Critical Home Repair Application Process

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Critical Home Repair Application Process

The Critical Home Repair (CHR) Program is a home preservation program that provides needed interior and

exterior repairs for low-income homeowners, so that they may maintain a safe, decent, and affordable place to

live. The CHR Program is designed to be a hand up, not a hand out, to low-income elderly, disabled, and

families who are in need such that they may feel proud and dignified about the place they call home. The CHR

Program focuses on safety, security, accessibility, weatherization, and keeping houses up to city and town codes.

The first step in the CHR Process is to determine the need of the family. The family must fill out the CHR

Application completely and provide any supporting documents that are needed to verify income and expenses.

It will then be determined by the affiliate if the family meets the low-income qualifications set by HUD. This is

determined by the number of family living in the home and all income for those that are 18 years of age and older

living in the home. At this time there is a required deposit due to the affiliate. The deposit amount will be based

on the extent of the CHR Project and how many hours it will take the Construction Supervisor to start the CHR

planning. The deposit will be a minimum of $50 to a maximum of $200 and will be applied to the balance due

once the CHR Project is complete. However, if the homeowner backs out of the CHR Project, the deposit will not

be refunded.

The next step is for our Construction Supervisor to come out for a home inspection to evaluate the home and

assess whether repairs or construction modifications can be made to the home. Typically, Habitat does not

provide CHR to a home when the repair to the home costs more than the value of the home.

If the repair or construction modification can be done, the Construction Supervisor will put together a project quote

to estimate the cost of the CHR. At this time, it will be discussed between the affiliate board, Executive Director

and homeowner as to what monthly payments will be required by the homeowner to the affiliate to reimburse for

costs incurred. If the CHR Project requires a builder’s permit, it will be the responsibility of the homeowner to pay

for that up front. The builders permit will range in price depending on the city the homeowner lives in. If the

homeowner cannot afford to pay for the builders permit up front, a written request must be submitted to the affiliate

and at that time the Executive Director will request approval from the board of directors.

Once a monthly payment agreement has been reached, the homeowner will sign the CHR Project Quote

acknowledging the agreement. Once the CHR Project is complete, the final cost will be put together in a

Promissory Note the details the monthly payment amount and the due date as well as any late fees that are

applied.

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954 E. Grand River, Williamston, MI 48895 Phone: (517) 655-1872 Fax: (517) 655-5727

Strengthening families and neighborhoods through partnership, house building and affordable homeownership

Application for Critical Home Repair

Applicant: Please complete this application as part of the selection process to determine if you qualify for Habitat for Humanity critical home repair. Please use ink and fill out the application as completely and accurately as possible. All information on this application will be kept confidential.

PLEASE TELL US WHO REFERRED YOU TO HABITAT, OR HOW YOU HEARD OF US SO WE MAY THANK THEM (CIRCLE) Friend or family (who) ____________________________Newspaper Flyer Website Radio Presentation

If other, please explain_____________________________________________________________________ Today’s Date: __________________________

APPLICANT INFORMATION

Applicant’s name Birthdate Co-Applicant’s name Birthdate Social Security Number Phone Age

______-____-______ (____)_________ _____ Email Address _____________________________ Married Separated Unmarried (circle one)

Social Security Number Phone Age ______-____-______ (____)_________ _____ Email Address _____________________________ Married Separated Unmarried (circle one) Dependents and others who live with you

Name Age Male/Female ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________

Dependents and others who live with you

Name Age Male/Female ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ Present Street Address Own or Rent

Number of years

Present Street Address Own or Rent Number of years

If Living at Present Address for Less Than Two Years Complete the Following Present Street Address Own or Rent

Number of years

Present Street Address Own or Rent Number of years

FOR OFFICE USE ONLY – DO NOT WRITE IN THIS AREA

Date Received _________________ Date Application Complete ___________________

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To be considered for a HFHGI Critical Home Repair, you and your family must be willing to complete a certain number of “sweat equity” hours. Your help in providing a Critical Home Repair for yourself and others is called “sweat equity” and may include clearing the lot, painting, helping with construction, working in the Habitat office, or other approved activities.

I AM WILLING TO COMPLETE THE REQUIRED SWEAT-EQUITY HOURS Applicant Yes No Co-Applicant Yes No

Please estimate the number of hours and likely time of day you will be able to work each week to complete your hours of sweat equity. For example: Monday 4-6, Wednesday 12-2, Saturday 10-5

Applicant

Monday Tuesday Wednesday Thursday Friday Saturday Co-Applicant

Monday Tuesday Wednesday Thursday Friday Saturday

PROPERTY INFORMATION

If you own your residence, what is your monthly mortgage payment, including taxes and insurance? $_________________ Balance $_________ Do you own land? Yes No (if yes, please describe, including location ______________________

Have you ever experienced a foreclosure? Yes No (if yes, what was the date?) ____________

EMPLOYMENT INFORMATION

Applicant Co-Applicant

Name and Address of Current Employer

Date of Employment Monthly Gross Wages Type of Business Business Phone

If working at Current Job Less Than One Year, Complete the Following Information

MONTHLY INCOME AND COMBINED MONTHLY BILLS

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Household Employment Income

(attach proof) $ $ $ Rent $

Food Assistance

(attach proof) Car Payments

Cash Assistance

(attach proof) Credit Cards

Social Security

(attach proof) Child Support

SSI

(attach proof) Student Loans

Disability

(attach proof) Other

Child Support

VA Benefit

Other

Total Total

Self-employed applicant(s) are required to provide the last 2

years federal income tax returns with schedule C. _______30 day pay stub ________W2 Statements

Office use only:

_______Previous years income taxes

All applicants must submit income documentation for all sources of income. Most recent 30 days’ pay stubs, W2 statements, last year’s income taxes, and documentation of any other income received.

SOURCE OF DOWNPAYMENT AND CLOSING COSTS

If down payment is requested, where will you be getting the money? If you are borrowing money to pay these costs, explain how and from whom?

ASSETS

LIST CHECKING AND SAVINGS ACCOUNT BELOW

Name and Address of Bank, Savings & Loan, or Credit Union Name and Address of Bank, Savings & Loan, or Credit Union Account Number Balance

$ Account Number Balance $ Account Number Balance

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Additional Household Income (over 18 years of age)

Name Age Monthly Income Employer

$ $ $ $

REPAIR REQUEST

What are you requesting to be repaired?

Permanent Wheel Chair Ramp Roof Replacement/Repair Weatherization Other: ___________________ What is the reason you are requesting the repair?

SOURCE OF REPAIR COST

Where will you be getting the money to pay for the repair of your home? If you are borrowing the money to pay these costs, explain how and from whom.

DEBT

To whom do you and the co-applicant owe money?

Car Payment Balance

$ $ Alimony/Child Support Payment Balance $ $ Furniture Payment Balance

$ $ Job-Related Expenses Payment Balance $ $ Credit Card Payment Balance

$ $ Other Payment Balance $ $

Medical Payment Balance

$ $ Other Payment Balance $ $

DECLARATIONS

Please check the box that best answers the following questions for you and the co-applicant

Applicant Co-Applicant Do you have any debt because of a court decision against you? Yes No Yes No Have you been declared bankrupt within the past 7 years? Date of discharge Yes No Yes No Have you had property foreclosed on in the last 7 years? Date of foreclosure: Yes No Yes No Are you currently involved in a lawsuit? Yes No Yes No Are you obligated to pay child support of separate maintenance? Yes No Yes No Are you a U.S. citizen or permanent resident? Yes No Yes No

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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.

ADDITIONAL AUTHORIZATION AND RELEASE

The undersigned applicant(s) applied for the Habitat for Humanity Homeownership/Critical Home Repair program. The applicant(s) authorize Habitat for Humanity of Greater Ingham County to evaluate the applicant’s actual need for the Homeownership/Critical Home Repair program, ability to repay the loan and other expenses of homeownership, and the willingness to participate in the Habitat partnership.

The evaluation will include personal visits, credit check, criminal records check and contact references.

The applicant(s) authorize Habitat to obtain records pertaining to them and their family as requested, including necessary records related to financial matters including State or Federal taxes, court proceedings, Family Independence Agency, medical care, and employment/income.

The applicant(s) release Habitat and its member volunteers from any and all liability, which may arise in connection with the release of information. The original or a copy of this application will be retained by Habitat for Humanity of Greater Ingham County, even if the application is not approved.

I also understand that my signatures on this application give Habitat for Humanity of Greater Ingham County and its partners in the program permission to use photos and family bio in appropriate publications.

Any information found to be fraudulent causes the application to be denied. Applicant’s Signature

____________________________________________ Date ____________________________ Co-Applicant’s Signature

____________________________________________ Date ____________________________

AUTHORIZATION AND RELEASE

I understand that by filing this application, I am authorizing Habitat for Humanity to evaluate my actual need for a Habitat home, my ability to repay the no-interest loan and other expenses of homeownership and my willingness to be a partner family. I understand that the evaluation will include personal visits, a credit check, and rental and employment verification. I have answered all the questions on this application truthfully. I understand that if I have not answered the questions truthfully, my application will be denied, and that even if I have already been selected to receive a Habitat home, I will be disqualified from the program. The original copy of this application will be retained by Habitat for Humanity, even if the application is not approved.

Applicant Signature Date Co-Applicant Signature Date