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To participate in the Comprehensive Homeownership Counseling Program, 1) complete the application, 2) collect the required items below, and then 3) register for an Orientation Session. Please read the instructions carefully. In order to attend a BNT Orientation, you MUST collect and BRING the following items with you to the session: Completed 10 page application. Please print this application and handwrite clearly. Credit Report fee of $16.00 for a single applicant or $32.00 for a joint report. MONEY ORDER OR CASH ONLY (NO PERSONAL CHECKS). Make money orders payable to Bridgeport Neighborhood Trust. --- Copies of the following items: --- Income (if applicable) You MUST Tax Returns - Last two years of tax returns 1040s with all schedules (signed) and W2s bring in Paystubs - Most recent month worth of paystubs from all employers including year to copies. date information (dated within the last 45 days) Social Security / SSI current benefit statement or letter from provider that states the amount and frequency of the benefit, three most recent bank statements verifying deposit amounts. Child support / alimony written agreement (divorce decree, separation agreement, judicial order or other legal written agreement) along with 2 most recent bank statements verifying deposit amounts or other documentation (i.e. 2 copies of checks) showing receipts. Bank statements cannot be over 90 days old. Unemployment - current benefit statement or letter from provider that states the amount, frequency and duration of the benefit. Food Stamps - current benefit statement or letter from provider that states the amount, frequency and duration of the benefit. Self-employed - last three years of tax returns, including Schedule C, and Profit and Loss Statement and bank statements (business and personal) for the last three months. Other income proof of receipt. Assets / Current Funds (if applicable) Bank Statements - Three (3) most recent bank statements for all open accounts: checking, savings, money market accounts and retirement accounts, i.e. 401K, IRA s etc. Additional Documents Photo ID - Identification such a driver s license, State ID, employer s ID card, etc. Bankruptcy (if applicable) Discharge letter, file date and bankruptcy number. ONCE YOU HAVE ALL THE REQUIRED ITEMS: Call BNT at (203) 290-4255 to schedule an appointment NO ORIGINALS LOCATION Where BNT - 570 State Street, Bridgeport, CT 06604 When Write your appointment date and time: We cannot accommodate children or guests; only applicants and co-applicants can be admitted. It is not necessary for both applicants to attend as long as one applicant brings the required documents for both applicants. Please bring copies of all your documents along with the application and arrive on time APPLICANT: - 1 -

Print application and handwrite clearly. Information will not be shared with any third party (e.g. credit agency or lender) without your explicit signed authorization. APPLICANT: APPLICANT Date: First Name: Last Name: Social Security Number: Home Phone: Highest Level of Education Completed: Number of Dependents: Middle Name: Suffix (Sr., J.r., etc): Email Address: Alternative Phone: Birth Date: Family Size: Please Circle/Mark all that apply: Marital Status: Married, Separated, or Unmarried Gender: Male or Female Veteran Yes N Disabled Yes No Race : o American Indian/Alaskan Native Ethnic Background: o Hispanic Citizenship: o US Citizenship Household Type: o Single Adult o Asian o Native Hawaiian or Other Pacific Islander o Black o White o Other multiple race o Non- Hispanic o Permanent Resident o Non-Resident o Female Head of Household o Male Head of Household o Married with Dependents o Married Without Dependents o Two or more unrelated adults If Foreign Born, please specify birth place Preferred Language Referral Source: HUD, CHFA, Agency Outreach, BNT Client, Agency Website, Flyer, Word of Mouth, friend, employer, non-profit, Realtor, Lender, Other (please specify) If you were referred by a bank or Realtor, which one: - 2 -

Print application and handwrite clearly. Information will not be shared with any third party (e.g. credit agency or lender) without your explicit signed authorization. APPLICANT ADDRESS & EMPLOYMENT CURRENT ADDRESS Street Address: City: State: Zip: County: Current Housing Payment: Owner Occupy: Yes No Length of Occupancy: Years: Months: CURRENT FULL-TIME EMPLOYMENT (if applicable) Employer Name: Street Address: City: State: Zip: Contact Phone: Start Date: Position/Title: End Date: CURRENT PART-TIME EMPLOYMENT (if applicable) Employer Name: Street Address: City: State: Zip: Contact Phone: Start Date: Position/Title: End Date: PREVIOUS EMPLOYMENT (if applicable) Employer Name: Street Address: City: State: Zip: Contact Phone: Start Date: Position/Title: End Date: OTHER INCOME (please circle all that apply): Self-employment, unemployment, alimony/child support, rental income, social security, pension, public assistance, dependent SSI, disability, income from contributing household member or other. - 3 -

Print application and handwrite clearly. Information will not be shared with any third party (e.g. credit agency or lender) without your explicit signed authorization. CO-APPLICANT First Name: Last Name: Social Security Number: Home Phone: Highest Level of Education Completed: Number of Dependents: Middle Name: Suffix (Sr., J.r., etc): Email Address: Alternative Phone: Birth Date: Family Size: Please Circle/Mark all that apply: Marital Status: Married, Separated, or Unmarried Gender: Male or Female Veteran Yes No Disabled Yes No Race : o American Indian/Alaskan Native Ethnic Background: o Hispanic Citizenship: o US Citizenship Household Type: o Single Adult o Asian o Native Hawaiian or Other Pacific Islander o Black o White o Other multiple race o Non- Hispanic o Permanent Resident o Non-Resident o Female Head of Household o Male Head of Household o Married with Dependents o Married Without Dependents o Two or more unrelated adults If Foreign Born, please specify birth place Preferred Language - 4 -

Print application and handwrite clearly. Information will not be shared with any third party (e.g. credit agency or lender) without your explicit signed authorization. CO-APPLICANT ADDRESS & EMPLOYMENT CURRENT ADDRESS Street Address: City: State: Zip: County: Owner Occupy: Yes No Length of Occupancy: Years: Months: CURRENT FULL-TIME EMPLOYMENT (if applicable) Employer Name: Street Address: City: State: Zip: Contact Phone: Start Date: Position/Title: End Date: CURRENT PART-TIME EMPLOYMENT (if applicable) Employer Name: Street Address: City: State: Zip: Contact Phone: Start Date: Position/Title: End Date: PREVIOUS EMPLOYMENT (if applicable) Employer Name: Street Address: City: State: Zip: Contact Phone: Start Date: Position/Title: End Date: OTHER INCOME (please circle all that apply): Self-employment, unemployment, alimony/child support, rental income, social security, pension, public assistance, dependent SSI, disability, income from contributing household member or other. - 5 -

Print application and handwrite clearly. Information will not be shared with any third party (e.g. credit agency or lender) without your explicit signed authorization. FINANCIALS GROSS INCOME: Salary, self-employment, unemployment, Alimony/Child Support, Rental Income, Social Security, Pension, Public Assistance, Unemployment, Dependent SSI, Disability, income from contributing household member or other Type of Income: Amount: Frequency (please circle one): Recipient (please circle one): $ Weekly / Bi-weekly / Monthly Borrower / co-borrower / nonborrower contributor $ Weekly / Bi-weekly / Monthly Borrower / co-borrower / nonborrower contributor $ Weekly / Bi-weekly / Monthly Borrower / co-borrower / nonborrower contributor $ Weekly / Bi-weekly / Monthly Borrower / co-borrower / nonborrower contributor $ Weekly / Bi-weekly / Monthly Borrower / co-borrower / nonborrower contributor BANK ACCOUNTS/ INVESTMENTS/ SAVINGS Type Institution Name Amount Recipient (please circle one): Checking $ Borrower / co-borrower / non-borrower contributor Savings $ Borrower / co-borrower / non-borrower contributor Retirement Account $ Borrower / co-borrower / non-borrower contributor Mutual Funds $ Borrower / co-borrower / non-borrower contributor Other $ Borrower / co-borrower / non-borrower contributor Other $ Borrower / co-borrower / non-borrower contributor Other $ Borrower / co-borrower / non-borrower contributor TOTAL ASSETS $ - 6 -

HOUSEHOLD MEMBERS AND MONTHLY EXPENSES Please print clearly and eligibly. List everyone in the household who will be living in the new home (including applicant and co-applicant). Please list adults first with the applicant as #1 and co-applicant as #2. Household Members First Name Last Name Gender Relationship Age Annual Income 1. 2. 3. 4. 5. Are any of these household members veterans or disabled? If so, who? In what city would you like to purchase a home? What is the minimum number of bedrooms needed for the above list of household members? **How soon would you like to purchase? Household Spending Plan/ Monthly Budget Incomes (USE NET OR TAKE HOME INCOME); Type Description Actual Base Salary Bonuses Commissions Other Totals Expenses Type Description Actual Rent/Mortgage payment Housing/Property taxes Housing/Home/Rental insurance Housing/Utilities - Electric Housing/Utilities - Natural gas - 7 -

MONTHLY EXPENSES Please print clearly and eligibly. Housing/Utilities - Garbage Telephone/Telecom/Basic service Telephone/Telecom/Cell phone Food/Groceries Food/Eating out/ Delivery Food Auto/Transportation/Auto loan payments Auto/Transportation/Gas and oil Auto/Transportation/Car maintenance Auto/Transportation/Parking Auto/Transportation Health care/medical bills Health care/dental Health care/vision Health care Personal care/clothing Personal care/shoes Personal care/dry cleaning/laundry Personal care/haircuts/barber Personal care/nails Personal care/toiletries Personal care/cosmetics Personal care Entertainment/Movie rentals Entertainment/Cable Entertainment/Holidays/Events Entertainment/Vacations/Travel Entertainment/Hobbies Liabilities/Credit cards/credit card payments Liabilities/Credit cards/bank fees Liabilities/Credit cards/taxes Liabilities/Credit cards/cashier's checks/payday loans Liabilities/Credit cards Children/Clothing Children/Day care Children/Child support Donations/Charities Donations Continuing education/tuition Other food expenses Other Auto expenses Other health care expenses Other personal care expenses Other Liabilities/Credit Cards Other donations - 8 -

MONTHLY EXPENSES Please print clearly and eligibly. Pets Children/Activities Savings/Savings account Savings/Investments Savings/IRA Other Other Other Totals Computer Standards for Internet Learning Do you have a computer at home? Yes / No Please circle the closest answer about your computer. Do you have internet: Yes / No How old is your computer: 2 or less / 4 or less / 5 or older Operating system: Windows XP / Windows 7 / Mac Do you have 2GB (or less) RAM memory installed: Yes / No Which browser do you use: Internet Explorer v7.0-9.0 / Mozilla / Chrome / Safari How computer skilled to you feel: Novice / Satisfactory / Fairly good / Techie If you do not have a computer, do you have access to one? If so, where? - 9 -

MORTGAGE READINESS Please circle the one that best describes you. 1) (MR) Mortgage Ready Customer has 2-3% saved towards down payment. Customer has 2 years of employment history. Customer has proof of legal status. Customer has 2-3 years of income tax and w-2 forms. Customer has verifiable income and rent history. Customer has Home Buyer Education Certificate. Customer has pre-qualification letter with purchase and sales contract. 2) (NR) Near Ready (0-3 months) Customer has between $1,000-$1,500 or 2-3% saved towards down payment. Customer has no more than $1,500 worth of collection debt. 1-2 accounts on collection status. 1-2 alternative letters. Customer has effective budget plan for 2 months. 3) (ST) Short-Term (3-6 months) Customer has between $500- $1,000 saved towards down payment. No more than 5-7 accounts on collection status. No more than $2,000 worth of debt. Customer has 1 ½ year of verifiable employment. Customer has effective budget plan for 2 months. Customer has maintained 3-6 months of no late payments. 4) (LT) Long-Term (6+ months) Customer has $0 of savings. Customer has multiple accounts in collection, repossessions, etc Customer has no employment history. Customer has debts over $7,000. Customer should enroll in IDA Program, etc - 10 -