APPLICATION FOR HOUSING

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APPLICATIONS ARE CLOSED FOR YEAR 2018. PLEASE KEEP UPDATED WITH US AND COME TO OUR REQUIRED INFORMAITONAL MEETING FOR YEAR 2019.

If you have any questions, call the main office at (801) 475-9821. If you need more space, use separate pieces of paper and attach them to this application. All information on this application will be kept confidential. We may ask that you submit additional papers, such as tax returns, proof of income, proof of public assistance, etc. If there is only 1 applicant on the form, please answer N/A to the Co-Applicant questions. The Co-Applicant is someone who will share ownership of the home, responsibility for the mortgage, and who will also live in the Habitat home. 

 

Habitat for Humanity of Weber and Davis Counties

2955 Harrison Blvd. Suite 202 Ogden UT 84403 | info@habitatwd.org | 801-475-9821

 

Enclose copies of the following documents (DO NOT SEND ORIGINALS) with the application. You may upload your copies or email your copies to info@habitatwd.org or mail your copies to the main office:

  • Your preivous year or current income tax return. If you did not file taxes for the previous or current year, please provide a letter, signed by you, that states you did not file taxes and the reason why.
  • Your last 2 paycheck stubs or other proof of income
  • Your last 2 bank statements showing all checking, savings, and loan balances. If you do not have a bank account, please write that on your application
  • Proof of child support and/or public assistance (Such as SSI, TANF, Social Security, disability, food stamps, etc) if you receive them.
  • Proof of home ownership (this may include recent property tax receipt or Deed of Trust). This is if you own a home.
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1. APPLICATION INFORMATION

APPLICANT #1

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MARITAL STATUS
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CO-APPLICANT

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MARITAL STATUS
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OTHER HOUSEHOLD MEMBERS

List everyone (other than applicant and co-applicant) who will live in your home. Please include what relationship the household member has to the applicant (i.e., daughter, son, mother, father, uncle, aunt, etc.)

You may include children you are expecting.

 

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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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DOES THIS PERSON RECEIVE INCOME?
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2. HOUSING HISTORY

APPLICANT #1

Is your current address the same as Co-Applicant
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IF YOU CURRENTLY OWN YOUR RESIDENCE

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IF YOU RENT YOUR RESIDENCE

Please attach a copy of lease or copy of a money order receipt or canceled rent check. If this does not apply to you, skip this section.

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FORMER ADDRESSES FOR PAST 2 YEARS

Were your former addresses for the past 2 years the same as Co-Applicant?
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CO-APPLICANT

Is your current address the same as Applicant #1
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IF YOU CURRENTLY OWN YOUR RESIDENCE

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IF YOU RENT YOUR RESIDENCE

Please attach a copy of lease or copy of a money order receipt or canceled rent check. If this does not apply to you, skip this section.

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FORMER ADDRESSES FOR PAST 2 YEARS

Were your former addresses for the past 2 years the same as Applicant #1?
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CONDITION OF YOUR CURRENT LIVING PLACE

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OTHER ROOMS IN THE PLACE
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Does your home have any problems that you consider to be hazardous to your health or safety (mold, bugs, electrical problems, broken stairs, etc.)?
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Are your home’s mechanical and weather-proofing systems functioning properly (plumbing, heating/cooling, refrigeration, roofing, windows, etc)?
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Do you or a family member have accessibility needs that are not met by your current house (handrails, ramps, wider doors, and other aids)?
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WHY DO YOU NEED A HABITAT HOME?

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3. EMPLOYMENT HISTORY

Beginning with your current employment, tell us about your recent 5 years of work history.

If you need more space, please attach another piece of paper with the information.

APPLICANT #1

CURRENT EMPLOYER
ARE YOU UNEMPLOYED?
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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SECONDARY EMPLOYER
DO YOU HAVE A SECOND JOB?
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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PREVIOUS EMPLOYERS
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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PREVIOUS EMPLOYERS
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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CO-APPLICANT

CURRENT EMPLOYER
ARE YOU UNEMPLOYED?
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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SECONDARY EMPLOYER
DO YOU HAVE A SECOND JOB?
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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PREVIOUS EMPLOYERS
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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PREVIOUS EMPLOYERS
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IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
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4. MONTHLY HOUSEHOLD INCOME AND RESOURCES

Please indicate monthly amounts that the applicants or anyone in the household receives for the type of income below. It is extremely important to disclose and document all household income. Under certain circumstances, we may not have to count certain sources of income, but we need to be aware of it. Our income limits are strict due to the nature of our program and funding sources.

Therefore, if undeclared income is discovered, application will be denied. 

JOBS-BASE SALARY, EARNINGS (BEFORE TAXES AND DEDUCTIONS)

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ARE ANY OF THESE HOUSEHOLD MEMBERS WHO EARN INCOME ALSO ENROLLED AS FULL-TIME STUDENTS?
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JOBS-OVERTIME, BONUSES, COMMISSIONS

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UNEMPLOYMENT

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PENSION

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CHILD SUPPORT

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IS THIS COURT-ORDERED?
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ALIMONY

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IS THIS COURT-ORDERED?
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SOCIAL SECURITY

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SSI

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DISABILITY

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TANF/FAMILIES FIRST/AFDC

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FOOD STAMPS

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REGULAR FINANCIAL SUPPORT FROM OTHERS

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OTHER

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5. CHECKING, SAVINGS, AND OTHER ACCOUNTS

ACCOUNT #1

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ACCOUNT #2

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ACCOUNT #3

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ACCOUNT #4

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6. OTHER ASSETS

Answer the following regarding valuable assets that you or the co-applicant own.

 

DO YOU CURRENTLY OWN HOME, LAND, OR PROPERTY?
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DO YOU OWN A:
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DO YOU OWN A:
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DO YOU OWN AUTOMOBILES?
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7. CURRENT MONTHLY BILLS AND EXPENSES

For each expense that everyone in your household has, please list monthly estimate of what each item costs your household.

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8. DEBTS, LOANS, AND OTHER CREDIT ACCOUNTS

List all debts, loans, and credit accounts that everyone in your household have including loans you have co-signed with anyone else, whether or not you make the actual payment.

CAR LOANS

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CREDIT CARDS

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STUDENT LOANS

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OTHER LOANS (CASH, PAYDAY, PERSONAL, TITLE, FURNITURE, RENTAL, ETC.)

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OTHER LOANS (CASH, PAYDAY, PERSONAL, TITLE, FURNITURE, RENTAL, ETC.)

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OTHER LOANS (CASH, PAYDAY, PERSONAL, TITLE, FURNITURE, RENTAL, ETC.)

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CHILD SUPPORT (YOU PAY)

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ALIMONY (YOU PAY)

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GARNISHMENTS

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COLLECTIONS

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JUDGMENTS/LIENS

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9. DOWN PAYMENT AND CLOSING COSTS

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10. TAX RETURN

DID YOU FILE AN INCOME TAX RETURN LAST YEAR?
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DID YOU RECEIVE EARNED INCOME CREDIT?
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11. WILLINGNESS TO PARTNER

To be considered for a Habitat home, you and your family must be willing to complete “sweat equity” hours, approved by Habitat for Humanity of Weber and Davis Counties. Your help in building your home and/or homes of others is called “sweat equity”. This may include clearing the lot, helping with construction, cleaning, painting, working in the Habitat office, the Ogden ReStore, and other approved activities.

ARE YOU WILLING TO COMPLETE THE REQUIRED SWEAT EQUITY HOURS?

APPLICANT #1
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CO-APPLICANT
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ARE YOU WILLING TO REPRESENT HABITAT WITH THE MEDIA?

APPLICANT #1
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CO-APPLICANT
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WHICH INFORMATION MEETING DID YOU ATTEND?

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12. DECLARATIONS

DO YOU HAVE ANY DEBT BECAUSE OF A COURT DECISION AGAINST YOU?

APPLICANT #1
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CO-APPLICANT
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HAVE YOU DECLARED BANKRUPTCY WITHIN THE PAST 7 YEARS?

APPLICANT #1
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CO-APPLICANT
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HAVE YOUR WAGES OR BANK ACCOUNTS EVER BEEN GARNISHED?

APPLICANT #1
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CO-APPLICANT
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HAVE YOU HAD PROPERTY FORECLOSED ON IN THE PAST 7 YEARS?

APPLICANT #1
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CO-APPLICANT
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ARE YOU CURRENTLY INVOLVED IN A LAWSUIT?

APPLICANT #1
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CO-APPLICANT
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ARE YOU PAYING ALIMONY OR CHILD SUPPORT?

APPLICANT #1
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CO-APPLICANT
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HAVE YOU EVER BEEN EVICTED?

APPLICANT #1
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CO-APPLICANT
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HAVE YOU EVER BEEN CONVICTED OF A CRIME?

APPLICANT #1
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CO-APPLICANT
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HAVE YOU EVER BEEN TURNED DOWN FOR CONVENTIONAL FINANCING?

APPLICANT #1
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CO-APPLICANT
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ARE YOU A U.S. CITIZEN OR LEGAL RESIDENT OF THE U.S.?

APPLICANT #1
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13. 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 employment verification. I understand that I will undergo a background check and give authorization to Habitat for Humanity of Weber and Davis Counties. I have answered all the questions  on this application truthfully. I understand that if I have not answered the questions truthfully, my application may be denied, and that even if I have already been selected to receive a Habitat home, I may be disqualified from the program. Habitat for Humanity reserves the right to request updated application information at any time. The original or a copy of this application will be retained by Habitat for Humanity even if the application is not approved.

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APPLICATION FOR HOUSING

APPLICATION FOR HOUSING

APPLICATIONS ARE CLOSED FOR YEAR 2018. PLEASE KEEP UPDATED WITH US AND COME TO OUR REQUIRED INFORMAITONAL MEETING FOR YEAR 2019.

If you have any questions, call the main office at (801) 475-9821. If you need more space, use separate pieces of paper and attach them to this application. All information on this application will be kept confidential. We may ask that you submit additional papers, such as tax returns, proof of income, proof of public assistance, etc. If there is only 1 applicant on the form, please answer N/A to the Co-Applicant questions. The Co-Applicant is someone who will share ownership of the home, responsibility for the mortgage, and who will also live in the Habitat home. 

 

Habitat for Humanity of Weber and Davis Counties

2955 Harrison Blvd. Suite 202 Ogden UT 84403 | info@habitatwd.org | 801-475-9821

 

Enclose copies of the following documents (DO NOT SEND ORIGINALS) with the application. You may upload your copies or email your copies to info@habitatwd.org or mail your copies to the main office:

  • Your preivous year or current income tax return. If you did not file taxes for the previous or current year, please provide a letter, signed by you, that states you did not file taxes and the reason why.
  • Your last 2 paycheck stubs or other proof of income
  • Your last 2 bank statements showing all checking, savings, and loan balances. If you do not have a bank account, please write that on your application
  • Proof of child support and/or public assistance (Such as SSI, TANF, Social Security, disability, food stamps, etc) if you receive them.
  • Proof of home ownership (this may include recent property tax receipt or Deed of Trust). This is if you own a home.
Upload the important documents
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1. APPLICATION INFORMATION

APPLICANT #1

NAME (FIRST, MIDDLE, LAST)
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DATE OF BIRTH
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SOCIAL SECURITY NUMBER
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HOME PHONE
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CELL PHONE
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WORK PHONE
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Email
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MARITAL STATUS
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CO-APPLICANT

NAME (FIRST, MIDDLE, LAST)
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DATE OF BIRTH
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SOCIAL SECURITY NUMBER
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HOME PHONE
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CELL PHONE
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WORK PHONE
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Email
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MARITAL STATUS
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OTHER HOUSEHOLD MEMBERS

List everyone (other than applicant and co-applicant) who will live in your home. Please include what relationship the household member has to the applicant (i.e., daughter, son, mother, father, uncle, aunt, etc.)

You may include children you are expecting.

 

NAME
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GENDER
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DATE OF BIRTH
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RELATIONSHIP
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DOES THIS PERSON RECEIVE INCOME?
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NAME
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GENDER
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DATE OF BIRTH
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RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
NAME
{binding displayValue}
GENDER
{binding displayValue}
DATE OF BIRTH
{binding displayValue}
RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
NAME
{binding displayValue}
GENDER
{binding displayValue}
DATE OF BIRTH
{binding displayValue}
RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
NAME
{binding displayValue}
GENDER
{binding displayValue}
DATE OF BIRTH
{binding displayValue}
RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
NAME
{binding displayValue}
GENDER
{binding displayValue}
DATE OF BIRTH
{binding displayValue}
RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
NAME
{binding displayValue}
GENDER
{binding displayValue}
DATE OF BIRTH
{binding displayValue}
RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
NAME
{binding displayValue}
GENDER
{binding displayValue}
DATE OF BIRTH
{binding displayValue}
RELATIONSHIP
{binding displayValue}
DOES THIS PERSON RECEIVE INCOME?
{binding displayValue}
{ binding firstError.message }

2. HOUSING HISTORY

APPLICANT #1

Is your current address the same as Co-Applicant
{binding displayValue}
ADDRESS
{binding displayValue}
MAILING ADDRESS, IF DIFFERENT
{binding displayValue}
MOVE IN DATE:
{binding displayValue}
DO YOU...
{binding displayValue}

IF YOU CURRENTLY OWN YOUR RESIDENCE

What is your monthly payment?
{binding displayValue}
What is your unpaid balance?
{binding displayValue}
{ binding firstError.message }

IF YOU RENT YOUR RESIDENCE

Please attach a copy of lease or copy of a money order receipt or canceled rent check. If this does not apply to you, skip this section.

Upload copies
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
What is your monthly payment?
{binding displayValue}
CURRENT LANDLORD'S NAME
{binding displayValue}
ADDRESS
{binding displayValue}
Phone
{binding displayValue}
{ binding firstError.message }

FORMER ADDRESSES FOR PAST 2 YEARS

Were your former addresses for the past 2 years the same as Co-Applicant?
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU...
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

CO-APPLICANT

Is your current address the same as Applicant #1
{binding displayValue}
ADDRESS
{binding displayValue}
MAILING ADDRESS, IF DIFFERENT
{binding displayValue}
MOVE IN DATE:
{binding displayValue}
DO YOU...
{binding displayValue}

IF YOU CURRENTLY OWN YOUR RESIDENCE

What is your monthly payment?
{binding displayValue}
What is your unpaid balance?
{binding displayValue}
{ binding firstError.message }

IF YOU RENT YOUR RESIDENCE

Please attach a copy of lease or copy of a money order receipt or canceled rent check. If this does not apply to you, skip this section.

Upload copies
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
What is your monthly payment?
{binding displayValue}
CURRENT LANDLORD'S NAME
{binding displayValue}
ADDRESS
{binding displayValue}
Phone
{binding displayValue}
{ binding firstError.message }

FORMER ADDRESSES FOR PAST 2 YEARS

Were your former addresses for the past 2 years the same as Applicant #1?
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU...
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU
{binding displayValue}
ADDRESS
{binding displayValue}
MOVE IN DATE
{binding displayValue}
DID YOU
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

CONDITION OF YOUR CURRENT LIVING PLACE

WHERE DO YOU LIVE?
{binding displayValue}
IF OTHER, PLEASE EXPLAIN:
NUMBER OF BEDROOMS
{binding displayValue}
OTHER ROOMS IN THE PLACE
{binding displayValue}
Does your home have any problems that you consider to be hazardous to your health or safety (mold, bugs, electrical problems, broken stairs, etc.)?
{binding displayValue}
Are your home’s mechanical and weather-proofing systems functioning properly (plumbing, heating/cooling, refrigeration, roofing, windows, etc)?
{binding displayValue}
Do you or a family member have accessibility needs that are not met by your current house (handrails, ramps, wider doors, and other aids)?
{binding displayValue}
{ binding firstError.message }

WHY DO YOU NEED A HABITAT HOME?

In the space below, describe the condition of and problems with your current housing (please be specific and thorough by providing all information you think we should know about your current housing).
If you are approved for a Habitat Home, how should your name(s) appear on legal documents?
{ binding firstError.message }

3. EMPLOYMENT HISTORY

Beginning with your current employment, tell us about your recent 5 years of work history.

If you need more space, please attach another piece of paper with the information.

APPLICANT #1

CURRENT EMPLOYER
ARE YOU UNEMPLOYED?
{binding displayValue}
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
SECONDARY EMPLOYER
DO YOU HAVE A SECOND JOB?
{binding displayValue}
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }
PREVIOUS EMPLOYERS
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
END DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
{ binding firstError.message }
PREVIOUS EMPLOYERS
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
END DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
{ binding firstError.message }
IF YOU HAD PREVIOUS EMPLOYERS NOT LISTED ABOVE, PLEASE ATTACH A DOCUMENT WITH THE INFORMATION NEEDED ABOVE
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
{ binding firstError.message }

CO-APPLICANT

CURRENT EMPLOYER
ARE YOU UNEMPLOYED?
{binding displayValue}
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
SECONDARY EMPLOYER
DO YOU HAVE A SECOND JOB?
{binding displayValue}
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }
PREVIOUS EMPLOYERS
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
END DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
{ binding firstError.message }
PREVIOUS EMPLOYERS
COMPANY NAME
{binding displayValue}
IS THIS SELF-EMPLOYMENT OR CONTRACT WORK?
{binding displayValue}
POSITION HELD
{binding displayValue}
ADDRESS
{binding displayValue}
TYPE OF BUSINESS
{binding displayValue}
NAME OF SUPERVISOR
{binding displayValue}
BUSINESS PHONE
{binding displayValue}
HIRE DATE
{binding displayValue}
END DATE
{binding displayValue}
RATE OF PAY
{binding displayValue}
{ binding firstError.message }
IF YOU HAD PREVIOUS EMPLOYERS NOT LISTED ABOVE, PLEASE ATTACH A DOCUMENT WITH THE INFORMATION NEEDED ABOVE
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
{ binding firstError.message }
{ binding firstError.message }

4. MONTHLY HOUSEHOLD INCOME AND RESOURCES

Please indicate monthly amounts that the applicants or anyone in the household receives for the type of income below. It is extremely important to disclose and document all household income. Under certain circumstances, we may not have to count certain sources of income, but we need to be aware of it. Our income limits are strict due to the nature of our program and funding sources.

Therefore, if undeclared income is discovered, application will be denied. 

JOBS-BASE SALARY, EARNINGS (BEFORE TAXES AND DEDUCTIONS)

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
ARE ANY OF THESE HOUSEHOLD MEMBERS WHO EARN INCOME ALSO ENROLLED AS FULL-TIME STUDENTS?
{binding displayValue}
IF YES, WHO?
{ binding firstError.message }

JOBS-OVERTIME, BONUSES, COMMISSIONS

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
EXPLAIN
{ binding firstError.message }

UNEMPLOYMENT

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
WHEN DID THIS INCOME BEGIN?
{binding displayValue}
{ binding firstError.message }

PENSION

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
WHEN DID THIS INCOME BEGIN?
{binding displayValue}
{ binding firstError.message }

CHILD SUPPORT

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
IS THIS COURT-ORDERED?
{binding displayValue}
{ binding firstError.message }

ALIMONY

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
IS THIS COURT-ORDERED?
{binding displayValue}
{ binding firstError.message }

SOCIAL SECURITY

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
WHEN DID THIS INCOME BEGIN?
{binding displayValue}
{ binding firstError.message }

SSI

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
WHEN DID THIS INCOME BEGIN?
{binding displayValue}
{ binding firstError.message }

DISABILITY

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
WHEN DID THIS INCOME BEGIN?
{binding displayValue}
{ binding firstError.message }

TANF/FAMILIES FIRST/AFDC

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
WHEN DID THIS INCOME BEGIN?
{binding displayValue}
{ binding firstError.message }

FOOD STAMPS

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
NEXT RECERTIFICATION DATE
{binding displayValue}
{ binding firstError.message }

REGULAR FINANCIAL SUPPORT FROM OTHERS

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
EXPLAIN
{ binding firstError.message }

OTHER

APPLICANT #1 $
{binding displayValue}
CO-APPLICANT $
{binding displayValue}
OTHER HOUSEHOLD MEMBERS $
{binding displayValue}
EXPLAIN
{ binding firstError.message }
{ binding firstError.message }

5. CHECKING, SAVINGS, AND OTHER ACCOUNTS

ACCOUNT #1

NAME OF BANK OR FINANCIAL INSTITUTION
{binding displayValue}
TYPE OF ACCOUNT
{binding displayValue}
ACCOUNT #
{binding displayValue}
BALANCE $
{binding displayValue}
NAME(S) ON ACCOUNT
{ binding firstError.message }

ACCOUNT #2

NAME OF BANK OR FINANCIAL INSTITUTION
{binding displayValue}
TYPE OF ACCOUNT
{binding displayValue}
ACCOUNT #
{binding displayValue}
BALANCE $
{binding displayValue}
NAME(S) ON ACCOUNT
{ binding firstError.message }

ACCOUNT #3

NAME OF BANK OR FINANCIAL INSTITUTION
{binding displayValue}
TYPE OF ACCOUNT
{binding displayValue}
ACCOUNT #
{binding displayValue}
BALANCE $
{binding displayValue}
NAME(S) ON ACCOUNT
{ binding firstError.message }

ACCOUNT #4

NAME OF BANK OR FINANCIAL INSTITUTION
{binding displayValue}
TYPE OF ACCOUNT
{binding displayValue}
ACCOUNT #
{binding displayValue}
BALANCE $
{binding displayValue}
NAME(S) ON ACCOUNT
{ binding firstError.message }
{ binding firstError.message }

6. OTHER ASSETS

Answer the following regarding valuable assets that you or the co-applicant own.

 

DO YOU CURRENTLY OWN HOME, LAND, OR PROPERTY?
{binding displayValue}
IF YES, WHAT IS THE MONTHLY PAYMENT?
{binding displayValue}
DO YOU OWN A:
{binding displayValue}
DO YOU OWN A:
{binding displayValue}
DO YOU OWN AUTOMOBILES?
{binding displayValue}
LIST EACH VEHICLE WITH YEAR, MAKE, AND MODEL (i.e. 1999 Toyota Camry)
APPLICANT #1 DRIVER'S LICENCE (Number and State)
CO-APPLICANT DRIVER'S LICENCE (Number and State)
{ binding firstError.message }

7. CURRENT MONTHLY BILLS AND EXPENSES

For each expense that everyone in your household has, please list monthly estimate of what each item costs your household.

RENT $
{binding displayValue}
WATER $
{binding displayValue}
ELECTRICITY $
{binding displayValue}
GAS (for home) $
{binding displayValue}
HOME PHONE/CELL PHONE $
{binding displayValue}
CABLE/TV SERVICES $
{binding displayValue}
INTERNET $
{binding displayValue}
SECURITY SYSTEM $
{binding displayValue}
RENTER'S INSURANCE $
{binding displayValue}
CAR INSURANCE $
{binding displayValue}
LIFE INSURANCE $
{binding displayValue}
HEALTH INSURANCE $
{binding displayValue}
CHILDCARE $
{binding displayValue}
GYM MEMBERSHIPS $
{binding displayValue}
DUES/SUBSCRIPTIONS $
{binding displayValue}
GROCERIES $
{binding displayValue}
HOUSEHOLD SUPPLIES (cleaning, diapers, etc.) $
{binding displayValue}
CLOTHING $
{binding displayValue}
EATING OUT $
{binding displayValue}
PERSONAL (haircuts, nails, etc.) $
{binding displayValue}
LAUNDRY/DRY CLEANING $
{binding displayValue}
CIGARETTES $
{binding displayValue}
ENTERTAINMENT $
{binding displayValue}
PET CARE (food, vet, etc.) $
{binding displayValue}
GIFTS (birthdays, holidays, etc.) $
{binding displayValue}
SCHOOL TUITION/SUPPLIES $
{binding displayValue}
VACATION/TRAVEL $
{binding displayValue}
GASOLINE (for car) $
{binding displayValue}
VEHICLE MAINTENANCE $
{binding displayValue}
CAR REPAIRS $
{binding displayValue}
BUS PASS/CARPOOLING $
{binding displayValue}
MEDICAL $
{binding displayValue}
GIVING (church, charity, etc.) $
{binding displayValue}
OTHER $
{binding displayValue}
{ binding firstError.message }

8. DEBTS, LOANS, AND OTHER CREDIT ACCOUNTS

List all debts, loans, and credit accounts that everyone in your household have including loans you have co-signed with anyone else, whether or not you make the actual payment.

CAR LOANS

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

CREDIT CARDS

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

STUDENT LOANS

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

OTHER LOANS (CASH, PAYDAY, PERSONAL, TITLE, FURNITURE, RENTAL, ETC.)

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
TYPE OF LOAN
{binding displayValue}
{ binding firstError.message }

OTHER LOANS (CASH, PAYDAY, PERSONAL, TITLE, FURNITURE, RENTAL, ETC.)

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
TYPE OF LOAN
{binding displayValue}
{ binding firstError.message }

OTHER LOANS (CASH, PAYDAY, PERSONAL, TITLE, FURNITURE, RENTAL, ETC.)

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
TYPE OF LOAN
{binding displayValue}
{ binding firstError.message }

CHILD SUPPORT (YOU PAY)

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

ALIMONY (YOU PAY)

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

GARNISHMENTS

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

COLLECTIONS

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }

JUDGMENTS/LIENS

NAME OF COMPANY
{binding displayValue}
MONTHLY PAYMENT
{binding displayValue}
UNPAID BALANCE
{binding displayValue}
ESTIMATED PAYOFF DATE
{binding displayValue}
{ binding firstError.message }
TOTAL MONTHLY DEBT PAYMENTS PER MONTH
{binding displayValue}
{ binding firstError.message }

9. DOWN PAYMENT AND CLOSING COSTS

How much can you afford for housing? (One-time down payment)
{binding displayValue}
How much can you afford for monthly housing-related costs (including mortgage payment, utilities, insurance, taxes)?
{binding displayValue}
Where will you be getting the money to pay the down payment (e.g., your parents, savings)? If you are borrowing money to pay your down payment, explain how and from whom you plan to borrow, and how you will pay back the lender.
{ binding firstError.message }

10. TAX RETURN

DID YOU FILE AN INCOME TAX RETURN LAST YEAR?
{binding displayValue}
DID YOU RECEIVE EARNED INCOME CREDIT?
{binding displayValue}
# OF EXEMPTIONS TAKEN?
{binding displayValue}
{ binding firstError.message }

11. WILLINGNESS TO PARTNER

To be considered for a Habitat home, you and your family must be willing to complete “sweat equity” hours, approved by Habitat for Humanity of Weber and Davis Counties. Your help in building your home and/or homes of others is called “sweat equity”. This may include clearing the lot, helping with construction, cleaning, painting, working in the Habitat office, the Ogden ReStore, and other approved activities.

ARE YOU WILLING TO COMPLETE THE REQUIRED SWEAT EQUITY HOURS?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

ARE YOU WILLING TO REPRESENT HABITAT WITH THE MEDIA?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

WHICH INFORMATION MEETING DID YOU ATTEND?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}
In what ways can you and your family help in building or renovating a home? Prior experience is NOT required, but please list skills you may already have.
{ binding firstError.message }

12. DECLARATIONS

DO YOU HAVE ANY DEBT BECAUSE OF A COURT DECISION AGAINST YOU?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

HAVE YOU DECLARED BANKRUPTCY WITHIN THE PAST 7 YEARS?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

HAVE YOUR WAGES OR BANK ACCOUNTS EVER BEEN GARNISHED?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

HAVE YOU HAD PROPERTY FORECLOSED ON IN THE PAST 7 YEARS?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

ARE YOU CURRENTLY INVOLVED IN A LAWSUIT?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

ARE YOU PAYING ALIMONY OR CHILD SUPPORT?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

HAVE YOU EVER BEEN EVICTED?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

HAVE YOU EVER BEEN CONVICTED OF A CRIME?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}

HAVE YOU EVER BEEN TURNED DOWN FOR CONVENTIONAL FINANCING?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}
IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, PLEASE EXPLAIN:

ARE YOU A U.S. CITIZEN OR LEGAL RESIDENT OF THE U.S.?

APPLICANT #1
{binding displayValue}
CO-APPLICANT
{binding displayValue}
{ binding firstError.message }

13. 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 employment verification. I understand that I will undergo a background check and give authorization to Habitat for Humanity of Weber and Davis Counties. I have answered all the questions  on this application truthfully. I understand that if I have not answered the questions truthfully, my application may be denied, and that even if I have already been selected to receive a Habitat home, I may be disqualified from the program. Habitat for Humanity reserves the right to request updated application information at any time. The original or a copy of this application will be retained by Habitat for Humanity even if the application is not approved.

APPLICANT #1 ELECTRONIC SIGNATURE
{binding displayValue}
DATE SIGNED
{binding displayValue}
CO-APPLICANT ELECTRONIC SIGNATURE
{binding displayValue}
DATE SIGNED
{binding displayValue}
{ binding firstError.message }
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