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More News from BAHFH >>

homeownership/preliminaryApp

PRELIMINARY APPLICATION FOR HOMEOWNERSHIP

Applicant
First Name:   Last Name: 
DOB (Mo./Day/Yr.)  SS#: 
Single (includes Divorced or Widowed)   Married (includes Separated)
Are you a citizen of the U.S.?  Yes  No  If not, when did you come to the U.S.? 
Are you a lawful Permanent Resident?  Yes  No
Have you ever been convicted of a felony? Yes  No  If Yes, please explain:

Co-Applicant
First Name:   Last Name: 
DOB (Mo./Day/Yr.)  SS#: 
Single (includes Divorced or Widowed)   Married (includes Separated)
Are you a citizen of the U.S.?  Yes  No  If not, when did you come to the U.S.? 
Are you a lawful Permanent Resident?  Yes  No
Have you ever been convicted of a felony? Yes  No  If Yes, please explain:

Current Address: 
City:   State:   Zip: 
Previous Address (if less than 2 years)
City:   State:   Zip: 
Telephone # (Daytime)   Telephone # (Alternate or cell)

List CURRENT employer(s), start date, and monthly wages for each working member of your household 18 years or older.
Employee's Name
(who works here?)
Company Name and City Start Date Gross Mo. Income

List Income: (Include AFDC/TANF, Food Stamps, Social Security, SSI, Disability, Alimony, Child Support, Other).
Please include food stamp amount separately.
Name of Recipient Type of Income Amount per Month

Monthly Expenses
Total amount you pay each month for:
Food:    Car Payments:    Credit Card Debt:   
Loans:    Other: 

Present Housing Situation:
How much do you pay in rent per month? $    Utilities? $
Is this rent subsidized (i.e. Section 8, etc.)? Yes  No
If Yes, please explain:
Number of Bedrooms:    Number of Bathrooms:    Other Rooms: 

Do you share housing with another family?  Yes  No
If Yes, please explain:

Do not include applicant or co-applicant. List every person living in your home with you currently (today) that would live with you in a Habitat Home. Add additional members on a piece of paper.
 
Name Age Sex Relationship to Applicant

Please describe the condition of your current home (why do you need a Habitat for Humanity home)?

How did you hear about Habitat for Humanity?

Have you applied for homeownership through Habitat for Humanity at this affiliate or any other affiliate in the past? If so, please explain where you applied, how many times you applied and what the outcome was after each application.

PLEASE NOTE: THIS IS A PRE APPLICATION FOR QUALIFICATION PURPOSES ONLY! IF YOU QUALIFY, YOU WILL BE NOTIFIED OF THE NEXT ORIENTATION. AT THAT TIME YOU WILL BE GIVEN A COMPLETE APPLICATION.
Equal Housing Opportuntiy

We are pledged 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, gender, physical or mental limitations, familial status, or national origin.
When application is completed please return your application to:

Bend Area Habitat for Humanity
1860 NE 4th Street
Bend, OR 97701

You may also call 541-385-5387 and ask to speak with the Family Coordinator.