DO NOT SEND ORIGINAL DOCUMENTATION, COPIES ONLY
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1 ITEMS NEEDED FOR HOME OWNERSHIP PROGRAM Completed Home Ownership Program Intake Questionnaire Initialed and signed Home Ownership Program Authorization Form Completed expense sheet (please make sure to fill this out completely) Most current bank statements for 2 months if available Most current paycheck stubs for a 30 day period Most current paycheck stubs for a 30 day period for household members other than borrower Documentation of additional income must be provided (ex. child support, SSI. etc.) Copy of acceptable identification. Please use one of the following: -Valid, non-expired driver s license with photo -Valid, non-expired OH/PA photo identification -Valid, non-expired Passport with photo -Valid, non-expired Alien I.D. Card with photo -Valid, Armed Forces I.D. with photo Check or Money Order payable to Dollar Bank for merged credit report: - $12.00 for each individual person - $20.00 for married couples - $24.00 for unmarried couples Mail all of the above to: Judith A. Mason, Assistant Vice President Community Development Dollar Bank Three Gateway Center, One-East Pittsburgh, PA After we receive all necessary information, we will call you to set up an appointment. DO NOT SEND ORIGINAL DOCUMENTATION, COPIES ONLY
2 Home Ownership Program - Intake Questionnaire Date: Applicant Referral From: Spouse / Co-Applicant Name Name Social Security Number Date of Birth Phone (h) (w) (c) Address Social Security Number Date of Birth Phone (h) (w) (c) Address Check One: Married Unmarried (include divorced, widowed) Separated Current Address Street Address City State Zip Monthly Rental Payment Years at Address Landlord Name Landlord Address Street Address City State Zip Employment Current Employer Position Monthly Income (Gross): Number of Years Employed If less than 2 years at current employer or 2 nd job Employer Position Monthly Income (Gross): Number of Years Employed Spouse / Co-Applicant s Employment Current Employer Position Monthly Income (Gross): Number of Years Employed If less than 2 years at current employer or 2 nd job Employer Position Monthly Income (Gross): Number of Years Employed Additional Household Income (example child support, SSI. etc.) Number of Individuals in Household
3 Home Ownership Program Authorization Initial(s) of Participants 1. (I) (We) fully understand that the Dollar Bank Home Ownership Program provides information that will assist in resolving credit problems that could be an issue in qualifying for a home purchase mortgage. 2. (I) (We) fully understand that the credit counseling process offered by Dollar Bank provides detailed information on mortgage requirements and assist me/us in understanding mortgage credit analysis. 3. (I) (We) fully understand that the program does not guarantee me/us an approval of a residential mortgage application with Dollar Bank or any other financial institution. 4. (I) (We) fully understand that Dollar Bank shall not be responsible for any credit decision or action, taken based on information provided by the Home Ownership Program of Dollar Bank. 5. (I) (We) authorize Dollar Bank to obtain a consumer credit report(s) to assist in the evaluation of my/our credit. 6. (I) (We) authorize Dollar Bank to correspond by electronic means ( , text message, etc) in regard to class notifications, special events reminders, etc. (This authorization is optional.) Signature Signature Printed name Printed Name Date Date
4 Expense Sheet A record of all expenses paid per month. Payments Monthly Due Date Comments Rent: Electric: Gas: Water/Sewer: Cell and Home Phone: Food/Lunches (see below for explanation): Cable/Satellite: Entertainment: Gas/Bus Pass: Child Care: Clothing: Insurance (Auto, Renters, Life): Charge Accounts: Loan Payments: Gifts: Church Donations: Miscellaneous: Total Expenses Per Month: Net Income Per Month: Payment Amount Savings (Deficit) Per Month: **It is important you record the amount you spend on food monthly. Food includes school lunches, dining out, groceries, etc.
5 Directions to Dollar Bank Corporate Headquarters at Three Gateway Center: After entering the building through the main entrance, please visit the Dollar Bank Reception Area located to the left. From the North Take I-279 going South to exit 1A on the left toward Fort Duquesne Boulevard. Keep right at the fork and merge onto Fort Duquesne Boulevard. Turn right at Stanwix Street. Turn right at Penn Avenue. Three Gateway Center will be on the right. From the South Take I-376 going East and take exit 70A to Liberty Avenue. Three Gateway Center will be on the left. From the East Take I-376 going West to exit 70D to Stanwix Street. Turn left onto Fort Pitt Boulevard. Turn right onto Commonwealth Place. Turn right onto Liberty Avenue. Three Gateway Center will be on the left. From the West End Take PA-65 going South toward I-376 East/Fort Pitt Bridge/Airport/Monroeville. Take exit 1A on the left toward Fort Duquesne Boulevard. Keep right at the fork and merge onto Fort Duquesne Boulevard. Turn right at Stanwix Street. Turn right at Penn Avenue. Three Gateway Center will be on the right. Parking Parking is available on Stanwix Street near Fort Duquesne Boulevard. Also, parking is available on Liberty Avenue in an underground parking garage. You may also try any of the parking meters located in front of Dollar Bank, although Dollar Bank does not redeem charges or parking tickets and overtime parking is strictly enforced.
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