Homeownership Program Interest Form

Name *
Name
Co-Applicant Name
Co-Applicant Name
Address *
Address
Please provide the first name and age of everyone who will be living in the house.
Please explain your current housing situation
Please list any other income in the household (Disability, SSI, child support, etc). Please list income type, amount, and family member the income is associated with.
By checking this, I verify that the information I have provided is true. I understand that intentionally providing false information will disqualify me from the MCHFH Homeownership Program *
Government Monitoring Information
PLEASE READ THIS STATEMENT BEFORE COMPLETING THE BOX BELOW: The following information is requested by the federal government for loans related to the purchase of homes, in order to monitor the lender’s compliance with equal credit opportunity and fair housing laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it or not. However, if you choose not to furnish it, under federal regulations this lender is required to note ethnicity, race and sex on the basis of visual observation or surname. If you do not wish to furnish the information below, please check the box below.
Applicant
Race
Ethnicity
Sex
Birthdate
Birthdate
Marital Status
Co-applicant
Race
Ethnicity
Sex
Birthdate
Birthdate
Marital Status

 We are pledged to the letter and spirit of U.S. policy for the achievement of equal housing opportunity throughout the Nation. We encourage and support an affirmative advertising and marketing program in which there are no barriers to obtaining housing because of race, color, religion, sex, handicap, familial status, or national origin.