NEIGHBORHOOD HOUSING & DEVELOPMENT CORPORATION 633 NW 8 TH AVE. GAINESVILLE, FL TELEPHONE (352) FAX (352)

Transcription

1 NEIGHBORHOOD HOUSING & DEVELOPMENT CORPORATION 633 NW 8 TH AVE. GAINESVILLE, FL TELEPHONE (352) FAX (352) Dear Prspective Hmewner: Thank yu fr cnsidering Neighbrhd Husing & Develpment Crpratin t help make yur dream f hmewnership a reality. Please cmplete the steps belw s that we may prcess yur intake packet fr prepurchase cunseling. 1. Cmplete the entire intake frm. Make sure it is signed and dated. If there is a c-applicant, make sure that all f their infrmatin is prvided and they have signed, as well. 2. Make cpies f all pertinent dcuments listed n the Dcument list (page 2). If needed, yu may bring them int the ffice and we can make cpies fr yu. If yu are receiving incme frm Scial Security, Retirement, SSI, Child Supprt, Disability, Rental, etc., please prvide dcumentatin. Include a letter f explanatin fr any gap f emplyment and any adverse credit issues. 3. Yu may drp ff yur cmpleted intake packet and required dcuments at Marin Cunty Cmmunity Services, mail t address abve, (acnklin@gnhdc.rg) r fax. Attentin: Anne Cnklin Once yur cmpleted intake packet and required dcuments have been received and reviewed, we will cntact yu t schedule an appintment. Sincerely, Pebbles Vance NHDC Cunselr Appintment Lcatin: Marin Cunty Cmmunity Services 2631 SE Third Street Ocala, FL /2017

2 NHDC Dcument list: Tw mst recent paycheck stubs fr all applicants. (Prf f Mnthly Incme) Tw mst recent checking and savings accunt mnthly statements. Scial Security Cards f applicant(s) & children. Drivers License r picture ID f applicant(s). Incme tax returns fr current and past year alng with W-2 frms. Letter f explanatin fr any gap f emplyment during the last tw years, als include any explanatin f negative credit n yur credit reprt. Divrce paper, if applicable. PERSONAL PROFILE INTAKE FORM Page 2 f 11

3 NEIGHBORHOOD HOUSING & DEVELOPMENT CORPORATION 633 NW 8 th AVE. GAINESVILLE, FL TEL: (352) FAX: (352) Fr Office Use Only: Janice Pebbles PERSONAL PROFILE INTAKE FORM CUSTOMER Please Print Clearly Name: Last MI First PHYSICAL ADDRESS Street City State Zip Cde Cunty MAILING ADDRESS (if different frm physical address) Street City State Zip Cde Hme: ( ) Wrk: ( ) Fax: ( ) Mbile/Cell ( ) / / Scial Security Number Birth Date (MM/DD/YYYY) N. f years at current address Credit Scre (if knwn): Repsitry (Circle crrespnding): Experian TransUnin Equifax Race (please circle all that apply): 1.Black r African American 3. Asian 5. White 2. Native Hawaiian/Other Pacific Islander 4. American Indian/Alaskan Native 6. Other Ethnicity (please select yes r n fr Hispanic Origin. Yu shuld select bth a Race categry and a yes r n fr Hispanic rigin: Hispanic: Yes N Are yu freign brn? Yes N Language spken in the hme (if nt English): Gender (please circle ne): Female Male Disabled? Yes N Are yu a veteran? Yes N Marital Status (please circle ne): Single Married Divrced Separated Widwed PERSONAL PROFILE INTAKE FORM Page 3 f 11

4 Grss Annual Family r Husehld Incme (Befre taxes): $ Current Husing Arrangement: 1. Rent 2. Hmeless 3. Hmewner with mrtgage 4. Living with family member and nt paying rent 5. Hmewner with mrtgage paid ff Are yu a first Time Buyer (yu have nt wned a hme in the past three years)? Yes N Husehld Type (please select the mst accurate)? 1. Female headed single parent husehld 2. Male headed single parent husehld 3. Single adult 4. Tw r mre unrelated adults 5. Married with children 6. Married withut children 7. Other Family/Husehld Size: Hw many dependents (ther than thse listed by any c-brrwer)? What ages are they?,,,,,,,, Are there nn-dependents wh will be living in the hme? Yes N If yes, list belw: Relatinship Age Relatinship Age Educatin (please circle ne): 1. Belw High Schl Diplma 2. High Schl Diplma r Equivalent 3. Masters Degree 4. Tw-Year Cllege 5.Bachelrs Degree 6. Abve Masters Degree Referred t by (please circle all that apply): Print Advertisement Bank Gvernment TV Realtr Staff/Bard member Walk-In Friend Radi Newspaper Article If yu were referred by a bank, which ne? If referred by anther surce nt listed abve, which ne? CO-APPLICANT Name: Last MI First Street City Zip Cde Cunty Hme: ( ) Wrk: ( ) Scial Security Number / / Birth Date Race (please circle all that apply): 1.Black r African American 3. Asian 5. White 2. Native Hawaiian/Other Pacific Islander 4. American Indian/Alaskan Native 6. Other Ethnicity (please select yes r n fr Hispanic Origin. Yu shuld select bth a Race categry and a yes r n fr Hispanic rigin: Hispanic: Yes N PERSONAL PROFILE INTAKE FORM Page 4 f 11

5 Are yu freign brn? Yes N Language spken in the hme (if nt English): Gender (please circle ne): Female Male Disabled? Yes N Are yu a veteran? Yes N Marital Status (please circle ne): Single Married Divrced Separated Widwed Educatin (please circle ne): 1. Belw High Schl Diplma 2. High Schl Diplma r Equivalent 3. Masters Degree 4. Tw-Year Cllege 5.Bachelrs Degree 6. Abve Masters Degree Relatinship t Custmer (please circle): Spuse Daughter Sn Sister Brther Girlfriend Byfriend Mther Father Dmestic Partner Other: CUSTOMER EMPLOYMENT Last 2 Years Please Print Clearly Primary Emplyer: Hire Date Street City State Zip Cde Phne: ( ) Part Time r Full Time (Please circle ne) Years in Prfessin: Grss Incme (befre taxes): $ Is this amunt paid hurly weekly every tw weeks twice a mnth mnthly? Previus Emplyer: Length f Emplyment Street City State Zip Cde Phne: ( ) Part Time r Full Time (Please circle ne) Years in Prfessin: Grss Incme (befre taxes): $ Is this amunt paid hurly weekly every tw weeks twice a mnth mnthly? Cntinue listing previus emplyers n a separate sheet f paper. Secndary Emplyer: Hire Date Street City State Zip Cde Phne: ( ) Part-Time r Full-Time (Please Circle ne) Grss Incme (befre taxes): $ Is this amunt paid hurly weekly every tw weeks twice a mnth mnthly? PERSONAL PROFILE INTAKE FORM Page 5 f 11

6 CO-APPLICANT EMPLOYMENT Last 2 Years Primary Emplyer: Hire Date Street City State Zip Cde Phne: ( ) Part Time r Full Time (Please circle ne) Years in Prfessin: Grss Incme (befre taxes): $ Is this amunt paid hurly weekly every tw weeks twice a mnth mnthly? Previus Emplyer: Length f Emplyment Street City State Zip Cde Phne: ( ) Part-Time r Full-Time (Please Circle One) Cntinue listing previus emplyers n a separate sheet f paper. Secndary Emplyer: Hire Date Street City State Zip Cde Phne: ( ) Part Time r Full Time (Please circle ne) Years in Prfessin: Grss Incme (befre taxes): $ Is this amunt paid hurly weekly every tw weeks twice a mnth mnthly? INCOME Please Print Clearly CUSTOMERCO-APPLICANT Type f Incme Mnthly Amunt Mnthly Amunt Salary Alimny/Child Supprt Rental Incme Scial Security Pensin Incme Public Assistance Self-emplyment Incme Dependent SSI Incme Disability Incme Other Emplyment CUSTOMER CO-APPLICANT PERSONAL PROFILE INTAKE FORM Page 6 f 11

7 Can yu dcument yur child supprt/alimny incme? Yes N Yes N If yes, hw lng will it cntinue? If yur child r a family member receives SSI, hw many mre years will the payments cntinue? If yu receive disability incme, is it fr a permanent disability? Yes N Yes N Regarding ther emplyment, have yu wrked in this field fr tw years r mre? Yes N Yes N LIABILITIES/DEBT Please list any debts yu have, including credit cards, aut lans, and student lan. D NOT include rent r utilities. Current Mnthly Wh s Debt? Paid T (Bank name(s) and Accunt Numbers) Balance Payment C=Custmer, A=C-Applicant B=Bth Please use additinal sheets if necessary. CUSTOMER CO-APPLICANT Have yur payments been made n time? Yes N Yes N Are yu currently in Chapter 13 bankruptcy? Yes N Yes N If yes, when did it begin? If yes, when will it be paid ut? If yes, hw much is the payment? Have yu had a Chapter 7 bankruptcy? Yes N Yes N If yes, when was it discharged? LIQUID FUNDS/SAVINGS/INVESTMENTS Please Print Clearly Please list the apprximate value f the fllwing: PERSONAL PROFILE INTAKE FORM Page 7 f 11

8 BANK NAME & ACCOUNT NUMBER(S) CUSTOMER CO-APPLICANT Checking accunt Savings accunt Cash CDs Securities (stcks, bnds, etc.) Retirement accunt Other Liquid Funds Are yu abut t receive additinal funds (e.g., tax refunds, prperty sales, etc.)? (Please circle One) Yes N If yes, hw much? $ MONTHLY LIVING EXPENSES Current mnthly rent r mrtgage Utilities Telephne Cellular/Pager Cable/Satellite TV Child Care Fd Insurance (car, medical,etc) Persnal Care Items Car incidentals (gas, repairs, etc) CUSTOMER CO-APPLICANT ADDITIONAL INFORMATION CUSTOMER CO-APPLICANT Have yu wned a hme in the last three (3) years? Yes N Yes N D yu have a cntract n a huse at this time? Yes N Are yu currently wrking with a real-estate agent? Yes N Mst cnvenient time fr an individual appintment? AM PM AUTHORIZATION I authrize NHDC HmeOwnership Center t: PERSONAL PROFILE INTAKE FORM Page 8 f 11

9 (a) pull my/ur credit reprt t review my/ur credit file fr husing cunseling in cnnectin with my pursuit n a lan t purchase real prperty; (b) pull my/ur credit reprt and review my/ur credit file fr infrmatinal inquiry purpses; and (c) btain a cpy f the HUD-1 Settlement Statement, Appraisal, and Real Estate Nte(s) when I purchase a hme, frm the lender wh made me/us a lan and/r the title cmpany that clsed the lan. I/We understand that any intentinal r negligent representatin(s) f the infrmatin cntained n this frm may result in civil liability and/r criminal liability under the prvisins f 18, United States Cde, Sectin Custmer C-Applicant Date Date NHDC Fee Schedule As f June Financial Fitness Prgram The Financial Fitness prgram fcus is n budgeting, credit educatin and ther financial tpics. It is intended fr clients wh have an interest in becming a hme wner but need t reslve sme issues keeping them frm securing a mrtgage. N charge 2. Hme Buyer Educatin Seminar $50 The Hme Buyer Educatin (HBE) Seminar is 8 hurs f instructin that fcuses n the hme purchase prcess. Clients graduating frm the class may be eligible fr City, Cunty, and State f Flrida subsidy assistance r special financing ffered by the mrtgage lender. PERSONAL PROFILE INTAKE FORM Page 9 f 11

10 3. Mrtgage Delinquency/Freclsure Interventin Cunseling N fee charged; hwever, a credit reprt is required. Other Fees Credit Reprts- N fee charged Acknwledgement f Fee Schedule I have read this schedule and I am aware f the fees. I am respnsible t pay fr nly thse services specifically requested. I am nt bligated t receive nr pay fr any ther services that may be ffered by NHDC r its partners. Signature Date PERSONAL PROFILE INTAKE FORM Page 10 f 11

11 PRIVACY POLICY AND PRACTICES OF Neighbrhd Husing and Develpment Crpratin Hmewnership Center We at Neighbrhd Husing and Develpment Crpratin Hmewnership Center (NHDCHC) value yur trust and are cmmitted t the respnsible management, use and prtectin f persnal infrmatin. This ntice describes ur plicy regarding the cllectin and disclsure f persnal infrmatin. Persnal infrmatin, as used in this ntice, means infrmatin that identifies an individual persnally and is nt therwise publicly available infrmatin. It includes persnal financial infrmatin such as credit histry, incme, emplyment histry, financial assets, bank accunt infrmatin and financial debts. It als includes yur scial security number and ther infrmatin that yu have prvided us n any applicatins r frms that yu have cmpleted. Infrmatin We Cllect We cllect persnal infrmatin t supprt ur lending peratins, financial fitness cunseling, and t aid yu in shpping fr a hme mrtgage frm a cnventinal lender. In additin, we cllect persnal infrmatin t assist yu with reslving mrtgage delinquency. We cllect persnal infrmatin abut yu frm the fllwing surces: Infrmatin that we receive frm yu n applicatins r ther frms, Infrmatin abut yur transactins with us, ur affiliates r thers, Infrmatin we receive frm a cnsumer reprting agency, and Infrmatin that we receive frm persnal and emplyment references. Infrmatin We Disclse We may disclse the fllwing kinds f persnal infrmatin abut yu: Infrmatin we receive frm yu n applicatins r ther frms, such as yur name, address, scial security number, emplyer, ccupatin, assets, debts and incme; Infrmatin abut ur transactins with us, ur affiliates r thers, such as yur accunt balance, payment histry and parties t yur transactins; and Infrmatin we receive frm a cnsumer reprting agency, such as yur credit bureau reprts, yur credit histry and yur creditwrthiness. T Whm D We Disclse We may disclse yur persnal infrmatin t the fllwing types f unaffiliated third parties: Financial service prviders, such as cmpanies engaged in prviding hme mrtgage r hme equity lans, Others, such as nnprfit rganizatins invlved in cmmunity develpment, but nly fr prgram review, auditing, research and versight purpses. We may als disclse persnal infrmatin abut yu t third parties as permitted by law. Prir t sharing persnal infrmatin with unaffiliated third parties, except as described in this plicy, we will give yu an pprtunity t direct that such infrmatin nt be disclsed. Cnfidentiality and Security We restrict access t persnal infrmatin abut yu t thse f ur emplyees wh need t knw that infrmatin t prvide prducts and services t yu and t help them d their jbs, including underwriting and servicing f lans, making lan decisins, aiding yu in btaining lans frm thers, and financial cunseling. We maintain physical and electrnic security prcedures t safeguard the cnfidentiality and integrity f persnal infrmatin in ur pssessin and t guard against unauthrized access. We use lcked files, user authenticatin and detectin sftware t prtect yur infrmatin. Our safeguard cmplies with federal regulatins t guard yur persnal infrmatin. Initial PERSONAL PROFILE INTAKE FORM Page 11 f 11