Applicant Information

Have you ever owned a home before?

Are You A Veteran

CURRENT HOUSING SITUATION

Employment/Education

Have you had a gap in employment in the last two years?

Co-Applicant

Have you had a gap in employment in the last two years?

Income

Income Sources: Check all that apply and make sure to include documentation from each income source: Applicant:

Co-Applicant:

Applicant

Co-Applicant

Children’s Income:

Housing Needs

Savings/Assets Source and amount used for down payment:

Credit/Loans/Debt

Applicant: Current Loans/Debt: (Current Personal loans, credit card(s), auto loans, student loans)

Co- Applicant: Current Loans/Debt: (Current Personal loans, credit card(s), auto loans, student loans)

VERIFICATION

I authorize Bogalusa Rebirth to assist me with obtaining my three annual credit reports through FreeCreditReport.com, furthermore, I agree to share the information contained in the reports with Bogalusa Rebirth so they may assist me with housing and credit counseling. Additionally, I agree that Bogalusa Rebirth may release/share any information (including documentation and other materials) pertinent to eligibility for participation in the program with lenders who provide mortgage financing. *Lenders may request their own authorization.

*Optional Demographic Information: Please check all that apply:

Please check one: