2012 homeowner application

8/3/2019 2012 Homeowner Application

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P.O. Box 1525/ 115 E. DeKalb ST Suite 5A, Camden, SC 29020

(803) 432-4333 (ph) (803) 432-4325 (fax

Habitat for Humanity of Kershaw County

HHKC Official HomeownershipApplication Package

C2012

Full and complete PRACTICE applications must havebeen RECEIVED in the Habitat Office by the date &

time shown below.

27 January 2012

12:00 NOON

Late applications WILL NOT be Accepted.

DO NOT REMOVE THIS PAGE


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Applicant Information Co-Applicant InformationFirst Name Middle Initial Last Name First Name Middle Initial Last Name

Male Female Male Female

Social Security Number: Social Security Number:

Date of Birth (mm/dd/yyyy):

/ /

Date of Birth (mm/dd/yyyy):

/ /Home and/or Cell Phone Number: Home and/or Cell Phone Number:

Work Phone Number: Work Phone Number:

Email: Email:

Married Single

*Please note if applicant is married but plans to apply to

Habitat as a single person, their divorce must be finalized

before we can consider the application.

Married Single

.

Present Address: Present Address:

Street Address Street Address

City State Zip Code City State Zip Code

Number of years at this address: Number of years at this address:

Household Occupants

List the names and date of birth for all occupants who will be living in the house. Do not include the Applicant and the Co-

Applicant. IMPORTANT: All occupants listed must currently be living with the Applicant. If special circumstances exists, please explain below.

Name (First and Last)Date of Birth

(mm/dd/yyyy)Age Relationship to Applicant(s)

Explanation(s):

If Living at Present Address for Less Than Two (2) Years, Complete the Following:

Dear Applicant: This application must be completed to determine if you qualify for a house

through Habitat for Humanity. Fill it out as completely and accurately as possible. All information

you include on this document will be kept confidential.

1.Applicant Information


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Applicant Co-ApplicantFormer Address: Former Address:

Street Street


Number of years at this address: Number of years at this address:

2.Present Housing ConditionsThis is a REQUIRED part of your application. We WILL NOT review applications without this information filled in.Number of Bedrooms:

Total Number of People in Current Housing: ____________Number of Bathrooms:

Applicant(s) must have a demonstrated need for simple, decent, affordable housing. Use the space below to provide the

Application Review Committee with information about your current housing situation. Indicate all problems, challenges, or

hardships. Your Housing Needwill be further evaluated by a home visit for assesment purposes.

3.Willingness to Partner


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Applicant Co-Applicant

To be considered for a Habitat home, you and your family, must be willing to complete 175 -300 sweat equityhours.

Your help in building your house and the homes of others is called sweat equityand may include clearing the lot,

painting, helping with construction, working in the Habitat ReStore - or office - or other approved activities.

I am willing to complete the required sweat

equity hours.

I am willing to complete the required sweat

equity hours.

4.Employment InformationApplicant Co-Applicant

Check this box if you are self employed. Check this box if you are self employed.

Name of Current Employer: Name of Current Employer:

Position/ Title: Position/ Title:

Employement Dates:

From: ___________________ To: ___________________

(month/year) (month/year)

Employement Dates:

From: ___________________ To: ___________________


Address of Employer: Address of Employer:

Street Street


Monthly Gross Income (Before Taxes): Monthly Gross Income (Before Taxes):

If you currently have more than one (1) job, please complete the next section





Employement Dates:

From: ___________________ To: ___________________


Employement Dates:

From: ___________________ To: ___________________



Street Street



If working at present job for less than one (1) year, complete the following

$ $

$ $


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Employement Dates:

From: ___________________ To: ___________________


Employement Dates:

From: ___________________ To: ___________________



Street Street



IMPORTANT NOTICE:

If At Any Time During The Application Process

Habitat For Humanity Of Kershaw County

Discovers Undeclared Income By Any Of The

Applicants, Co-Applicants, Or Family Members,That Will Be Grounds For Application Denial.

5a. Financial Information Monthly Household IncomeApplicant Co-Applicant

1. Gross Monthly Wages (Before Taxes): 1. Gross Monthly Wages (Before Taxes):

2. Social Security Income: 2. Social Security Income:

3. Child Support (Monthly amount & how long you expect to receive it): 3. Child Support (Monthly amount & how long you expect to receive it):

4. Alimony 4. Alimony

5. Other (Please specifyAFDC/TANF, Food Stamps etc.): 5. Other (Please specifyAFDC/TANF, Food Stamps etc.):

Total Monthly Income:

(1+2+3+4+5)


(1+2+3+4+5)

Other Household Member #1 (18 Years or older) Other Household Member #2 (18 Years or older)

$ $

$ A $ B


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Name: Name:

Age: Age:

Relationship: Relationship:

1. Gross Monthly Wages (Before Taxes): 1. Gross Monthly Wages (Before Taxes):

2. Social Security Income: 2. Social Security Income:

3. Child Support (Monthly amount & how long you expect to receive it): 3. Child Support (Monthly amount & how long you expect to receive it):

4. Alimony 4. Alimony

5. Other (Please specifyAFDC/TANF, Food Stamps etc.): 5. Other (Please specifyAFDC/TANF, Food Stamps etc.):


(1+2+3+4+5)


(1+2+3+4+5)

Total Household Monthly Income: (A+B+C+D)

You mustprovide official documentation of all sources of income.(Check stubs, Employer Computer Print-out, DSS Print-outs, Social Security Print-outs, Written

Evidence of Income, Etc. )

5b. Financial Information Monthly Household ExpensesExpense Monthly Payment Debt Monthly Payment

Rent: Car Payment

Total Utilities: Credit Card #1:

Child Care: Credit Card #2:

Phone: Credit Card #3:

Cell Phone:Other Credit Cards

Total:

Cable/ Satellite: Furniture:

School Lunch: Appliances:

Auto Insurance: Student Loan(s):

Other: Hospital / Medical:

Other:Other Loans (Please

Specify):

Other: Child Support:

Other: Alimony:

Total Monthly

Expenses:

Total Monthly

Expenses:

IMPORTANT: Section 5c MUST BEcompleted asthoroughly as possible.

5c. Debt Listing

$

$ C $ D

$ $


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List below all payments, of any kind (medical, car furniture, debt consolidation loans, dental, hospital,

etc.) Though you have completed section 5a & 5b, this is where you identifyAlloutstanding debts.Information in this section is important to a complete evaluation of your application.

Businesses or People you

owe money to:Account #:

Amount of Monthly

Payment:Unpaid Balance:

Number of

Payments Left:

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________

_____________________ __________ ________________ _______________ ____________


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6. Financial Assests Bank Account(s) and Property Information


Total Number of Checking Accounts: _________________

Total Number of Savings Accounts: _________________

Total Number of Other Type Accounts:_________________

Please Provide specific bank account information forALL

accounts in the space provided below.

Total Number of Checking Accounts: _________________

Total Number of Savings Accounts: _________________

Total Number of Other Type Accounts:_________________

Please Provide specific bank account information forALL

accounts in the space provided below.

Bank Account(s) Information Bank Account(s) Information

Name of Bank: ____________________________Account Number: ____________________________

Type of Account: ____________________________

Avg. Monthly Balance: ____________________________

Check if Joint Account with Co-Applicant

Name of Bank: ____________________________Account Number: ____________________________

Type of Account: ____________________________


Check if Joint Account with Applicant

Name of Bank: ____________________________

Account Number: ____________________________

Type of Account: ____________________________



Name of Bank: ____________________________

Account Number: ____________________________

Type of Account: ____________________________



Name of Bank: ____________________________

Account Number: ____________________________

Type of Account: ____________________________



Name of Bank: ____________________________

Account Number: ____________________________

Type of Account: ____________________________



Property Information Property Information

Do you own property?

Yes No

Do you own property?

Yes No

If Yes-

What is your monthly Payment: _____________________

What is your Unpaid Balance: _____________________

Address: ________________________________

________________________________

If Yes-

What is your monthly Payment: _____________________

What is your Unpaid Balance: _____________________

Address: ________________________________

________________________________

Type of Property:

House/Condo

Land

Other: (specify) _______________

Type of Property:

House/Condo

Land

Other: (specify) _______________

7. Down Payment and Closing Cost InformationAll Habitat for Humanity of Kershaw County home buyers must pay a $500.00 down payment. Where will you get this

money from (example; savings, parents, etc.) ? If you are borrowing money to pay this cost, explain how and from whom.


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8. DeclarationsApplicant Co-Applicant

Please Check the box that best answers the following questions.A. Do you have any debt

because of a court decision

against you (i.e. tax lien,

judgement, etc.):

Yes No

A. Do you have any debt

because of a court decision

against you (i.e. tax lien,

judgement, etc.):

Yes No

B. Have you declared

bankruptcy within the past 7

years?

Yes No

B. Have you declared

bankruptcy within the past 7

years?

Yes No

C. Have you had property

foreclosed on within the

past 7 years?

Yes No

C. Have you had property

foreclosed on within the

past 7 years?

Yes No

D. Have you been convicted

of a drug related offense

within the last 5 years?

Yes No

D. Have you been convicted

of a drug related offense

within the last 5 years?

Yes No

Answering Yesto these questions does not automatically disqualify you. If you

answered Yesto any questions A-D, however, explain in the space provided below.

E. Have you ever been convicted of a sexual offense?

Yes No

E. Have you ever been convicted of a sexual offense?

Yes No

Conviction of a sexual offense is grounds for application denial.

F. Are you a legal, permanent resident of the U.S. or U.S.

Citizen?

Yes No

F. Are you a legal, permanent resident of the U.S. or U.S.

Citizen?

Yes No

Additional Information on Items A-D Additional Information on Items A-D


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9. Authorizations

Authorization #1:I / We understand that by filing this application, I am authorizing Habitat for Humanity of Kershaw County 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,

employment verification, and a criminal record background check. 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. The orginal, or a

copy, of this application will be retained by Habitat for Humanity of Kershaw County even if the application is not

approved.

Authorization #2:I / We understand that Habitat for Humanity screens all potential staff (whether paid or unpaid), board members, and

applicant families on the sex offender registry. By completing this application, I am submitting to such an inquiry.

Authorization #3:I / We the undersigned, by the execution of the attached consent form grant Habitat for Humanity of Kershaw County

permission to do a credit check for the Applicant and Co-Applicant as a part of the financial evaluation.

Authorization #4:I / We the undersigned, by the execution of the attached consent form grant Habitat for Humanity of Kershaw County

permission to do a criminal background check upon the tentative selection of the applicant(s) as a Habitat for Humanity

home buyer.


Printed Name Printed Name


Signature Date Signature Date

Occupant 18 Years or Older Occupant 18 Years or Older









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10. Consent to Criminal Background CheckApplicant Co-Applicant

I ______________________________________, an(Printed Name)

Applicant, Co-Applicant, or Occupant 18 years of age or

older, for a Habitat for Humanity of Kershaw County (HHKC)

house, do hereby give my consent to HHKC to conduct such

criminal background check as it deems necessary to qualify

me as a homeowner.

Signed and dated this _______day of _____________, 201__

I ______________________________________, an(Printed Name)





me as a homeowner.


Signature Signature


I ______________________________________, an(Printed Name)



house, do hereby give my consent to HHKC to conduct suchcriminal background check as it deems necessary to qualify

me as a homeowner.


I ______________________________________, an(Printed Name)



house, do hereby give my consent to HHKC to conduct suchcriminal background check as it deems necessary to qualify

me as a homeowner.


Signature Signature


I ______________________________________, an(Printed Name)

Applicant, Co-Applicant, or Occupant 18 years of age orolder, for a Habitat for Humanity of Kershaw County (HHKC)



me as a homeowner.


I ______________________________________, an(Printed Name)

Applicant, Co-Applicant, or Occupant 18 years of age orolder, for a Habitat for Humanity of Kershaw County (HHKC)



me as a homeowner.


Signature Signature

11.Credit Report AuthorizationApplicant Co-Applicant

I ______________________________________, hereby(Printed Name)

authorize Habitat for Humanity of Kershaw County to

request credit reports on my behalf from any and all credit

bureaus. This action Is in direct relation to the review of my

application for homeownership.


I ______________________________________, hereby(Printed Name)

authorize Habitat for Humanity of Kershaw County to

request credit reports on my behalf from any and all credit

bureaus. This action Is in direct relation to the review of my

application for homeownership.


Signature Signature


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You must submit a $25.00 fee with your application. If Habitat does not receive the fee, your

application will not be reviewed.

YOUR APPLICATION MUST INCLUDE A CASHIERS CHECK OR MONEY ORDER

PAYABLE TO: Habitat for Humanity of Kershaw County**Fee is for background and credit check.**

***No cash or personal checks are accepted.***

Equal Housing Opportunity

We Pledge to the letter and spirit of U.S. policy for the achievement of equal housing

opportunity throughout the nation. We 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 nation origin.

12. For Office Use Only DO NOT WRITE IN THIS SPACE

Date Received: _______________________

More information requested?

Yes No

Date Application Completed: _______________________

Accepted Denied

Date Letter Sent: _____________________________

Date of Home Visit: _____________________________

Date Letter Sent: _____________________________


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2012 homeowner application

Documents