CHN Housing Partners Homeownership Preservation Application

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Thank you for contacting CHN Housing Partners for assistance with your mortgage and/or property taxes. We are here to help! 

CHN Housing Partners has provided housing counseling and mortgage assistance to homeowners of Cuyahoga County for over 15 years.

How does it work? 

STEP 1: Complete the application
Once an application is submitted and has been deemed complete, someone from CHN will contact you to schedule a virtual appointment. (Please see page 7 of this application for a complete list of documentation.)

STEP 2: Meet with a HUD-Certified Housing Counselor
During this appointment, you will have the opportunity to discuss mortgage and/or property tax options with a housing counselor, review your credit report, and put together a financial plan. Housing counseling services are available for all residents of Cuyahoga County, regardless of income or location. 

Some applicants may be eligible for financial assistance. All available financial assistance programs are grants (the funds do not need to be paid back) and the funds will be sent directly to the mortgage servicer or Property Tax Assessor. Some programs may require that applicants meet income and hardship eligibility requirements. 

Online Application Guidelines
To apply for programs with CHN Housing Partners, you must complete an application with us along with providing documents to verify the information submitted. We have split this into the following sections:

1. Application information: Your contact and demographic information
2. Household members: Other members of your household and their demographic information
3. Income sources: All sources of income and public benefits for all household members over 18
4. Assets: All liquid assets for all household members over 18
5. Housing & utility details: Details about your mortgage and utilities for program-specific purposes and to help us assess what program(s) you may need
6. Document upload: We will request scanned copies, legible photos or screenshots of documents as verification for your eligibility for programs. 

You may encounter a slow system or downtime due to a high volume of traffic on the site. Please use the "Save my progress and resume later" feature located at the top of the form OFTEN to avoid losing any information. (This form is powered by FormAssembly.)


Fair Housing Act (42 USC 3600, et seq.)
If you have an impairment, disability, language barrier, or otherwise require an alternative means of completing this form or accessing information about our services, please talk to us about arranging alternative accommodations. We serve all clients regardless of income, race, color, religion/creed, sex, national origin, age, family status, disability, or sexual orientation/gender identity. We administer our programs in conformity with local, state, and federal anti-discrimination laws, including the federal Fair Housing Act (42 USC 3600, et seq.)

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Applicant and Co-Applicant Details

In this section, please enter your most up to date contact information and demographic information.

CHN Housing Partners (CHN) is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all personal information shared verbally and/or in writing will be managed within ethical and legal consideration. Additionally, we want you to understand how we use the personal information we collect. Please carefully review this notice as it describes our policy regarding the collection and disclosure of your nonpublic, personal information.
 
CHN's Housing Counseling Disclosure and Privacy Policy

The Applicant (and Co-Applicant, if applicable) should be an adult member of your household who will be able to represent, provide information for, and make decisions on behalf of your household. 

Please prepare for upload: Photo Identification and Social Security Cards for each Applicant and Co-Applicant.
Applicant Information

















Enter date in MM/DD/YYYY format









Co-Applicant Information










Enter date in MM/DD/YYYY format








WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

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Household Members

Please enter additional members who reside in your household (i.e. children, dependents, other family members, etc.). Use the "Add Additional Household Member" link to add as many as you need.

You do not need to re-enter Applicant or Co-applicant (if applicable) information here.


Please prepare for upload: For each household member, be prepared to provide verification that they are your dependents - such as Social Security Cards and Birth certificates

Household Member


Enter date in MM/DD/YYYY format










WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

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Current Income Sources and Public Benefits


Please enter all sources of Income and Public Benefits that the household is CURRENTLY receiving, for all household members over the age of 18. 


Use the "Add Additional Income Source" link to add as many as you need


Current Annual Income is the estimated income for the current year including any wages,

benefits, alimony, child support and other forms of financial income or support.


Income includes: Full-time employment, part-time employment, self-employment, spousal support, child support, investment income, Social security, SSI, SSDI, income from assets, pension/annuity, unemployment, adoption subsidy, short term disability, long term disability, veteran's benefits, zero income, family contribution, other

Public benefits include: Food stamps, WIC, ADC, OWF/TANF, rental subsidy, utility allowance, other public benefit

Please prepare for upload: Verification of income for the past 60 days - pay stubs, employment letters, award letters, etc. 


Current Income or Public Benefit Source

Enter the Household Member who this income belongs to


Provide the Job Title for Employment types, if applicable
Please take the total income you received in the last 30 days and multiply by 12 to determine your annual income:

Please estimate to the best of your ability. Our staff will review your documents and provide a full eligibility determination.
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

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Assets Declaration
Please enter all liquid Assets you have control over for all household members over the age of 18. Liquid assets are cash on hand or assets in any other form that can be converted to cash within 20 days (SSA.gov). Please include all bank accounts; if the account balance is $0, enter $0 as the value.

Asset types include: Bank Accounts - Savings and/or Checking, Investment Accounts, Retirement, Certificates of Deposit, Cash on Hand, Pre-paid Debit Cards, Health Savings Accounts, Life Insurance Cash Value

Asset


Please estimate to the best of your ability - enter 0 if unsure
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

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Household and Utility details

We will be asking more specific questions about your Housing Details here, including your living situation, mortgage payment amount, and utility details. This information will allow for us to screen eligibility for the wide range of programs we offer. You will be under no obligation to participate in programs we recommend.

Please prepared for upload: Mortgage statement, copies of utility bills for all utilities and additional verification as requested in each section that follows
Housing





Mortgage Servicer Information

By providing your mortgage servicer's information, you authorize us to contact them to discuss your housing situation. Your will review a third-party letter of authorization with your housing counselor during your appointment and this form will be sent to your mortgage company. 














We encourage you to check your property tax bill using this link: myplace.cuyahogacounty.us
If you occupy this home as your primary residence, you are eligible for a 2.5% credit on your bill. If you occupy this home as your primary residence and are permanently disabled and/or are 65 or older, you may be eligible for the Homestead exemption. Applications for both can be obtained on the website linked above. 
Hardship Statement
We require a statement of Hardship that helps explain why you need assistance. Please select the category that represents the primary hardship reason and any additional detail in the Hardship Statement. 


Please briefly explain your hardship here:

up to 255 characters
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

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Upload Documents

Please use this page to upload documents that support your application. You can attach electronically downloaded documents, use a scanner, or take pictures or screenshots of your documents with your phone.

You can upload multiple files per section by using the "Add another ..." link. There is a limitation of 20 files per form. If you have more than 20 files to upload, please email them to info@neorenthelp.org.

Gather the required documents:
1. Photo identification for all household members 18 years or older
2. Verification of household members (Social Security card preferred, or birth certificate) for all household members
3. Mortgage Statement
4. Income documentation for the most recent 60 days
5. Bank Statements for the most recent 60 days. Include statements for all active accounts, including all pages (even if blank). 
6. Federal Income Tax Returns for the past two years. Include your entire Form 1040 and any applicable schedules (e.g. Schedule C for self-employment income). Sign and date page 2 of your Form 1040. (Do not include the City and State.)

*Note: These are the only documents required for your initial eligibility screening. Additional documentation may be required depending on the resolution type. Your housing counselor will advise of additional required information.  


Complete applications with all required supporting documents will be processed faster - please upload as much as you are able to and ensure you have documents for each section!  


If taking photos with your phone/camera, you can line up your IDs and Social Security cards within one image, instead of one at a time
ID
Mortgage Statement

Upload a copy of your most recent mortgage statement. The mortgage statement should include: the account number, payment amount, delinquent balance. 





Utility Bills
Upload Utility Bills in each section listed here based on programs you are requesting assistance for. Please upload the actual bill, showing usage, even if the bill is not in your name.






WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

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Acknowledgement & Submit

I/we certify that all provided information is correct to the best of my knowledge and have received a copy of CHN's Housing Counseling Disclosure and Privacy Policy. I/we authorize CHN Housing Partners to verify all information contained on this online form and to pull my credit report. I/we understand that I may be assisted by federal funds which carry severe penalties, including incarceration.

CHN's Housing Counseling Disclosure and Privacy Policy

By typing my full name below, I hereby authorize CHN to release nonpublic personal information it obtains about me to any third parties necessary to provide me with the services I requested. I acknowledge that I have read and understand the above privacy practices. I understand I will receive a copy of all information submitted at the email address I provided on Page 2, "Applicant E-mail Address".
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.




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