Applicant Information

1A, 1B. Applicant Info, Military Svcs.

2. Willingness To Partner

3. Present Housing

4. Property Info

5. Employment Info

6. Monthly Income

7. Down Payment & Closing Cost

8. Assets

9. Liabilities And Expenses

Employment Verif. Authorization

Landlord Reference Authorization

10. Declarations

11, 12. Signature, Right for Appraisal

13. Demographic Information

14. Unmarried Addendum

Reasons to be Selected

Equal Credit Opportunity Act Notice

Habitat for Humanity of Madison and Clark Counties (HFHMCC) offers an opportunity for homeownership to households with low income in need of decent and affordable housing. Houses are built and renovated in Madison and Clark Counties and sold to approved applicants through affordable mortgages.

First Name *

Middle Name

Last Name *

Prefix

SSN *

Gender

Suffix

DOB

Age

Phone

Email *

Marital Status

Preferred Language

Interpreter Required

Preferred House Location

Present Address

Address

Address Line 2

City

State

Zip

Occupy Type

Number of Years

Number of Months

Co-applicant exists

First Name *

Middle Name

Last Name *

Prefix

SSN *

Gender

Suffix

DOB

Age

Phone

Marital Status

Present Address

Address

Address Line 2

City

State

Zip

Occupy Type

Number of Years

Number of Months

Dependents of Co-applicant
Dependents and others who will live with you (not listed by applicant)

Add A New Dependent

Did you (or your deceased spouse) serve, or are you currently serving, in the United States Armed Forces? (Army, Marine Corps, Navy, Air Force, Space Force, Coast Guard, Reserve or National Guard)
If yes, check all that apply:

Currently serving on active duty with projected expiration date of service/tour

Currently retired, discharged, or separated from service

Only period of service was as a non-activated member of the Reserve or National Guard

Surviving spouse

Is anyone else in your household serving, or did they serve, in the United States Armed Forces?
If yes, check all that apply:

Currently serving on active duty with projected expiration date of service/tour

Currently retired, discharged, or separated from service

Only period of service was as a non-activated member of the Reserve or National Guard