Neighborhood Revitalization Home Repair Program Eligibility Guidelines Habitat s Neighborhood Revitalization Home Repair program offers limited home repairs and improvements in order to maintain safe, decent living conditions and reasonable operating costs. It is not an emergency repair program. Qualified applicants that demonstrate the greatest need for a Habitat repair will be eligible for services at an affordable cost. All repair projects are subject to availability of funds. Repairs or Replacements Include: Appliance Replacement Blown-In Attic Insulation Exterior Door Replacement Exterior Steps Repair or Replacement Exterior Window Repair Fence (if safety or security issue) Garage Door HVAC (air conditioning) Minor Electrical Repairs Minor Floor and Wall Repairs Minor Plumbing Repairs Ramp (porch or wheelchair ramp construction) Roof/Soffit/Gutters Repair or Replacement Septic Siding/Stucco Repair Water Heater Replacement Water System/Well Weatherization/Windows and Doors Note: Standard home improvements are not considered. The applicant must meet the following guidelines to qualify: Proof of ownership, with name listed on title Have lived in the house for at least one year Have not declared bankruptcy in last three years Real estate/property taxes must be paid current Be in good standing on mortgage payments (if applicable) Does not have a reverse mortgage Be willing to partner with Habitat by contributing sweat equity hours (see below) Meet Habitat s income guidelines (household income below 80% AMI-area median income) Be willing and financially able to repay Habitat for work done (see below) Background Checks Habitat performs background checks and sex offender checks on all adult members of the family. It is Habitat for Humanity of Lee and Hendry Counties policy to not accept any applicants who have been convicted of a sex crime and/or who must legally have their name on the national sex offender registry. Habitat also has a strict policy regarding criminal convictions. Habitat will use its sole discretion when making decisions about partnering with a family who has a history of criminal activity.
Sweat Equity Habitat requires that families put in a certain number of sweat equity hours. Sweat equity demonstrates a family s willingness to partner with Habitat and is accomplished by volunteering on a Habitat construction project, in the Habitat ReStore or office, or other approved activities. For the Neighborhood Revitalization Home Repair program, families will need to be willing to partner with Habitat by contributing sweat equity hours. Ability to Repay To be eligible for Habitat s Neighborhood Revitalization Home Repair program, your total household income cannot exceed 80% of the area median income (AMI), adjusted for family size as shown on the charts below. All applicants are expected to repay the cost of repairs over time. We will look at your total income to debt ratio to make sure that the repayment amount will not put a financial burden on you or your family. Household Size Lee County (80% AMI) Hendry County (80% AMI) 1 31,600 25,450 2 36,100 29,050 3 40,600 32,700 4 45,100 36,300 5 48,750 39,250 6 52,350 42,150 7 55,950 45,050 8 59,550 47,950 Repayment Guidelines Homeowners are expected to repay all or a portion of repair costs by paying back a 0% interest loan. You should anticipate paying a fixed monthly payment, based on your income and the amount of the repair work, for a 1 to 5-year period. You will be required to sign a Promissory Note acknowledging the repayment obligation. Promissory Notes greater than 5,000 will be secured by a Mortgage on your property. If you are interested in working with Habitat and believe you qualify for critical home repair work according to the above guidelines, we encourage you to fill out and return the enclosed application. Should you be selected as a candidate for Habitat s Neighborhood Revitalization Home Repair program, you will be contacted and a formal agreement will be provided. Our goal at Habitat is to build lasting relationships with our Partner Families and to see them succeed in every way. Applications should be mailed or delivered Tuesday Friday from 6:30am 5:00pm with required documents in a sealed envelope to: Habitat for Humanity of Lee and Hendry Counties Attn: NR Home Repair Program 1288 North Tamiami Trail North Fort Myers, FL 33903 If you have any questions, please feel free to contact Lisa at our office by telephone at 239-652-1687 or by email at blancac@habitat4humanity.org.
Neighborhood Revitalization Home Repair Program Application 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, sex, handicap, familial status, or national origin. v1.1 Please complete this application to determine if you qualify for the Habitat for Humanity Neighborhood Revitalization Home Repair program. Fill out the application as completely and accurately as possible. All information you include on this application will be kept confidential in accordance with the Gramm-Leach-Bliley Act. Where did you learn about the Home Repair program? 1. APPLICANT INFORMATION s Name (Legal Name of Homeowner-All Names Listed on Deed) Social Security Number Home Phone Date of Birth Co- s Name (Legal Name of Homeowner-All Names Listed on Deed) Social Security Number Home Phone Date of Birth Cell Phone Email Cell Phone Email Married Separated Unmarried (Incl. single, divorced, widowed) Dependents who live with you(not listed by co-applicant) Married Separated Unmarried (Incl. single, divorced, widowed) Dependents who live with you(not listed by applicant) Name/Relationship Date of Birth Male Female Name/Relationship Date of Birth Male Female Present address (street, city, state, ZIP code) Own Rent Present address (street, city, state, ZIP code) Own Rent Number of years County Neighborhood Number of years County Neighborhood 2. WILLINGNESS TO PARTNER Sweat equity demonstrates a family s willingness to partner with Habitat and is accomplished by volunteering on a Habitat construction project, in the Habitat ReStore or office, or other approved activities. I AM WILLING TO COMPLETE THE REQUIRED SWEAT-EQUITY HOURS: Yes No 3. FOR OFFICE USE ONLY DO NOT WRITE IN THIS SPACE Date received: Date of letter to proceed: Date of Selection Committee Approval: Date of Partnership Agreement:
4. REPAIR REQUEST PLEASE WRITE A DETAILED EXPLANATION OF YOUR NEEDED REPAIRS, WHY YOU FEEL YOU SHOULD BE SELECTED AND HOW IT WILL HELP YOU:
5. PROPERTY INFORMATION What year was your home built? Are you a Habitat homeowner? Do you have homeowner s insurance? No Yes (Please attach a copy of your current homeowner s insurance declaration) What is your monthly mortgage payment? /month Unpaid balance Are your property taxes and homeowner s insurance current? No Yes 6. EMPLOYMENT INFORMATION Name and address of CURRENT employer Start Date Name and address of CURRENT employer Start Date Job Title Paid: Weekly Bi-Weekly Other Pay Rate: Hours per week: # Business phone Job Title Paid: Weekly Bi-Weekly Other Pay Rate: Hours per week: # Business phone If working at current job less than two years, complete the following information Name and address of LAST employer From To Name and address of LAST employer From To Job Title Paid: Weekly Bi-Weekly Other Pay Rate: Hours per week: # Business phone Job Title Paid: Weekly Bi-Weekly Other Pay Rate: Hours per week: # Business phone 7. MONTHLY INCOME Please enter all monthly income. Alimony, child support or separate maintenance income need not be revealed if the applicant or co-applicant does not chose to have it considered for repaying this loan. Income Source Others in household Total Wages Temporary Assistance Alimony Child support Social Security SSI Disability Other Other Other Total PLEASE NOTE: Self-employed applicants may be required to provide additional documentation such as tax returns and financial statements. Name Income source Monthly income Date of birth
8. ABILITY TO REPAY Do you have sufficient funds to repay the cost of repairs over time? Yes No 9. ASSETS Name of bank, savings and loan, credit union, etc. Address City, state ZIP Account number Current balance 10. DEBT To whom do you and the co-applicant(s) owe money? Account Monthly payment Unpaid balance Months left to pay Monthly payment Unpaid balance Months left to pay Automobile Other motor vehicle/boat Furniture, appliances (includes rent-to-own) Alimony Child support Student Loan Payday\Title loans Credit card Total medical Other Other Total
Monthly expenses Account Total Rent Utilities Insurance Child care Internet service Cell phone Land line Other Other Other Other Other Total 11. DECLARATIONS Please circle the word that best answers the following questions for you and the co-applicant a. Do you have any outstanding judgments because of a court decision against you? Yes No Yes No b. Have you been declared bankrupt within the past three years? Yes No Yes No c. Have you had property foreclosed on in the past three years? Yes No Yes No d. Are you currently involved in a lawsuit? Yes No Yes No e. Are you receiving or paying alimony or child support? Yes No Yes No f. Are you a U.S. citizen or permanent resident? Yes No Yes No g. Have you ever served in the military? Yes No Yes No h. Is anyone in the home disabled? Yes No Yes No i. Have you ever applied for Habitat s NR Home Repair program before? Yes No Yes No If you answered no to question f, or "yes" to any other question, please explain.
13. SHARING YOUR PERSONAL INFORMATION If your application is a more appropriate fit with other, similar programs may we share it with them? No Yes SIGNATURE OF HOMEOWNER DATE Unless you give us information with other organizations, your application will be kept confidential. If you check yes, you give Habitat for Humanity of Lee and Hendry Counties your consent to share the information you provide on this application with similar organizations if the Neighborhood Revitalization Home Repair program is not able to assist you. Please sign above to confirm your decision. 14. HOMEOWNER S CHECKLIST Did you complete all 16 sections of this application? Did you sign the application? (SECTION 13 and SECTION 15) Did you include a copy of your driver s license or state ID card AND social security card for each person on the title of the home (even if he or she does not live in the home) AND each adult resident 18 or older in the home? Did you enclose a copy of the deed on your home or other proof of ownership, such as current property tax receipt? Did you enclose a copy of the current mortgage balance and lender information? Did you provide income verification for every adult in the household? (2 years most recent tax returns, at least 3 consecutive months of most recent pay stubs or any other income statements such as social security, child support etc. AND 2 months current bank statements). Did you include a copy of your current homeowner s insurance declaration page (if applicable)? 15. AUTHORIZATION AND RELEASE I certify that the information on this application is accurate and I own the property at the address given on this application. I understand that by filing this application, I am authorizing Habitat for Humanity of Lee and Hendry Counties to evaluate my actual need for the Neighborhood Revitalization Home Repair program, my ability to repay the no-interest/low-interest loan and my willingness to be a partner through sweat equity. I understand that the evaluation will include a home assessment by Habitat representatives, income and employment verification. I give permission for photos to be taken of my home. I understand that if selected, the final decision on the type of repairs that will ultimately take place will be made at the discretion of the Neighborhood Revitalization Committee. I have answered all the questions on this application truthfully. I understand that if I have not answered the questions truthfully, my application may be denied, and that even if I have already been selected to receive repairs, I may be disqualified from the program. The original application will be retained by Habitat for Humanity along with all related documentation even if the application is not approved. I understand that additional requirements must be met before being selected for the Habitat program. I also understand that Habitat for Humanity screens all applicant families on the sex offender registry. By completing this application, I am submitting myself to such an inquiry. I further understand that by completing this application, I am submitting myself to a criminal background check. signature Date signature Date X X Other household members 18 years and older: Print Name: Date: Signature: Print Name: Date: Signature: Print Name: Date: Print Name: Date: Signature: Signature: PLEASE NOTE: If more space is needed to complete any part of this application, please use a separate sheet of paper and attach it to this application. Please mark your additional comments with A for applicant or C for co-applicant. s name s name
16. INFORMATION FOR GOVERNMENT MONITORING PURPOSES PLEASE READ THIS STATEMENT BEFORE COMPLETING THE BOX BELOW: The following information is requested by the federal government for loans related to the purchase of homes, in order to monitor the lender s compliance with equal credit opportunity and fair housing laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it or not. However, if you choose not to furnish it, under federal regulations this lender is required to note ethnicity, race and sex on the basis of visual observation or surname. If you do not wish to furnish the information below, please check the box below. I do not wish to furnish this information Race (applicant may select more than one racial designation): American Indian or Alaska Native Native Hawaiian or other Pacific Islander Black/African-American White Asian I do not wish to furnish this information Race (applicant may select more than one racial designation): American Indian or Alaska Native Native Hawaiian or other Pacific Islander Black/African-American White Asian Ethnicity: Hispanic or Latino Non-Hispanic or Latino Ethnicity: Hispanic or Latino Non-Hispanic or Latino Sex: Female Male Sex: Female Male Birthdate: / / Birthdate: / / Marital status: Married Separated Unmarried (Incl. single, divorced, widowed) Marital status: Married Separated Unmarried (Incl. single, divorced, widowed) To be completed only by the person conducting the interview Interviewer s name (print or type) This application was taken by: Face-to-face interview By mail By telephone Interviewer s signature Interviewer s phone number Date