MOUNTAIN COUNTRY HOMES OF HOPE          Monthly Cash Flow Statement   Page 3

 

Applicant Name: ______________________________________________________________

 

 

Monthly Salary-Before Taxes

 

INCOME

 

Normal Monthly Expenses

 

EXPENSES

 

     Applicant

 

$

 

Rent

 

$

 

     Co-applicant

 

$

 

Water

 

$

 

Monthly Salary- After Taxes

 

$

 

Electric and/or Gas

 

$

 

     Applicant

 

$

 

Child Care

 

$

 

     Co-applicant

 

$

 

Vehicle gas, insurance, maintenance

 

#1 $

#2 $

 

*Alimony or Child Support

 

$

 

Phone

 

$

 

Food Stamps

 

$

 

Cell Phone

 

$

 

AFDC

 

$

 

Cable or Satellite

 

$

 

SSI

 

$

 

Child Support

 

$

 

Other

 

$

 

Food-not including Food Stamps

 

$

 

 

 

 

 

Misc:

 

$

 

Total Monthly After Tax Income- (A)

 

$

 

*Total of Monthly Expenses- (B)

 

$

(* Cannot be counted as income if it is not received at regular monthly intervals with a one year verification

 

Name of Creditor and amounts of ALL unpaid loans including: car, credit cards, medical, bank and personal

 

  Monthly Payment

 

Unpaid Balance

 

1.

 

 

 

 

 

2.

 

 

 

 

 

3.

 

 

 

 

 

4.

 

 

 

 

 

5.

 

 

 

 

 

6.

 

 

 

 

 

7.

 

 

 

 

 

8.

 

 

 

 

 

9.

 

 

 

 

 

10.

 

 

 

 

                    Total Monthly Payments- (C)

 

$

 

 

 

Do you have auto insurance? [ ] Yes  [ ] No     Name of carrier:___________________________________

Have you ever applied for a conventional home loan? [ ] Yes   [ ] No  

If YES, were you turned down? [ ] Yes   [ ] No       Name of Lender:_______________________________

 

TURN OVER

MOUNTAIN COUNTRY HOMES OF HOPE

Pre-qualifying Form Continued

Page -4-

 

Do you pay child support:  [ ] Yes  [ ] No   If yes, How much a month?:_______________    

 

Are you current? [ ] Yes  [ ] NoIf No, how many months in arrears are you? ______________

 

Have you ever owned a home?  [ ] Yes  [ ] NoDo you own land? [ ] Yes  [ ]  No

 

Are you an American citizen? [ ] Yes  [ ] No     If No, do you have a Green Card or Work Visa? _______________

 

Date of Expiration: ____________________

 

 

 

I/We have read, understand and agree to the conditions stated in the Application Requirements.  Further, I/We attest that all the information I/We provided is true and correct to best of my/our knowledge.  I/We understand that any false information provided will preclude Me/Us from consideration or approval for a home through the Homes of Hope program.

 

 

 

_______________________________________Date:___________________________

       Applicant # 1 Signature

 

 

________________________________________               Date: ___________________________

       Applicant # 2 Signature