First-Time Homebuyer

PRE-QUALIFICATION
INTAKE FORM


Click to Print
This Form

 

NOTICE:  This form must be submitted to Yary Jaen at the MSCDC office located at 875 Main Street, Worcester before your eligibility can be determined.  Every line item must be filled in; if it does not pertain to you please write N/A, otherwise your form will be incomplete and will NOT be processed.

 

Pre-Qualification Intake Form

(Please Return Completed Intake Form to Main South CDC)

Date: _____________________

Applicants Name: _______________________________________________________                                   

Address:      ___________________________________________________________

Home # ______________  Work # ____________________ Cell # ­__________________

Email: _________________________   Primary Language: __________________________

Family Size:  Adults: __________         Children: ____________

Do you receive SSI, Disability, Child Support, etc?          Yes      No    

   If yes, please list type and amount:  ______________________________________________

Total Household Annual Income

(Include all sources from all household members over 18):

Head of Household: ______________________________           Annual Income: $__________

Type of Income(s):  _______________________________              

Spouse: _____________________________________ ___          Annual Income: $__________

Type of Income(s): _______________________________               

Other: _________________________________________            Annual Income: $__________

Type of Income(s): _______________________________                                                                                   

Total Household Monthly Debt: $___________   Total Household Income: $____________

# Bedrooms Desired?  □ 1   □ 2   □ 3   □ Other ___

Have you owned a home in the past 3 Years?  □ Yes    □ No

Have you completed the 5 week First Time Home Buyer Workshop?    □ Yes    □ No

   If so, when and where?  _____________________________________________________

How did you hear about this program?  ____________________________________________

________________________________________________________________________

 

FOR OFFICE USE ONLY:


Eligible
_________________ Not Eligible _________________ Not Interested __________________

 

Comments:

 

 

 

 

 

To download the Pre-Qualification form, please click here.
You will need Adobe Reader to download this file.