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Housing Counseling

Housing Counseling

CDFI: (Community Development Financial Institution) is a lending operation designed to make loan funds available to serve low-income people & communities lacking adequate access and accepts credit risks beyond the tolerance of regulated lenders.

Part One: Biographic and Demographic Info

Primary Applicant *Last, First, Middle

Street Address *

Apartment, suite, etc *

City *

State/Province *

ZIP / Postal Code *

Email Address *E.g. [email protected]

Contact Number *Mobile, Home, Work

Best Time To Reach You

Preferred Contact Method

Date of Birth *

Month

Day

Year

Gender *

Race *

Ethnicity *

Languages SpokenSpecify primary and or secondary language spoken.

Are you a Veteran? *

Are you Disabled? *

Special Needs (eg. Interpreter/Translation Service, Wheel Chair Access )

Highest Education Level Attempted

Marital Status *Marital Status

Family Household Size *Number of people living in the household.

Household MembersAll parties living in the household

Name

Age

Gender

Dependent

Relationship

Part Two: Employment Status Info

Employer 1 Name* *

Street Address *

Apartment, suite, etc *

City *

State/Province *

ZIP / Postal Code *

Country *

Employer 1 Phone Number* *

Dates of Employment (From - To)* *

Previous Employer Name

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Previous Employer Phone

Part Three: Housing Status and Housing Goals

My Current Housing Status Is:* *Renting/LeasingHomeowner with MortgageHomeowner with no Mortgage DebtLiving with FamilyHomelessOther

My Current Housing Goal Is:* *Buy A Home (Pre-Purchase Counseling)Prevent Foreclosure (DFC)Obtaining Rental Housing (RHC)Transition from HomelessnessObtain a Reverse MortgageCredit and Budget Counseling (FBC)Fair Housing (FHW)Home Improvement and Rehab (HIC)Other HCA Services

Part Four: Rental or Mortgage Info

If you are renting, How long have you been renting? Years, Months* *

Check All That ApplyI Pay Market RentI receive rent subsidy and/or public housing residentI am a Section 8 recipientI am facing evictionI am delinquent with my rent and need assistanceI am delinquent with my utilities and need assistanceI am interested in filing a fair housing claimOther

If you own your property answer the following Section.

Do you have a mortgage? If so answer the following questions. *

Is this loan Current or Delinquent? *

Mortgage Servicer Name *

Loan Number *

Loan Balance *

Interest Rate *

Principal and Interest Rate (Including Taxes and Insurance) *

Private Mortgage Insurance (PMI) *

Fixed or Adjusted Interest Rate *

Date of last payment. *

Past Due Amount. *

Have you previously applied for a loan modification or forbearance? If yes please provide details on the outcome of your previous prevention efforts. *

Do you have the ability and willingness to resume mortgage payments? If "NO", are you seeking and alternative outcome such as Deed-in-Lieu of Foreclosure or Short Sale? Explain. *

Has your hardship ended? Yes or No *

Part Five: Credit, Income, Debt and Monthly Expenses

Salary/Wages *Monthly

Rental Income *Monthly

Child Support *Monthly

Social Security Payments *Monthly

Disability Income *Monthly

Unemployment Income *Monthly

Pension *Monthly

Public Assistance Income *Monthly

Other Income *Monthly

Tot. Combined Gross Income: *Monthly

Debt *Monthly

Rent *

Mortgage (Principal & Interest) *

Property Taxes, HOA, Insurance *

Car Payment *

Car Insurance *

Credit Cards (Tot) *

Childcare/Daycare *

Child Support/Alimony *(Amount Paid)

Personal Loans *

School Loans *

Medical Debt *(Tot. of current medical bills)

Gas/Transportation *

Household Utilities *(Electric, Water, Gas, Cable, Internet (wifi)

Cell Phone *

Food *

Tithing *

Misc *

Total Monthly Debt *

Please do not fill in this field.

The Housing Counseling Program provides first-time home-buyer classes and individual counseling sessions, mortgage delinquency & default resolution counseling, financial management/budget counseling and Georgia Dream Down Payment Assistance to help families improve their credit.

Southwest Georgia United Empowerment Zone, Inc. (SW GA United) began in 1994 as a grassroots, community-based initiative for economic development and community improvement in Crisp and Dooly Counties in rural southwest Georgia.

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CONTACTS

[email protected]
(229) 273-8582
123 S. 7th Street, Cordele, GA 31015

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