Please complete the form below and we will get back to you as quickly as possible. Your application will be processed within 24 hours & one of our consultants will contact you & advise you if you have been approved for our Homebuyer's Assistance Program.
Please be aware that once you apply, we incur charges to complete your criminal background and eviction check. Therefore, please DO NOT apply until all of your questions have been answered and you understand the purpose and process of our program. Thank you.
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| Today's Date | |
| Name(s) | |
| Phone Number(s) | |
| Current Address (Please include your current city, state and zip code) | |
| Date(s) of Birth | |
| Best time to contact you | |
| Are you currently employed? | Yes
No
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| Name of Employer | |
| How long in your current job? | |
| What is your GROSS monthly income? | |
| Other monthly income? (alimony, child support, spouse, etc) | |
| How would you rate your credit history? | Excellent
Good
Fair
Poor
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| Briefly describe any derogatory credit. | |
| Have you ever been in foreclosure? | Yes
No
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| If yes, when did it occur? | |
| Have you ever filed for bankruptcy? | Yes
No
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| If yes, when was it discharged? | |
| Have you ever been convicted of a felony? | Yes
No
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| If yes, when and briefly describe the circumstances. | |
| Have you ever been evicted? | Yes
No
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| If yes, when and briefly describe the circumstances. | |
| Are you currently up to date on your bills? | Yes
No
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| Amount of funds currently available for down payment? | |
| How soon are you planning to move? | |
| What areas are considering moving to? | |
| Maximum Desired Monthly Rent? | |
| Desired Number of Bedrooms and Bathrooms? | |
| Type of Property Desired? |
Single Family
Condo
Townhouse
Multi-Family
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| How did you hear about us? | |
| If you were referred to us by a friend or family member, please provide us their name so we may properly thank them. | |
| What is your email address? | |
| I/(We) understand by submitting this application, we will be verifying the information contained herein to include your background, criminal record and eviction history and hereby grant such permission. | Yes
No
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| I/(We) also understand that, if approved, I am ready to enroll in the Homebuyer's Assistance Program and get started on my way to becoming a homeowner. | Yes
No
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| I/(We) certify that all the information given herein is true and accurate to the best of my knowledge | Yes
No
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| Is there any other information you feel is necessary or would be helpful to us in considering your application? | |
| Have you spoken to a representative? If so, please provide their name. | |
| Electronic Signature(s) | |
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