First-time Homebuyer Assistance Program Application - City of Hickory

12/07
CITY OF HICKORY
FIRST­TIME HOMEBUYER ASSISTANCE PROGRAM
APPLICATION FORM
__________________________________________________________________
APPLICANT INFORMATION:
Date_________________________________
Name: Mr.__ Mrs.__ Ms.__ ____________________________________________________
Marital Status: Married Single Separated Divorced Widow(er)
Telephone (Home)_________________________ (Work)_____________________________
Present Street Address__________________________________________________________
City___________________ Zip Code___________________ County___________________
How Long At Above Address? ____________________
If less than one year at current address, what is previous address? _____________________
Present Mailing Address________________________________________________________
Family Size__________ Race: Am Id____ Asian____ B____ W____
Female Head of Household: YES____ NO____ Children: YES____ NO____
Total Household Annual Gross Income $____________________
MAXIMUM TOTAL HOUSEHOLD GROSS INCOME (HUD SECTION 8 DEFINITION)
1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons
$28,850 $32,950 $37,100 $41,200 $44,500 $47,800 $51,100 $54,400
Has applicant owned a home in the past year? YES____ NO____
Has applicant put required $500 down as earnest deposit? YES____ NO____
Is applicant US citizen? YES___ NO___ (If no, proof of Permanent Resident Alien status is required.)
PROPERTY INFORMATION:
Address_______________________________________________________________________
Location: City___________________ County___________________ Zip Code__________
IN What CITY LIMITS is the PROPERTY located, IF ANY?_________________________
IN What COUNTY is the PROPERTY located?_____________________________________
Sales Price $____________________ Appraised Value $____________________
Maximum Sales Price is $132,000.
Was the unit built prior to 1978? YES___ NO___
.
REALTOR/LENDER/ATTORNEY INFORMATION:
REALTOR ______________________________ Firm _______________________________
Address __________________________________________ Tel __________ Fax__________
LENDER __________________________________ Loan Officer________________________
Address __________________________________________ Tel __________ Fax__________
ATTORNEY ______________________________ Firm _______________________________
Address __________________________________________ Tel __________ Fax__________
ESTIMATED CLOSING DATE:__________________________ TIME:_______________
CLOSING DATE:_______________________________________ TIME:_______________
CLOSING LOCATION:________________________________________________________

HOUSEHOLD INFORMATION:
List the names of all family members including the applicants along with their sources of income or employer, annual gross
income, age, sex, race and handicapped status. Note: Income includes gross wages from employment including overtime,
alimony, child support, pensions, interest income, social security, income from assets, and etc.
Note: This information must be completely filled out.
Name of each Source of Income Gross Annual Age Sex Race Handicapped
Household Member or Employer Income Yes/No
1.___________________ ___________________ _________ ____ ____ ____ ______
2.___________________ ___________________ _________ ____ ____ ____ ______
3.___________________ ___________________ _________ ____ ____ ____ ______
4.___________________ ___________________ _________ ____ ____ ____ ______
5.___________________ ___________________ _________ ____ ____ ____ ______
6.___________________ ___________________ _________ ____ ____ ____ ______
7.___________________ ___________________ _________ ____ ____ ____ ______
8.___________________ ___________________ _________ ____ ____ ____ ______
9.___________________ ___________________ _________ ____ ____ ____ ______