Check Eligibility Form
Please complete this form and schedule an appointment to discuss eligibility.
Step 1: Household Information
Total Number of Household Members
Total Number of Household Members
Number of Household Members (18 and over)
Number of Household Members (Under 18)
Total Household Income (All Income)
What state are you looking to purchase a home? County?
Step 2: Applicant Information
Applicant’s Full Legal Name
Address
Phone Number
Email
Applicant’s Income Information
Name of Employer
How long have you been with current job?
When are you paid?
Weekly (52 times per year)
Every other week (26 times per year)
Twice a month (24 times per year)
Monthly (12times per year)
How are you paid?
Hourly
Salary
What is your hourly rate below (Example: 24.50)
What is your annual salary? (Example: 50,000.00)
Estimate your monthly debt (Example: Auto Loan, Credit Cards, Personal Loans, Student Loans)
Do you receive the following?
Social Security (SS)
Supplemental Security Income (SSI)
Disability
Child Support
Alimony
Public Assistance
Pension
Unemployment
SNAP Benefits
If you checked yes on Social Security (SS), How much?
If you checked yes on Supplemental Security Income (SSI), How much?
Do you pay rent? If so, how much?
Part-time Employment? (If Any)
Name of Employer?
How long have you been with current job?
When are you paid?
Weekly (52 times per year)
Every other week (26 times per year)
Twice a month (24 times per year)
Monthly (12 times per year)
How are you paid?
Hourly
Salary
What is your hourly rate below (Example: 24.50)
What is your annual salary? (Example: 50,000.00)
Co-Applicant information (If Any)
Estimate your monthly debt (Example: Auto Loan, Credit Cards, Personal Loans, Student Loans)
Do you receive the following?
Social Security (SS)
Supplemental Security Income (SSI)
Disability
Child Support
Alimony
Public Assistance
Pension
Unemployment
SNAP Benefits
Part-Time Employment?
Name of Employer?
How long have you been with current job?
When are you paid?
Weekly (52 times per year)
Every other week (26 times per year)
Twice a month (24 times per year)
Monthly (12 times per year)
How are you paid?
Hourly
Salary
What is your hourly rate below (Example: 24.50)
What is your annual salary? (Example: 50,000.00)
Household Member Information (If any)
Eligibility is based on your total household income. This represents everyone in the household over the age of 18. Please provide the following information for each household member that will be living in the house with applicant.
Household Member 1
Full Name
Full Name
Relationship to Applicant
Age
Full-Time Student
Yes
No
Income
Submit
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