Home Ownership Pre-Application Form

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Our Home Ownership
Program »

Please review the information on Our Home Ownership Program web page before submitting this form. Please note that this Home Ownership Pre-Application Form is NOT an application for a Habitat home, but provides us with some basic information so that we may provide you with additional information regarding the program and the associated home ownership criteria. Please allow up to 4 weeks for information to be provided to you.

RELEASE FORM
The applicant(s) understand and authorize Habitat for Humanity to perform an in-depth study to determine the applicant’s need for housing, ability to pay homeowners expenses, employment and credit histories, and willingness to partner should the applicant(s) decide to formally apply to the HFHLPC Home Ownership Program. The study will include a credit check and verification by the applicant’s landlord and employer.
We understand that if we qualify for home ownership, our partnership agreement with Habitat for Humanity includes the completion of several hundred hours of sweat equity in the building of our home and the homes of others before we may become Habitat homeowners.
The statements made in this Application are true and correct to the best of the undersigned’s knowledge and belief. These statements are made for the purposes of obtaining a loan from Habitat for Humanity of La Plata County. You are required to notify Habitat of any change in your financial or living situation after the date of application. The undersigned understand that if chosen as a Habitat partner family, the undersigned must occupy this house as our primary residence.
By submitting this online interest form, you are electronically agreeing to the above terms.

YOUR INFORMATION *Applicant First Name:
*Applicant Last Name:

*Applicant Date of Birth:

*Applicant: I am able to provide my Social Security Number and Driver's License Information at the follow up interivew:

*Are you, the Applicant, a US Citizen or Lawful Permanent Resident?

*Applicant Marital Status:
Co-Applicant First Name:
Co-ApplicantlastName:

Co-Applicant Date of Birth:

Co-Applicant: I am able to provide my Social Security Number and Driver's License Information at the follow up interivew:

Is the Co-Applicant a US Citizen or Lawful Permanent Resident?

Co-Applicant Marital Status:
*Address:
*City:
*State:
*Zip:

*How long at this address? (Please select date when first moved to this address):

Applicant Email Address:
Co-Applicant Email Address:
*Home Phone:
Cell Phone:
Work Phone:
*When is a good time to call you?
*Which number?
*How did you learn of Habitat for Humanity?

TOTAL MONTHLY INCOME & LIVING SITUATION

Please list all jobs held by family members age 18 and older, including Assistance received, if applicable:
*Name | Age | Hourly Wage: $/hr | Hours/Week Worked:

Name | Age | Hourly Wage: $/hr | Hours/Week Worked:

Select type of assistance received each month
(You will be required to provide documentation of this income.):

TANF

SSI

Disability

Food Stamps

Child Support

Maintenance

Other (must describe later)

*How many people would be living in the Habitat house, including you?

*Number of bedrooms in current home where I live:

*Number of people living in current home, including you:

*Please select those items listed below that are in good working order in your current home:

Heat

Appliances

Windows & Doors

Walls, Ceilings, Floor

*Please select those items listed below with which you are experiencing problems in your current home:

Plumbing

Water Damage

Mice. Cockroaches, Pests

*Do you feel safe in your current neighborhood?

*Please explain why your current housing does not meet your needs:

*Current monthly rent:
*Current monthly electric bill:
*Current monthly heat/gas bill:
*Currently, my family is (please select one):

*I have lived in La Plata County since:

*I understand that Habitat for Humanity is a homeownership program, and I am prepared to make the monthly mortgage payments.:

*I have been sued and still owe money from the lawsuit:

*I have filed for bankruptcy within the past two years.:

*I have lost my home to foreclosure in the past two years:

*Each applicant is willing to complete 250 hours for single heads of household and 500 sweat equity hours for an applicant and co-applicant, including attending homebuyer classes:

*Is anyone in your household involved in illegal activity:

*I am a co-signer for another person's loan:

*Why are you interested in the Habitat Home Ownership Program?

Would you like to subscribe to our email list?

No thanks.

Yes, please subscribe me.

We are pledged to the letter and spirit of U.S. policy for the achievement of equal housing opportunity throughout the nation. In compliance with Fair Housing Law, Title VIII of the Civil Rights Act of 1968 (Fair Housing Act), as amended, HFHLPC does not discriminate based on race, color, national origin, religion, sex, familial status (including children under the age of 18 living with parents or legal custodians, pregnant women, people securing custody of children under the age of 18), handicap (disability), sexual orientation or gender identity.

© 2012 Habitat for Humanity of La Plata County
120 Girard Street in Bodo Park, Durango, CO 81303
[ ReStore: (970) 382-9931 ] [ Admin: (970) 382-2215 ] [Contact via Email]
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