Veterans Homeownership Program Application
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3VETERANS HOMEOWNERSHIP PROGRAM APPLICATION
Application Instructions on Final Page
VETERAN
(INCLUDE COPIES OF YOUR ID & SOCIAL SECURITY CARD)
Name:
Date of birth:
Age:
SSN#:
home
Current
address:
mailing
Current
address if different:
Email address:
Phone#:
VETERAN HOUSEHOLD
Own Your Home?
Rent?
Length at Residence?
Date Lease Ends?
Own Other Real Estate Property?
First Time Homebuyer?
Number of Dependents?
#1 Dependent Name:
Date of Birth:
Age:
Relationship:
#2 Dependent Name:
Date of Birth:
Age:
Relationship:
#3 Dependent Name:
Date of Birth:
Age:
Relationship:
#4 Dependent Name:
Date of Birth:
Age:
Relationship:
#5 Dependent Name:
Date of Birth:
Age:
Relationship:
#6 Dependent Name:
Date of Birth:
Age:
Relationship:
VETERAN ANNUAL INCOME
(INCLUDE COPIES OF YOUR TWO RECENT PAY STUBS, LAST FEDERAL TAX RETURN, VA AWARD LETTER, SOCIAL SECURITY AWARD LETTER)
Do you receive VA Disability benefits?
Amount: $
Social Security benefits?
Amount: $
Current employer:
Employer address:
How long?
Phone:
MONTLY INCOME
AMOUNT
MONTHLY EXPENSES
AMOUNT
SALARY / WAGES
$
MORTGAGE / RENT
$
CHILD SUPPORT
$
VEHICLE PAYMENTS
$
FOOD ASSISTANCE
$
PERSONAL LOANS
$
SOC SEC DISABILITY
$
STUDENT LOANS
$
SOC SEC INSURANCE
$
CREDIT CARDS
$
VA BENEFIT
$
CHILD SUPPORT
$
PENSION / RETIREMENT
$
$
ALIMONY
$
$
UNEMPLOYMENT BENEFIT
$
$
WORKERS COMP
$
$
OTHER ____________________
$
OTHER _______________________
$
OTHER ____________________
$
OTHER _______________________
$
TOTAL INCOME ALL SOURCES
TOTAL EXPENSES
$
$
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