Affordable First Time Homebuyer Program Application
Please fill out the application as completely and accurately as possible. All information you include in this application will be kept confidential.
APPLICANT INFORMATION
Name: ______Social Security Number: _____-____-_____
Address:______Apt #: ______Email: ______
City: ______State: ______Zip Code: ______
Home Phone: (_____) ______Work Phone: (____)______Cell Phone: (____)______
Date of Birth: ____/_____/_____ Gender: □ Male □ Female
Present Address: □ Own or □ Rent Number of Years: ______
If less than 2 years
Previous Address: ______City______State: ____ Zip Code: _____
Number of Years: ______
Optional:
Ethnicity Credit Score: ______
□ African American□ Caucasian□ Latino or Hispanic
□Asian, Pacific Islander □ Native American□ Other (please specify): ______
CO-APPLICANT INFORMATION
Name: ______Social Security Number: _____-____-_____
Address:______Apt #: ______Email: ______
City: ______State: ______Zip Code: ______
Home Phone: (_____) ______Work Phone: (____)______Cell Phone: (____)______
Date of Birth: ____/_____/_____ Gender: □ Male □ Female
Present Address: □ Own or □ Rent Number of Years: ______
If less than 2 years
Previous Address: ______City______State: ____ Zip Code: _____
Number of Years: ______
Optional
Ethnicity: Credit Score: ______
□ African American□ Caucasian□ Latino or Hispanic
□Asian, Pacific Islander □ Native American□ Other (please specify): ______
EMPLOYMENT INFORMATION
APPLICANT
Name of Employer: ______
Address of Employer: ______
Length of Time Employed: ______
CO-APPLICANT
Name of Employer: ______
Address of Employer: ______
Length of Time Employed: ______
APPLICANT HOUSEHOLD INFORMATION
Have you owned a home in the past three years?
□ Yes □ No
Marital Status:
□ Single (never married)□ Married□Separated□Divorced□Widowed
PrimaryLanguage of Household? ______
How long from now do you plan to purchase a home?
□ Less than 1 year □1-2 years □ more than 2 years □ Unsure
Is your entire household income 80% or Below Median Family Income (see table)?
Family Size / Income Range / Family Size / Income Range1 Person / ≤ $36,350 / 5 Persons / ≤ $56,100
2 Persons / ≤ $41,550 / 6 Persons / ≤ $60,250
3 Persons / ≤$46,750 / 7 Persons / ≤ $64,400
4 Persons / ≤ $51,900 / 8 Persons / ≤ $68,550
□ Yes □ No, it is more□ No, it is less
Household Members
/Income
(use as many lines per member as needed) / Office Use OnlyName / Member Type
Last, First / Adult / Dependent Child /
Other
(please describe) / Source / Amount / #? / $?If more space is needed, please continue on the back side of this page.
LENDER INFORMATION
Are you pre-qualified for a home loan with a local lender? □ Yes□ No
If yes –
Name of the Bank:
Loan Officer’s Name:
Loan Officer’s Phone Number:
Loan amount you are pre-qualified for: $
PRESENT LIVING CONDITIONS
Number of bedrooms (please circle): 1 2 3 4 5
Other rooms in the place you currently live:
□ Kitchen □ Bathroom □ Living Room □ Dining Room □ Other ______
If you currently pay rent, what is your monthly payment? $______/ month
(please supply a copy of your lease or a cancelled rent check)
Total Amount Spent on Utility Bills Each Month: $______
(please attach a copy of last month’s bills)
OTHER INFORMATION
Will you be receiving a gift or borrowing money to pay down payment or closing costs?
□Yes Amount: $______□ No
Are you enrolled in any other down payment initiatives, savings programs etc.?
□ Yes□ No
If yes –
Name of Program:
Additional Funding provided by this Program: $
□ I acknowledge that my application will be kept on file for one year. If I am unable to secure a loan for this project, I will be placed on a waiting list and notified once another unit becomes available.
□I would like more information about upcoming projects and/or events.
My biggest concern about the entire homeownership process is:
□ Credit □ Employment □ Savings □ Other______
RELEASE OF INFORMATION
□I authorize and direct any Federal, State, or Local agency, organization, business or individual to release to the Ecological Construction Laboratory, or its representatives any information or materials needed to complete and verify my application. I understand and agree that this authorization or the information obtained with its use may be given to and used by the Department of Housing and Urban Development (HUD) in administering and enforcing program rules, regulations, and policies.
Conditions:
□I agree that a photocopy of this authorization may be used for the purposes stated above. The original of this Authorization is on file with the Ecological Construction Laboratory and will stay in effect for the duration of my participation in this program. I understand that I have the right to view my file and correct any information that I can prove is incorrect.
Applicant Signature:Date:
Print Name:
Social Security Number:
Co – Applicant Signature: Date:
Print Name:
Social Security Number:
Witness Signature:Date:
Please mail your information to:
Ecological Construction Laboratory (e-co lab)
Attn: Homebuyer Application
110 S. Race St. Suite 202
Urbana, IL 61801
Ecological Construction Laboratory e-co lab • 110 S Race Street Suite 202 •Urbana Illinois 61801
(217) 344-1294 website: