PO Box 53
Frankfort, MI 49635
Phone: 231-399-0300
Email: info@benziehabitat.org

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Home Ownership Application

Application for Habitat Homeownership Program

Please complete the Application as completely and accurately as possible. Your Application will be kept confidential.

Home Ownership Application

Applicant Information

Are you a veteran? *
Current USPS Mailing Address *
Current USPS Mailing Address

If you have lived at your current address less than 2 years, include Previous Address.

Previous Address *
Previous Address
Do you have a Co-applicant? *
Do you have Dependents or Others who will live with you? *

Co-applicant Information

Are you a veteran? *
Current USPS Mailing Address *
Current USPS Mailing Address

If you have lived at your current address less than 2 years, please include Previous Address.

Previous Address *
Previous Address

Dependent Information

List Dependents & Others who will live with you
Dependent Gender *

Willingness to Partner

To be considered for Habitat homeownership, you and your family must be willing to complete “sweat equity” hours. This will involve attending home ownership classes, helping with construction and construction clean-up at your build, landscaping, and working on other Habitat projects such as fundraisers, office help, or other tasks.

Applicant: I am willing to complete 200 required sweat-equity hours. *
Co-applicant: I am willing to complete 200 required sweat-equity hours. *

Present Housing Conditions & Need For Housing

Please indicate all that your home has:
Do you rent or own your home? *
$
Landlord Address
Landlord Address
Include physical aspects of your current home and other factors such as financial, safety, or family insecurity.

Applicant Employment & Income Information

Are you currently employed? *
Address of Current Employer *
Address of Current Employer
$

If working at current job less than one year, complete the following:

Address of Previous Employer
Address of Previous Employer
$

Co-applicant Employment & Income Information

Are you currently employed? *
Address of Current Employer *
Address of Current Employer
$

If working at current job less than one year, complete the following:

Address of Previous Employer
Address of Previous Employer
$

Other Income Sources

If your household has other regular income such as Social Security or Self Employment, please list source and Annual Income Amount.
$
$
$
$

Applicant Debt Information

Debt Type *
$
$
$
$

Co-applicant Debt Information

Debt Type *
$
$
$
$

Applicant Declarations

Are there any judgments or liens against you? *
Have you filed for bankruptcy within the past seven years? *
Have you had property foreclosed on or deed in lieu of foreclosure in the past seven years? *
Are you currently involved in a lawsuit or collection action? *
Have you directly or indirectly been obligated on any loan that resulted in foreclosure, transfer of title in lieu of foreclosure or judgment? *
Are you currently delinquent or in default on any student loan or other loan, mortgage financial obligation or loan guarantee? *
Are you paying alimony or child support or separate maintenance? *
Are you a co-signer or endorser on any loan? *
Are you a US citizen or permanent resident? *

Co-applicant Declarations

Are there any judgments or liens against you? *
Have you filed for bankruptcy within the past seven years? *
Have you had property foreclosed on or deed in lieu of foreclosure in the past seven years? *
Are you currently involved in a lawsuit or collection action? *
Have you directly or indirectly been obligated on any loan that resulted in foreclosure, transfer of title in lieu of foreclosure or judgment? *
Are you currently delinquent or in default on any student loan or other loan, mortgage financial obligation or loan guarantee? *
Are you paying alimony or child support or separate maintenance? *
Are you a co-signer or endorser on any loan? *
Are you a US citizen or permanent resident? *

Additional Comments

Authorization And Release

I understand that by filing this Application, I am authorizing Habitat for Humanity (HFH) to evaluate my
need for the Habitat Homeownership Program, my ability to repay an affordable loan and other expenses of home ownership, and my willingness to be a partner through sweat equity.

I understand that the evaluation will include phone calls and visits with HFH personnel, employment
verification, credit reports, bank account reports, tax returns, and required background checks, including Michigan State Police Criminal Background, national Sex Offender Registry, and federal Anti Money Laundering SDN list, and possible requests for other specific documents.

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 a Habitat home, I may be disqualified from the program and forfeit any rights or claims to a Habitat home. The original or a copy of this Application will be retained by HFH even if the application is not approved.

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