, its affiliate(s), and partners and/or to another agency or agencies as appropriate that may be able to assist with particular concerns that have been identified. I understand that I am not obligated to use any of the services offered to me. I/We understand that a counselor may answer questions and provide information but cannot give legal advice. If I want legal advice, I will be referred for appropriate assistance. I have read and received a copy of the Urban League of Palm Beach County s Conflict of Interest Policy Statement. Signature Print Name Revised mm 9

10 PRIVACY POLICY The Urban League of Palm Beach, Inc. is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations. Your nonpublic personal information, such as your total debt information, income, living expenses and personal information concerning your financial circumstances, will be provided to creditor, program monitors, funders and other third parties, only with your authorization and signature on the Client Authorization for Counseling Agency form. The agency maintains physical, electronic and procedural safeguards that comply with federal regulation to guard your non-public personal information. We may also use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable research information and designing future programs. TYPES OF INFORMATION THAT WE GATHER ABOUT YOU Information we receive from you orally, on applications or other forms, such as your name, address, social security number, assets, and income. Information about your transactions with us, your creditors, others, such as your account balance, payment history, parties to transactions and credit card usage; and Information we receive from a credit reporting agency, such as your credit history. YOU MAY OPT-OUT OF CERTAIN DISCLOSURES 1. You have the opportunity to opt-out of disclosures of your nonpublic personal information to third parties (such as your creditors), that is, direct us not to make those disclosures. 2. If you choose to opt-out, we will not be able to answer questions from your creditors. If at any time, you wish to change your decision with regard to your opt-out, you may call us at (561) and do so. RELEASE OF YOU INFORMATION TO THIRD PARTIES 1. So long as you have not opted-out, we may disclose some or all of the information that we collect, as described above to your creditors or third parties where we have determined that it would be helpful to you, would aid us in counseling you, or is a requirement of grant awards which make our services possible. 2. We may also disclose any nonpublic personal information about you or former customers to anyone as permitted by law. 3. Within the organization, we restrict access to nonpublic personal information about you to those employees who need to know that information to provide services to you. We maintain; physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic information. Signature Please Print Name Revised mm 10

11 EDUCATION SERVICES DISCLOSURE STATEMENT The Urban League of Palm Beach County provides the following housing counseling services: Pre/Post purchase counseling, foreclosure mitigation and default counseling, rental assistance, home buyer education and financial literacy education. I/We understand that it is my/our right and responsibility to decide whether to engage in any education course with the Urban League of Palm Beach County. I/We understand that the Urban League of Palm Beach County has the discretion to charge reasonable fees for these education services, and that these fees will be explained to me prior to the education class. I further understand that fees will not be charged if they create a financial hardship and that I will not be denied receiving the education class if I cannot pay the fees. I/We understand that the Urban League of Palm Beach County provides information on a broad range of housing programs and products, and that the Urban League of Palm Beach County provides rental housing through its affiliate, New Urban Community Development Corporation. The Urban League of Palm Beach County partners with banks and mortgage providers, fair housing agencies, legal service providers, insurance providers, foundations, title companies, real estate agents and/or brokerages, and credit counseling service providers. I understand that I am not obligated to choose any particular loan product or housing program discussed in the education classes. I/We understand that the Urban League of Palm Beach County does not guarantee that I/We will receive mortgage financing from any mortgage financing entity, or financial products from any financial entity. I/We may be referred to other housing services of the organization, its affiliate(s), and partners and/or to another agency or agencies as appropriate that may be able to assist with particular concerns that have been identified. I understand that I am not obligated to use any of the services offered to me. I/We understand that a counselor may answer questions and provide information but cannot give legal advice. If I want legal advice, I will be referred for appropriate assistance. I have reviewed and understand the above Education Services Disclosure Statement. Client s signature Counselor signature Disclosure Statement Verbally Read to Class? Yes No Revised mm 11

12 BUDGET Income Person 1 Person 2 FORM Gross Income Net Income Expenses Current Amt Adjusted Amt Current Amt Adjusted Amt Savings Giving Savings (Goal) Tithes Charitable Giving Other Housing & Utilities Rent/Mortgage Second Mortgage Miscellaneous & Entertainment Homeowner Ins. Bank Fees/Checks Property Taxes Birthday Gifts Association Dues Books/Magazine/Newspaper Home Maintenance Camp/Fish/Hunt Electricity Children Allowance Gas/Heating Oil Christmas Gift Telephone Concerts Plays Water/Sewer/Garbage Film/Developing Cell Phone Health Club/Training Cable TV Hobbies Internet Movie Rentals Music/CDs/Video Games Pet Care Transportation Postage Car Payment(s) School Supplies/Activities Insurance Sporting Events Gasoline Tobacco/Alcohol Licensing Vacations Public Transportation Other Maintenance Household Expenses Food Groceries School Lunches Other Debts Meals Out Taxes Student Loans Credit Cards Dependent Care Medical Bill Child Care Furniture Loans Child Support/Alimony Personal Loans Tuition Other Personal Care Medical Medicine Clothing Hair Care Laundry/Dry Cleaning of all Expenses Excess/Deficit Revised mm 12

13 SIGN-IN SHEET AND DATA FORM Urban League of Palm Beach County Homebuyer Education Workshop 1700 Australian Avenue, West Palm Beach, FL We receive funding for Housing Counseling Programs from Palm Beach County, HUD and National Urban League. Therefore, we are required to gather statistics on the households of persons served by our programs. Data collected will be in accordance with the Urban League privacy policies. Please fill in the information requested below. Thank you for your cooperation. Your Highest Level of Education: Some High School Some College High School College Income: Median Income In the chart below, find your household size. In the column for your household size, circle the box that most closely matches the yearly gross income of your household. Annual household income includes the earnings of all working adults, and the income of individuals receiving government or other assistance such as social security, disability, TANF, pensions, retirement, etc. Family Size Extremely Low (30%) Income 1 Person FY 2014 Income Area Limits 2 Persons Palm Beach County 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons $13,740 $15,690 $17,640 $19,590 $21,180 $22,740 $24,300 $25,860 $ 63,300 Very Low (50%) Income Low (80%) Income $22,900 $26,150 $29,400 $32,650 $35,300 $37,900 $40,500 $43,100 $36,640 $41,840 $47,040 $52,240 $56,480 $60,640 $64,800 $68,960 My household gross income exceeds the income levels stated above for my family size of. I certify that this information is correct to the best of my knowledge. Client s Signature Client s Name Printed Address Revised mm 13

14 EQUAL HOUSING OPPORTUNITY The Urban League of Palm Beach County, Inc. Does Business in Accordance With All Federal, State and Local Fair Housing Laws and Ordinances (The Fair Housing Amendments Act of 1988) It is Illegal to Discriminate Against Any Person Because of Race, Color, National Origin, Religion, Sex, Disability or Familial Status. In Addition, Palm Beach County Ordinance includes: Age, Marital Status, Sexual Identity, Orientation or Expression. In the sale or rental of housing or residential lots In advertising the sale or rental of housing In the financing of housing In the provision of real estate brokerage services Anyone who feels he or she has been discriminated against may file a complaint of housing discrimination at the: Fair Housing Center of the Greater Palm Beaches, Inc West Lantana Road Suite 200 Lantana, FL FAIR (3247) (561) Acknowledged by: Signature Name Printed Revised mm 14

15 Client Bill of Rights AS A PROGRAM PARTICIPANT BEING SERVED BY THE URBAN LEAGUE OF PALM BEACH COUNTY, INC., YOU HAVE THE RIGHT TO: Understand and use these rights. If for any reason you do not understand or need help understanding these rights, the Urban League of Palm Beach County must provide assistance. Participants will receive services without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation or source of income. Receive considerate and respectful services from any employee of the Urban League of Palm Beach County. Complain without fear of reprisals about the care and service you are receiving and to have the Vice President of Programs respond to you, when such a request is made. Participants will be provided with vital agency contact information, including appropriate supervisor upon request. Know the names, positions and functions of any Urban League of Palm Beach County employee, volunteer, intern, and/or independent contractor or consultant providing services on behalf of Urban League of Palm Beach County involved in your case. Participants will be informed as to why they are receiving services and what is expected of them based upon affiliate services and agreements of service. Refuse service and be told what effect this may have on your case. By refusing services, you are responsible to accept the consequences of your actions. Staff will have the necessary Release of Information signed by the participants before obtaining any information that pertains to the participant being served by the Urban League of Palm Beach County. All information obtained will be used to assist families towards achieving goals, identifying barriers, receiving status updates, and prevention. Such information will remain confidential between the Urban League of Palm Beach County and the referral agency, if applicable. Participants are not to exchange any money or gifts for services provided by Urban League of Palm Beach County staff. Urban League of Palm Beach County staff is not to behave as a Payee, child care provider, or respite provider. No child is to be transported by Urban League of Palm Beach County staff, without the parent or guardian present or signed Transportation Release and Consent Agreement. Families receiving transportation that is provided by Urban League of Palm Beach County shall occur within a registered and insured vehicle. By signing this document, I acknowledge this information has been reviewed ad explained to me. I further understand my rights as a client of the Urban League of Palm Beach County. Signature of Client Signature of Urban League of Palm Beach County Staff Signature of Urban League of Palm Beach County Supervisor Revised mm 15

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