HomeOwnership Center, Inc. Customer Information Form Step 1 of 10 10% Thanks for your interest in the HomeOwnership Center! We look forward to working with you along this journey to your new home. After you've completed the steps below, our Home Ownership Advisor will call you to schedule an appointment. The following 3 steps should take you less than 15 minutes. Here's what you need to do next: Step 1 - Complete Intake Forms Please complete and submit the intake forms below. You can also download the forms as a PDF and submit via US mail, by fax, or drop them by our office. Step 2 - Create Account and Upload Documents Finally, you will need to create an account and upload several documents, including ones related to your income, bank accounts, and income taxes, with our secure document uploader. A list of the required documents may be found after you have completed Step 2. If you prefer, you may bring these documents to our office, submit them via US Mail, or send them by fax, however they must be received in our office before we will schedule your appointment. Click Here for Video Demo Appointments with our counselor are on average 60-90 minutes long. It will be a thorough review of your income, expenses, budget and credit. You will receive recommendations and be advised how to improve your budget/credit as well as possibly having the option to speak with our loan originator. **If you have an impairment, disability, language barrier, or otherwise require alternative means of completing the form or accessing information about housing counseling, please talk with our staff about alternative accommodations. Number of Applicants*12Customer 1Name* First MI Last Current Address (P.O. Box Not Accepted)* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Alternate PhoneEmail* Social Security Number*Date of Birth* MM slash DD slash YYYY Age*Marital Status* Single Engaged Married Divorced Widowed Race/National Origin* American Indian/Alaskan Hispanic/Latino African American White Asian American Other Gender* Male Female Head of Household* Yes No Military Active Military Veteran Years of School Completed*Household Size - Number of Adults*Household Size - Number of Children*How did you hear about us?*Choose OneHOC StaffFriendWebsiteGoogleFacebookNewspaperDigital BillboardOtherOther* Customer 2Name* First MI Last Current Address (P.O. Box Not Accepted)* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneWork PhoneEmail* Social Security Number*Date of Birth* MM slash DD slash YYYY Age*Marital Status* Single Engaged Married Divorced Widowed Race/National Origin* American Indian/Alaskan Hispanic/Latino African American White Asian American Other Gender* Male Female Head of Household* Yes No Military Active Military Veteran Years of School Completed*How did you hear about us?*Choose OneHOC StaffFriendWebsiteGoogleFacebookNewspaperMovie Theater AdOtherOther* Customer 1: 2 year Work History (All Jobs, Full Time, Part Time, Seasonal etc.)Job 1: Name of EmployerJob 1: PositionJob 1: Dates EmployedFromToJob 1: Hourly Rate/Salary*Job 1: Hours per weekJob 1 Pay: Paid Weekly Paid Bi-Weekly Job 2: Name of EmployerJob 2: PositionJob 2: Dates EmployedFromToJob 2: Hourly Rate/SalaryJob 2: Hours per weekJob 2 Pay: Paid Weekly Paid Bi-Weekly Job 3: Name of EmployerJob 3: PositionJob 3: Dates EmployedFromToJob 3: Hourly Rate/SalaryJob 3: Hours per weekJob 3 Pay: Paid Weekly Paid Bi-Weekly Customer 2: 2 year Work History (All Jobs, Full Time, Part Time, Seasonal, etc.)Job 1: Name of EmployerJob 1: PositionJob 1: Dates EmployedFromToJob 1: Hourly Rate/Salary*Job 1: Hours per weekJob 1 Pay: Paid Weekly Paid Bi-Weekly Job 2: Name of EmployerJob 2: PositionJob 2: Dates EmployedFromToJob 2: Hourly Rate/SalaryJob 2: Hours per weekJob 2 Pay: Paid Weekly Paid Bi-Weekly Job 3: Name of EmployerJob 3: PositionJob 3: Dates EmployedFromToJob 3: Hourly Rate/SalaryJob 3: Hours per weekJob 3 Pay: Paid Weekly Paid Bi-Weekly Other Household Income (Social Security/Disability/Retirement/Death Benefits, etc.)Other Household IncomeName of RecipientMonthly Amount $Source Child Support – Customer 1 and/or 2Do you receive Child Support?* Yes No Can you document this income?* Yes No How long will it continue?*Monthly Amount Received?*Do you pay Child Support?* Yes No Monthly Amount Paid?* Housing Information – Customer 1 and/or 2Do you Rent, Own or Live with Family at your current residence?* Rent Own Live with Family How long have you lived there?YearsMonthsWhat is your current monthly rent, NOT including utilities?Have you owned a home in the last 3 years?* Yes No Do you receive assistance from the Section 8 rental assistance program?* Yes No I certify that all information and answers to the above questions are true and complete to the best of my knowledge.Credit Report Authorization: Authorization is hereby granted to The HomeOwnership Center, Inc., to obtain a consumer credit report through a credit-reporting agency chosen by the HomeOwnership Center, Inc. I/We understand and agree that the HomeOwnership Center, Inc. intends to use the consumer credit report for the purpose of evaluating my financial readiness to buy a home and/or to conduct credit counseling. My signature below authorizes the release to the credit reporting agency of financial information, which I have supplied to the HomeOwnership Center, Inc. in connection with such evaluation.* Agree E-Sign Disclosure: By signing, you consent to receive electronic disclosures, notices, documents and other information applying to this request. You may withdraw your consent at any time by contacting the HomeOwnership Center, Inc. representative you are working with.* Agree Cusomer 1 Signature*Customer 1 Date* MM slash DD slash YYYY I certify that all information and answers to the above questions are true and complete to the best of my knowledge.Credit Report Authorization: Authorization is hereby granted to The HomeOwnership Center, Inc., to obtain a consumer credit report through a credit-reporting agency chosen by the HomeOwnership Center, Inc. I/We understand and agree that the HomeOwnership Center, Inc. intends to use the consumer credit report for the purpose of evaluating my financial readiness to buy a home and/or to conduct credit counseling. My signature below authorizes the release to the credit reporting agency of financial information, which I have supplied to the HomeOwnership Center, Inc. in connection with such evaluation.* Agree E-Sign Disclosure: By signing, you consent to receive electronic disclosures, notices, documents and other information applying to this request. You may withdraw your consent at any time by contacting the HomeOwnership Center, Inc. representative you are working with.* Agree Cusomer 2 Signature*Customer 2 Date* MM slash DD slash YYYY Monthly Expenses WorksheetPlease fill out the monthly budget below with your best estimates. Questions and details will be discussed at your first appointment.HousingRent or mortgageHeating (gas or oil)ElectricityWater or sewageTelephones (land-lines and cell phones)Renters or homeowners insurance (if separate)Trash serviceOtherTransportationGasCar paymentCar insuranceCar repairs and maintenanceLicense plates and registration feesFoodGroceriesSchool lunchesWork-related (lunches and snacks)InsuranceHealth (medical and dental, IF NOT payroll deducted)Supplemental Life InsuranceSupplemental Disability InsuranceMedicalDoctorDentistPrescriptionsChildcareChildcare or babysittersChild support or alimonyClothingClothingLaundry and dry cleaningDonationsReligious or charityEducationTuitionBooks, papers and suppliesNewspapers and magazinesLessons (sports, dance, music)GiftsBirthdaysPersonalBarber or beauty shopChildren’s allowancesTobacco productsBeer, wine or liquorEntertainmentMovies, sporting events, concerts, etc.Cable/satellite TVRestaurants and take-out mealsGambling and lottery ticketsFitness or social clubsVacations/tripsHobbies or craftsMiscellaneousChecking account fees, money order fees, etc.Pet care and suppliesPostagePictures and photo processing“Mad” moneyDebtsStudent loanCredit card (monthly minimum)Credit card (monthly minimum)Credit card (monthly minimum)Medical billsPersonal loanOtherOtherOtherOtherTotal Regular Monthly Expenses*AssetsCash “on hand”*Savings*Total Assets*Notes:Receive announcements and updates on services through email? Yes No What service are you interested in:* Credit Advising Home Loan Refinance Home Repair Education Workshop Create AccountUsername*Name* First Last Email* Password* Enter Password Confirm Password Strength indicator CompanyThis field is for validation purposes and should be left unchanged. Δ
