Home Interest Form

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Please review the Apply for a Home web page to ensure you meet our guidelines before submitting this form to HFHMC. Please note that this Interest Form is NOT an application for a Habitat home, but provides us with your contact information so that we can notify you when we have our Home Interest Meeting at which time you will receive an application.

Program Qualifications

*Have you owned a home in Marion county in the past three years?

Yes

*How long have you lived in Marion County?

Less than 1 year

Less than 2 years

Less than 3 years

3 years or more

*Are you a U.S. Citizen or Permanent Resident?

U.S. Citizen

Permanent Resident

*How many people are in your family?
*What is your monthly gross income? Please include all sources of income (SSI benefits, child support, etc.).:

Have you ever declared bankruptcy?

Yes

If yes, when was it discharged?

Are you legally married?

Yes

Is your current housing situation overcrowded, unsafe, or unaffordable?

Yes

*Have you had a foreclosure in the past 3 years?

Yes

Do you have any liens or judgments?

Yes

Contact Information *First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
Email Address:

Would you like to subscribe to our email list?

No thanks.

Yes, please subscribe me.

Home Phone:
Cell Phone:
Work Phone:

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, national origin, age, marital status, or sources of income.

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