Fillable A Community Asset! P. O. Box 1830 Lower

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A Community Asset! P. O. Box 1830 Lower

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A Community Asset!
P. O. Box 1830
Lower Lake, CA 95457
Tel 707 994-1100
Lake County Home Ownership Qualifying Pre-Application:
This is not a promise of services. Pre-application is for information only. If Preliminary qualifications are met, further
documentation and a completed Home Ownership Application will be requested to determine final eligibility for services.
Selection is not automatic; all complete applications will be reviewed and considered by Habitat for Humanity Lake County
administration.
Date: Client Name:
Current Contact Mailing Address:
Contact Phone # Contact email:
Home Address:
Mailing Address:
Are you a Veteran: Yes: No:
How long have you lived at this address:
How long have you lived in Lake County:
Describe your living conditions:
Number of individuals living in the home: How many children?
Gross Annual Household Income of all family members over 18: (will be verified) Please include ALL
sources of money/assistance you receive and the amounts? Compare this amount to the income
guidelines on page 1:
Are you willing to partner with Habitat for Humanity in the building process: Yes: No:
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A Community Asset P. O. Box 1830 Lower

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Completed 20 May 2022

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