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Effective from March 11
th
, 2020
MONTGOMERY COUNTY HABITAT FOR HUMANITY
P. 0. Box 2624
Conroe, Texas 77305-2624
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.
PROGRAM OVERVIEW:
Habitat for Humanity is a non-profit worldwide organization providing affordable housing to people in
need. Habitat’s qualifying homebuyers invest 350 hours of their own labor, called sweat equity,
contributing alongside volunteers and other Habitat homeowners, in addition to paying an affordable
mortgage and receiving financial education. The loans on these homes are no-interest loans.
FOLLOW THESE DIRECTIONS TO APPLY
1. Before proceeding to complete the application, read all of the Eligibility Requirements on the next
page.
2. Complete the application fully and honestly. In the event that Habitat determines that any information
contained in your application was materially and intentionally inaccurate, you will not be accepted into
the program. All information is confidential and seen only by the Habitat Family Selection Committee,
staff and Board of Directors.
3. These items must be
submitted with the application:
Note: Please make copies of these documents. Originals will not be returned.
Copies of the last three pay stubs from employment
Copies of W-2 forms for most recent last two years
Copies of tax returns for most recent last two years
Copy of benefit letters for social security, disability, retirement, and proof of child support, if any
4. Return the completed application and attachments by mail to the address listed above.
AFTER YOU HAVE APPLIED
The Family Selection Committee will review your application. One of the committee volunteers will call you to
set up a meeting and discuss
your application. Once your application is reviewed, you will receive a notice
of action within a month.
IF YOU ARE SELECTED
If your family qualifies to purchase a home, you will begin to build a relationship with Habitat by becoming
partners in every stage of the planning and construction.
In fact, by the time you own your home, you and
your family will have contributed at least 350 hours
alongside
Habitat volunteers toward the construction of
your new home.
If you have any questions about your eligibility or need assistance with this application, please call the Habitat
Office at 936-441-4663 or email familyservices@habitatmctx.org
_
Application Due:
Fast
Track: 9 –
Noon: 1501 S 7
th
St,
Conroe, TX 77301
(936) 441-4663
Next Meeting:
Page 1 of 13
Page 2 of 13
Effective from March
11th
, 2020
ELIGIBILITY REQUIREMENTS
You must meet the following criteria to be eligible to purchase a home from Habitat for
Humanity of Montgomery County:
I.
NEED
A.
Inadequate Shelter
1.
Inadequate current shelter due to problems with heat, water, wiring, bathroom, kitchen, structure,
neighborhood safety, etc. OR
2.
Inadequate number of bedrooms as determined by the number of persons in household as well as
the age and sex of these household members. For example: a boy and a girl or a teenager and an
infant sharing the same bedroom are considered overcrowding. OR
3.
Living in an unsafe neighborhood. OR
4.
An adult living “doubled up” with parents, friends or relatives.
5.
Financially overburdened: current rent/house payment > than 30% of gross income.
B.
Inadequate Financial Resources
1.
Lack of personal resources to buy or build adequate shelter AND
2.
Not able to qualify for a VA, FHA, conventional or government loan.
II.
INCOME: ABILITY TO PAY (ALL FIVE REQUIREMENTS MUST BE MET)
You must:
A.
Fall within HUD’s income limits guidelines for Montgomery County.
Family Size 1 2 3 4 5
Gross Minimum Income 23,100 23,100 23,100 23,100 23,100
Gross Maximum Income 32,050 36,650 41,250 45,800 49,450
B.
Have a record of consistent taxable income through stable employment or other sources for at
least one year.
C.
Have enough income to pay house payment, insurance and taxes. This generally runs about
$575-$675 a month total. As a homeowner, you are responsible for paying utility bills, home
maintenance, and repairs when necessary. Property taxes are determined by the City of
Conroe and Montgomery County.
D.
Have monthly expenses that do not exceed 45% of your monthly gross income.
E.
All debt obligations, past and present ,will be considered by a committee reviewing a recent
credit history report. The amount of debt allowed will vary. An established credit score helps
support future payment obligations.
F.
Any adult members of the household, 18 and up, require a background check clearance.
III.
WILLINGNESS TO PARTNER WITH HABITAT
You must:
A.
Be willing to build your home with Habitat. This will include contributing a minimum 350 hours of
Sweat Equity. This will be done by a combination of working on houses of other Habitat Partner
Families, taking required classes, working on your own home or at the Habitat MCTX ReStore.
B.
Be willing to meet Habitat’s requirements by making prompt mortgage payments and responding to
requests for information.
C.
Understand and commit to the responsibilities of home ownership.
D.
Demonstrate honesty and responsibility through your credit history, your references, and the
accuracy of information provided on your application.
Affiliate name
Affiliate mailing address for receipt of completed application
Affiliate phone number
Application
For H
ous in g
We arepledged to theletter and spirit ofU.S. policy for the
achievement of equal housing opportunity throughout the
nation. We encourage and support an affirmative advertising
andmarketing programinwhichthere arenobarriers to
obtaining housing because of race, color, religion, sex,
handicap, familial status, or national origin.
1 . A p p l i c a n t i n f o r m a t i o n
2 . F o r o f f i c e u s e o n l y – D o n o t w r i t e i n t h i s s p a c e
Date Received: Date of Letter sent:
Page 3 of 13
Effective from March 11th, 2020
Applicant
Co-applicant
Applicant’s name Co-applicant’s name
Dependents
and others who will live with you (not listed by co-applicant)
Name Age
Male Female
Dependents
and others who will live with you (not listed by applicant)
Name
Age
Male Female
Present Address (street, city, state, ZIP code)
Own
Rent
Number of Years
Present Address (street, city, state, ZIP code)
Own
Rent
Number of Years
If living in current place less than 2 years, complete the following information
Last Address (street, city, state, ZIP code) Own Rent
Number of Years
Last Address (street, city, state, ZIP code) Own Rent
Number of Years
Social Security Number Phone Date of Birth Social Security Number Phone Date of Birth
Dear Applicant: Please complete this application to determine if you qualify for a Habitat for Humanity homeownership program.
Please fill out the application as completely and accurately as possible. All information you include on this application will be kept
confidential in accordance with the Gramm-Leach-Bliley
Habitat for Humanity of Montgomery County
P.O. Box 2624
Conroe, TX 77305
TEL:
(936) 441-4663
Conroe, TX 77301
FAX: (936) 756-4667
Married Separated Unmarried (Incl. single, divorced, widowed)
Did you or anyone in your household serve or is
currently in the military? □Yes □No
Married Separated Unmarried (Incl. single, divorced, widowed)
Did you or anyone in your household serve or is
currently in the military? □Yes □No
Effective
from Jan March 11, 2020
Page 4 of 13
3 . W i l l i n g n e s s t o p a r t n e r
To be considered for a Habitat home, you and your family must be willing to complete a certain number of “s
weat-equity” hours. Your help in building
your home and the homes of others is called “sweat equity,” and may include clearing the lot, painting, helping with construction, working in
Habitat office, attendinghomeownership classes or other approved activities.
I am willing to complete the required 350 Sweat Equity Hours
Applicant:
Co-applicant:
Yes
No
4
.
P
r
e
s
e
n
t
h o u
s
i n
g
c
o n
d
i
t
i o n
s
Nu
mber
of
b
edr
oo
m
s
(pl
ea
s
e
c
i
rc
le)
1
2
3
4
5
Other rooms in the place where you are currently living:
Kitchen Bathroom
Living Room Dining Room Other (please describe)
If you rent your residence, what is your monthly rent payment? $ /month
(Please supply a copy of your lease or a copy of a money order receipt or canceled rent check.)
Name, address andphonenumber of currentlandlord:
In the space below, describe the condition of the house or apartment where you live. Why do you need a Habitat home?
5 . P r o p e r t y I n f o r m a t i o n
If you own your residence, what is your monthly mortgage payment? $
/month
Unpaid Balance $
Do you own land?
No
Yes
(If yes, please describe, including location)
Is there a mortgage on the land?
No
Yes If yes:
Monthly Payment
$
Unpaid Balance $
If you are approved for a Habitat home, how should your name(s) appear on the legal documents?_
6 . E m p l o y m e n t i n f o r m a t i o n
Applicant
co- applicant
Name and Address of current employer
Date of Employment
Name and Address of current employer
Date of Employment
Monthly (gross) Wages
$
Monthly (gross) Wages
$
Position
BusinessPhone
Position
BusinessPhone
If working at the current job less than 1 year, complete the following information
Name and Address of last employer
Date of employment
Name and Address of last employer
Years on This Job
Monthly (gross) Wages
$
Monthly (gross) Wages
$
Position
BusinessPhone
Position
BusinessPhone
Page 5 of 13
7 . M on th ly i n c o m e a n d c o m b i n e d m o n t h ly b i l l s
Gross monthly income
Applicant
Co- Applicant Monthly bills Monthly Amount
1
Base employment
Income
$
$
Rent
$
TANF
Utilities
Food Stamps
Car Payments
Social Security
Insurance
SSI
Child Care
Disability
Average Credit Card
Payment
Alimony
Student Loans
Child Support (received)
Alimony/Child Support
(needs to pay)
Other
Others
Total
$
$
Total
$
Please attach the following documents:
1)
Copies of last 3 pay-stubs
2)
Copies of W-2 & Tax returns for last two years.
3)
Copies of benefit letters for social security,
disability, retirement, and proof of child support,
if any.
2
List additional household members over 18 who receive income:
Name Age
Monthly Income
$_
$_
$_
8 . A s s e t s
List checking and savings account below
Name and Address of Bank, Savings & Loan, or Credit Union:
Name and Address of Bank, Savings & Loan, or Credit Union:
Account Number:
Balance $
Account Number:
Balance $
Do you own a:
Yes
No
Do you own a:
Yes
No
Boat
Mobile Home
Washer
Dryer








Car (#1)
Make and Year
Car
(#2)
Make and Year
Effective from March 11th, 2020
Effective from March 11th, 2020
Page 6 of 13
9 . D e b t
To whom do y ou and the Co- applicant owe money?
Column 1
Column 2
Car
Monthly
Unpaid
Payment Balance
$
$
Cell Phone Contracts
Monthly
Unpaid
Payment Balance
$
$
Mos. left topay:
Mos. left to pay:
Furniture, Appliances and Televisions
Monthly
Unpaid
Payment Balance
$
$
other money You owe
Name and Address of Company
Monthly
Unpaid
Payment Balance
$
$
Mos. left topay:
Mos. left to pay:
Credit Card
Monthly
Unpaid
Payment Balance
$
$
Alimony/Child Support
$
/month
Job-related expenses
$
/month
Medical
Monthly
Unpaid
Payment Balance
$
$
(Child Care, Union Dues, etc.)
$
/month
Total of Payments
$
/month
10 . D e c l a r at i o n s
Please check the box that best Answers the followin g questions for you and the co- applicant
APPLICANT
CO-APPLICANT
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
YesNo YesNo
1.
Have you ever owned a home before, either in US or elsewhere?
2.
Are you a U.S Citizen?
2a. If Not, are you a Legal Permanent Resident of United States?
3.
Are there any outstanding judgments against you?
4.
Have you been declared bankrupt within the last 7 years?
5.
Are you in a lawsuit?
6.
Have you ever had a loan foreclosed or a car, furniture or home repossessed?
7.
Have you ever been evicted from an apartment or rental apartment?
8.
Have you, or any members of your household, ever been convicted of a felony?
9.
Do you have to pay alimony, child support or separation maintenance?
10.
Are you a co-signer on anyone else’s note or loan?
YesNo YesNo
PLEASE EXPLAIN ANY QUESTIONS YOU HAVE ANSWERED YES TO ON A SEPARATE SHEET.
Effective from March 11th, 2020
Page 7 of 13
11. P e r s o n a l R e f e r e n c e
Please list the names of three people who know you well, such as employers, landlords, religious leaders, community leaders,
neighbors and friends. (These should NOT be relatives).
12 . A u t h o r i z at i o n a n d r e l e a s e
Applicant Signature
Date
Co-applicant Signature
Date
X
X _
Please note: If more space is needed to complete any part of this application, please use a separate sheet of paper and attach it to
this application. Please mark your additional comments with “A” for Applicant or “C” for Co-applicant.
Name and Address
Telephone
(Inc. area code)
Relationship to
Reference
How long has he/she known
you?
1
2
3
I understand that by filing this application, I am authorizing Habitat for Humanity to evaluate my actual need for a Habitat home,
my ability to repay the no-interest loan, the expenses of homeownership, and my willingness to be a partner family. I
understand that the evaluation will include personal visits, a credit check, and an employment verification. I have answered all
the questions on this application truthfully. I understand that if I have not answered the questions truthfully, my application may
be denied, and that even if I have already been selected to receive a Habitat home, I may be disqualified from the program. The
original, or a copy of this application, will be retained by Habitat for Humanity-- even if the application is not approved.
I also understand that Habitat for Humanity screens all potential staff (whether paid or unpaid), board members, and applicant
families on the sex offender registry, and that by completing this application, I am submitting myself and all persons listed on the
first page of the application to such an inquiry. I further understand that by completing this application, I am submitting myself
and all persons listed on the first page of the application to a criminal background check.
click to sign
signature
click to edit
click to sign
signature
click to edit
Effective from March 11th, 2020
Page 8 of 13
RELEASE
AUTHORIZATION
Applicant and Co-applicant
Date:
Name:
To Whom It May Concern:
This letter authorizes Habitat for Humanity of Montgomery County to obtain any and all information
necessary to process my application for housing, including but not limited to, information concerning my/
our savings and checking deposits and my/our consumer credit and mortgage credit histories, verification
of employment, and criminal background check.
A photocopy of this letter will be considered as valid as the original
Please respond as soon as possible to facilitate the processing of my application.
Applicant’s Signature
Co-Applicant’s Signature
Print Applicant’s Name Print Co-Applicant’s Name
click to sign
signature
click to edit
click to sign
signature
click to edit
Page 9 of 13
Effective from March 11th, 2020
CONFIDENTIAL RELEASE AND WAIVER
RELEASE AUTHORIZATION
For household any members over 18, OTHER THAN applicant/
co-applicant
Date:
Name:
To Whom It May Concern:
This letter authorizes Habitat for Humanity of Montgomery County to obtain any and all information
necessary to process my application for housing, including but not limited to, information concerning my/
our savings and checking deposits and my/our consumer credit and mortgage credit histories, verification
of employment, and criminal background check.
A photocopy of this letter will be considered as valid as the original.
Please respond as soon as possible to facilitate the processing of my application.
DL#
Signature
Printed
Name Date
DOB:
SS#
Address
click to sign
signature
click to edit
Page 10 of 13
Effective from March 11th, 2020
Date:
Name:
To Whom It May Concern:
This letter authorizes Habitat for Humanity of Montgomery County to obtain any and all information
necessary to process my application for housing, including but not limited to, information concerning my/
our savings and checking deposits and my/our consumer credit and mortgage credit histories, verification
of employment, and criminal background check.
A photocopy of this letter will be considered as valid as the original.
Please respond as soon as possible to facilitate the processing of my application.
Signature
DL#
Printed
Name Date
DOB:
SS#
Address
CONFIDENTIAL RELEASE AND WAIVER
RELEASE AUTHORIZATION
For household any members over 18, OTHER THAN applicant/
co-applicant
Page 11 of 13
Effective from March 11th, 2020
Employment Verification Request
Employer Information
Employer’s Name:
Employer’s Address:
Employer’s phone number:
Start date:
Supervisor or Human Resource Contact name:
Contact fax number:
EQUAL CREDIT OPPORTUNITY ACT NOTICE
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis
of race, color, religion, national origin, sex, marital status or age (provided the applicant has the capacity to enter into
a binding contract); because all or part of the applicant's income derives from any public assistance program; or
because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal
agency that monitors compliance with this law concerning this company is the Federal Trade Commission, with offices
at FTC Regional Office for the Southwest Region at Dallas, or Federal Trade Commission, 600 Pennsylvania
Ave., NW Washington DC 20580.
You need not disclose income from alimony, child support or separate maintenance payment if you choose not to do
so. However, because we operate a Special Purpose Credit Program, we may request and require, in order to
determine an applicant’s eligibility for the program and the affordable mortgage amount, information regarding the
applicant’s marital status; alimony, child support and separate maintenance income; and the spouse’s financial
resources.
Accordingly, if you receive income from these sources and do not provide this information with your application, your
application will be considered incomplete, and we will be unable to invite you to participate in the Habitat program.
Applicant(s):
X X
Print name: Print name:
Date:
Date:
Page 12 of 13
Effective from March 11th, 2020
PLEASE READ THIS STATEMENT BEFORE COMPLETING THE BOX BELOW:
We are requesting the following
information to monitor our compliance with the federal Equal Credit Opportunity Act, which prohibits unlawful
discrimination. You are not required to provide this information. We will not take this information (or your decision not
to provide this information) into account in connection with
your application or credit transaction. The law provides that a creditor may not discriminate based on this
information, or based on whether or not you choose to provide it. If you choose not to provide the information, we
may note it by visual observation or surname.
Applicant
Co-applicant
□
I do not wish to furnish this information
Race
(applicant may select more than one racial designation):
□
American Indian or Alaska Native
□
Native Hawaiian or other Pacific Islander
□
Black/African-American
□
White
□
Asian
Ethnicity:
□
Hispanic or Latino
□
Non-Hispanic or Latino
Sex:
□ Female □ Male
Birthdate:
/
/
Marital status:
□
I do not wish to furnish this information
Race
(applicant may select more than one racial designation):
□
American Indian or Alaska Native
□
Native Hawaiian or other Pacific Islander
□
Black/African-American
□
White
□
Asian
Ethnicity:
□
Hispanic or Latino
□
Non-Hispanic or Latino
Sex:
□ Female □ Male
Birthdate:
/
/
Marital status:
To be completed only by the person conducting the interview
This application was taken by:
□ Face-to-face interview
□
By mail
□
By telephone
Interviewer
’
s name (print or type)
Interviewer’s signature Date
Interviewer
’
s phone number
INFORMATION FOR GOVERNMENT MONITORING PURPOSES
Page 13 of 13
Effective from March 11th, 2020
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(936) 441-4663 Conroe, TX 77301 St, Noon: 1501

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