WIXLIB

FIRST-TIME HOMEBUYER EDUCATION PROGRAMThe Center for Affordable Homeownership is committed to empowering potential homebuyers with the abilityto make educated and informed decisions regarding the process of purchasing and maintaining a home. Ourpurpose is to serve as the central homeownership counseling and educational resource center for the citizensof Hillsborough County and the City of Tampa. The process starts by attending a First-Time HomebuyerEducation training class. Once you have completed the training, you will be ready for one or more counselingsessions.FIRST-TIME HOMEBUYER PROGRAM PROCESSWhen you have the items below, submit the entire package to our office to register for the next available class.A calendar is also attached for all training classes for the 2019 calendar year.1. Registration ProcessBefore your seat is confirmed, you will need to complete the attached program application in its entirety;sign all authorization forms; make PHOTOCOPIES of the requested documents listed below: 40.00 ( 70.00 for married couple) Non-refundable application fee per person, in money orderform only, made payable to TAMPA HOUSNG AUTHORITY (cash or checks will not be accepted).o NOTE: SCHOLARSHIPS MAY BE AVAILABLE TO CITY OF TAMPA RESIDENTSCALL (813) 341-9101 X2450 TO SEE IF YOU ARE ELIGIBLEo 32.00 CREDIT REPORT FEE AT TIME OF COUNSELING (Refer to Counseling Agreement)o DEADLINE TO REGISTER IS THE MONDAY PRIOR TO CLASS DATE. Two (2) most recent (consecutive) paystubs and/or proof of ALL other income for ALL applicants. If self-employed, profit and loss statements for last six (6) months (each month separated). Award letter for SSI, Social Security, retirement/pension, etc. Two (2) most recent bank statements for ALL checking and savings accounts; all pages required. Picture ID (Driver’s License/Florida ID Card) for applicants 18 and over.The Registration packet, along with the above-mentioned documents, must be dropped to our officeat 5301 West Cypress Street, Tampa, FL 33607** NO FAXES or EMAILS.2. First-Time Homebuyer Education TrainingDesigned to empower the prospective homebuyer with the knowledge and skills of the basic homebuyingprocess. The training course includes: Shopping for a Home, Understanding Credit, Money Management,Obtaining a Mortgage and much more 3. One-on-One Counseling ( 32.00 CREDIT REPORT FEE)Upon completion of the First-Time Homebuyer Education Training, a HUD Certified housing counselor willmeet with you to determine your readiness to buy based on your specific income, debt, savings and creditstatus, and develop your personal plan of action toward your home purchase.** A letter or email, confirming your reserved seat status, will be provided to you prior to class start date.Should packets be received with less than one-week before start of class, a verbal confirmation will be provided.Please note: Children are not permitted in any of the First-Time Homebuyer Education Classes or Counselingsessions. Please contact our office with any questions at (813) 341-9101 EXT 2450.5301 WEST CYPRESS STREET TAMPA, FL 33607 Phone: 813.341.9101 EXT 2450 Fax: 813.251.9526

Check One: (Office Use Only)oooMonth:Public Housing/Section 8Fee Waived (COT)Homebuyer Education Program Registration Form* 40.00 ( 70.00 for married couple) Non-Refundable Registration Fee Must Accompany Application(Scholarships MAY be available for Section 8, Public Housing, &/or City of Tampa Residents) INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED APPLICANT:CO-APPLICANT:Date of Birth:Date of Birth:SSN:SSN:Email Address:Email Address:Home Phone:Home Phone:Work Phone:Cell Phone:Work Phone:Cell Phone:Relationship to Applicant:REFERRED BY (check all that CTION A – APPLICANT AND CO-APPLICANT er: FemaleMaleMarriedSeparatedSingleDivorced WidowCO-APPLICANT:Gender: FemaleMarriedSingleCurrent Address of ApplicantCurrent Address of Co-ApplicantHow Long: year(s) month(s)How Long: year(s) month(s)Rent Payment: Rent Payment: Current occupation/position/title:Current occupation/position/title:Current Employer:Current Employer:Date of Hire: / /Date of Hire: / /MaleSeparatedDivorcedWidowAre you currently a Section 8 Participant with THA? Yes No If YES, STOP. You MUST provide a referral from the Section 8 Homeownership Counselor with this application or you WILL NOT beregistered.Are you a Public Housing Resident with THA? Yes NoIf yes, please provide property name:Applicant Education (Please check one):Co-Applicant Education (Please check one):oooooBelow High School Diplomao Below High School DiplomaHigh School Diploma or Equivalento High School Diploma or EquivalentTwo-year college/Associateso Two-year college/AssociatesBachelor’s Degreeo Bachelor’s DegreeMaster’s Degree or Highero Master’s Degree or Higher5301 West Cypress Street, Tampa, FL 33607 Phone: (813) 341-9101 Ext 2450 Fax: (813) 251-9526Page 1 of 2

Applicant Race/EthnicityHispanicNon-HispanicCo-Applicant Race/EthnicityHispanicNon-HispanicRace:o American Indian/Alaskan Nativeo Asiano Whiteo African AmericanRace:ooooApplicant Immigrant Status:Co-Applicant Immigrant Status:American Indian/Alaskan NativeAsianWhiteAfrican AmericanU.S CitizenU.S. CitizenPermanent Resident AlienPermanent Resident AlienNon-Resident AlienNon-Resident AlienCountry of Origin:Country of Origin:Names of Household MembersSECTION B – HOUSEHOLD MEMBERS (including self)AgeNameRelationship to ApplicantRelationshipHousehold Type? Single AdultFemale- single parentAgeMarried without childrenMale - single parentMarried with childrenTwo or more unrelated adultsSECTION C – BANK ACCOUNTS, CREDIT UNIONS, ETC.Type of Account (Checking/Savings)Bank NameAmountSECTION D –MONTHLY INCOME INFORMATION (before taxes)ApplicantBase pay:Pension:SSI/Disability:Child Support:Other*: Co-ApplicantOther Income *Alimony, Dependent SSI, Workers’ Compensation, etc.Are you or Co-Applicant currently in Chapter 13 bankruptcy? Yes NoIf yes, when did it begin? ; when will it be paid out? ; how much is the payment?Have you or Co-Applicant had a Chapter 7 bankruptcy?YesHave you or Co-Applicant owned a home in the last three (3) years?Are you a Veteran?Do you have a contract on a house at this time?Are you currently working with a real-estate agent?NoIf yes, when was it or will it be discharged?YesYesYesYesNoNoNoNoI/We understand that any intentional or negligent representation(s) of the information contained on this form may result in civil and/or criminal liabilityunder the provisions of Title 18, United States Code, Section 1001.ApplicantDateCo-ApplicantDate5301 West Cypress Street, Tampa, FL 33607 Phone: (813) 341-9101 Ext 2450 Fax: (813) 251-9526Page 1 of 2

2: Managing Your MoneyMonthly Expenses WorksheetHousingRent or mortgageheating (gas or oil)ElectricityWater or sewagetelephones (landlines and cell phones)Renters or homeowners insurance(if not included in mortgage)trash servicehome maintenance and furnishingsCleaning suppliesLawn service TransportationGasCar paymentCar insuranceCar inspectionCar repairs and maintenanceLicense plates and registration feesPublic transportation or taxiParking and tolls FoodGroceriesSchool lunchesWork-related (lunches and snacks) insurancehealth (medical and dental, if not payroll-deducted)Life disability 46medicaldoctordentistPrescriptions childcareChildcare or babysittersChild support or alimony clothingClothingLaundry and dry cleaning donationsReligious or charity Total Regular monthly Expenses EducationtuitionBooks, papers and suppliesnewspapers and magazinesLessons (sports, dance, music) giftsBirthdaysMajor holidays PersonalBarber or beauty shoptoiletriesChildren’s allowancestobacco productsBeer, wine or liquor EntertainmentMovies, sporting events, concerts, etc. Video rentals internet service Cable/satellite tV Restaurants and take-out meals Gambling and lottery tickets Fitness or social clubs Vacations/trips hobbies or crafts miscellaneousChecking account and money order feesPet care and suppliesPostagePictures and photo processing“Mad” money debtsStudent loanCredit card (monthly minimum)Credit card (monthly minimum)Credit card (monthly minimum)Medical billsPersonal loan Otherotherotherother REa lizin g TH E a mer ica n d re a m NeighborWorks America

Privacy PolicyThe Center for Affordable Homeownership is committed to assuring the privacy of individuals and/or families who have contracted usfor assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all information sharedboth orally and in writing will be managed within legal and ethical considerations. Your “nonpublic personal information,” such asyour total debt information, income, living expenses and personal information concerning your financial circumstances, will beprovided to creditors, program monitors, and others only with your authorization and signature on the Counseling Agreement. Wemay also use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable researchinformation and designing future programs.Types of information that we gather about you Information we receive from you orally, on applications or other forms, such as your name, address, social security number,assets, and income. Information about your transactions with us, your creditors, or others, such as your account balance, payment history, parties totransactions and credit card usage, tax statements, bank statements. Information we receive from a credit reporting agency, such as your credit history.You may opt-out of certain disclosures:1. You have the opportunity to “opt-out” of disclosures of your nonpublic personal information to third parties (such as yourcreditors), that is directed to us not to disclose.2. If you chose to “opt-out”, we will not be able to answer questions from your creditors. If at any time you wish to change yourdecision with regard to your “opt-out” decision, you may contact us in writing at The Center for Affordable Homeownership at5301 West Cypress Street, Tampa, FL. 33607.Release of information to third parties:1.2.3.So long as you have not “opted out”, we may disclose some or all of the information that we collect, as described above toyour creditors or third parties where we have determined that it would be helpful to you, would aid us in counseling you, or isa requirement of grant awards which make our services possible.We may also disclose any nonpublic personal information about you or former clients to anyone as permitted by law (e.g., ifwe are compelled by legal process).Within the organization, we restrict access to nonpublic personal information about you to those employees who need toknow the information to provide services to you. We maintain physical, electronic, and procedural safeguards that complywith federal regulations to guard your nonpublic personal information.Signature of Acknowledgement(In addition to the above, you further acknowledge you have received a copy of this Privacy Policy)Applicant SignatureDateCo-Applicant SignatureDateRevised July 2013