Page 1

Application - Primary Applicant
Please be sure your email address includes ".com", ie. yourname@gmail.com
Make sure your date of birth is using the MM-DD-YYYY format including the dashes. For example, if your birthdate is August 8, 1980, you would enter 08-08-1980. Please type in the dashes to prevent a delay in the processing of your application. 
The state of North Carolina requires married applicants to file a joint application.  If married, the co-applicant portion of this application must be filled out.
Providing this information is for reporting purposes only and has no bearing on homeownership denial or approval.
Providing this information is for reporting purposes only and has no bearing on homeownership denial or approval.
This includes, but is not limited to ANY of the following: timeshares, property purchased during a previous marriage, heir property, vacant land, mobile homes.



Gross Employee Income
Applicant Gross Income (Please enter your before tax hourly wage as a number without a dollar sign. e.g. 1500.).  
  • INCLUDE all long term, permanent income sources that are CURRENTLY being received such as work-related income, alimony, disability, social security income, pensions, etc. 
  • DO NOT INCLUDE temporary income sources such as UNEMPLOYMENT or income not being received at this time, e.g. employment income from jobs where you are furloughed or laid off.

You can enter decimal if needed.

Whole number only.

Estimated for you.
Estimated for you.
Estimated for you.
This is estimated for you.

Page 2

Application - Co-Applicant #1
Please be sure your email address includes ".com", ie. yourname@gmail.com
Make sure your date of birth is using the MM-DD-YYYY format including the dashes. For example, if your birthdate is August 8, 1980, you would enter 08-08-1980. Please type in the dashes to prevent a delay in the processing of your application. 
Used for Credit Check.
Social Security Numbers are encrypted and marked PII Sensitive. Full access is restricted to select Habitat staff with only the last 4x digits available to non-restricted Habitat staff. You can contact Habitat of Wake County for further details at homeownershipapp@habitatwake.org.
The state of North Carolina requires married applicants to file a joint application.  If married, the co-applicant portion of this application must be filled out.
Providing this information is for reporting purposes only and has no bearing on homeownership denial or approval.
Providing this information is for reporting purposes only and has no bearing on homeownership denial or approval.
This includes, but is not limited to ANY of the following: timeshares, property purchased during a previous marriage, heir property, vacant land, mobile homes.


Gross Employee Income
Applicant Gross Income (Please enter your before tax hourly wage as a number without a dollar sign. e.g. 1500.).  
  • INCLUDE all long term, permanent income sources that are CURRENTLY being received such as work-related income, alimony, disability, social security income, pensions, etc. 
  • DO NOT INCLUDE temporary income sources such as UNEMPLOYMENT or income not being received at this time, e.g. employment income from jobs where you are furloughed or laid off.

You can enter decimal if needed.

Whole number only.

Estimated for you.
Estimated for you.
Estimated for you.
This is estimated for you.

Page 3

Application - Co-Applicant #2
Please be sure your email address includes ".com", ie. yourname@gmail.com
Make sure your date of birth is using the MM-DD-YYYY format including the dashes. For example, if your birthdate is August 8, 1980, you would enter 08-08-1980. Please type in the dashes to prevent a delay in the processing of your application. 
Used for Credit Check.
Social Security Numbers are encrypted and marked PII Sensitive. Full access is restricted to select Habitat staff with only the last 4x digits available to non-restricted Habitat staff. You can contact Habitat of Wake County for further details at homeownershipapp@habitatwake.org.
The state of North Carolina requires married applicants to file a joint application.  If married, the co-applicant portion of this application must be filled out.
Providing this information is for reporting purposes only and has no bearing on homeownership denial or approval.
Providing this information is for reporting purposes only and has no bearing on homeownership denial or approval.
This includes, but is not limited to ANY of the following: timeshares, property purchased during a previous marriage, heir property, vacant land, mobile homes.


Gross Employee Income
Applicant Gross Income (Please enter your before tax hourly wage as a number without a dollar sign. e.g. 1500.).  
  • INCLUDE all long term, permanent income sources that are CURRENTLY being received such as work-related income, alimony, disability, social security income, pensions, etc. 
  • DO NOT INCLUDE temporary income sources such as UNEMPLOYMENT or income not being received at this time, e.g. employment income from jobs where you are furloughed or laid off.

You can enter decimal if needed.

Whole number only.

Estimated for you.
Estimated for you.
Estimated for you.
This is estimated for you.

Page 4

Monthly Household Expenses
If an expense does not apply, enter "0'". If there is a co-applicant, please combine monthly expenses for primary applicant and co-applicant. Enter whole number. Decimal not required.
Monthly Payments







Calculated for you

Additional Income-Earning Adults living in the Home
Gross Monthly Income
Additional adult's Gross Monthly Income (Please enter their before tax monthly income as a number without a dollar sign. e.g. 1500.).  
  • INCLUDE all long term, permanent income sources that are CURRENTLY being received such as work-related income, alimony, disability, social security income, pensions, etc. 
  • DO NOT INCLUDE temporary income sources such as UNEMPLOYMENT or income not being received at this time, e.g. employment income from jobs where you are furloughed or laid off.
This field will automatically calculate.
Additional people living in the Home
Please provide the names of everyone else that will be living in the home. These are people not identified as Applicant or Co-Applicant.

Page 5

Declarations and Consent 

Please indicate what part of our service area (Wake and Johnston Counties) you would be the most interested in purchasing a home.

  • This is NOT your final selection; you may change your mind later. This is only for information gathering for us to gauge interest in different areas.
  • Should you qualify for our program, we cannot guarantee where we will have homes available in the future and/or that we will have available homes in multiple parts of our service area.
  • We do not build in any county other than Wake and Johnston.
  • Additionally, this selection will NOT impact your qualification for our program.
  • Any applications received from anyone who has lived and/or worked in our service area for at least 12 months will be evaluated without consideration to which part of our service area they live in.


I have reported all verifiable, long term, permanent sources of income for all household members. I have not reported any income from temporary sources such as unemployment, or from sources that I am not currently receiving such as from jobs where I am no longer employed or am not working any hours. I understand that I will be providing documentation for all reported income later in the application process.


By checking this box, you and your family acknowledge that to be considered for a Habitat for Humanity home, you and your family must be willing to complete a certain number of "Sweat Equity" hours. Your help in building your home and the homes of others is called "sweat equity," but it may include helping on the construction site, working in the Habitat office and ReStores, attending homeownership classes or other approved activities.



I hereby acknowledge that completion of this pre-application does not guarantee acceptance into Habitat for Humanity Wake County's program, nor does it guarantee an extension of credit. If an appraisal or any other valuation of property takes place in association with your application, you have a right to receive a copy of the valuation within 7 business days.;


Notice: The Federal Equal Credit Opportunity prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, or age (provided the applicant has the capacity to enter into a binding contract) 

  1. because all or part of the applicant's income derives from any public assistance program 
  2. or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. 
The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Washington, DC 20580.


By checking this box, you (and your co-applicant, if you have one) are acknowledging that by submitting this application you understand and grant Habitat for Humanity permission to proceed with the following:

  • Habitat for Humanity will evaluate your actual need for the Habitat homeownership program, ability to repay the affordable mortgage and other expenses of homeownership, and your willingness to be a partner through "sweat equity". 
  • Habitat for Humanity's evaluation will include credit checks, employment/income verifications, landlord verifications, credit references, tax record searches, and bank deposit verifications. 
  • Habitat for Humanity will perform a criminal background check on all members of the household and will screen all members of the household for the sex offender registry.


By checking this box, you are stating that all application questions have been answered truthfully. It is understood that if questions have not been answered truthfully, this application may be denied. If your household has been selected to receive a Habitat for Humanity home and any answers on this application are found to have been answered untruthfully, you may be disqualified from the program.
Habitat for Humanity, NMLS #1624283

Page 6

E-Sign Act Disclosure and Agreement

We are pleased to offer you the opportunity to receive information about your account electronically. To receive correspondence and notices from us electronically, instead of paper copies through the mail, please review this notice and provide your consent.


Scope of Communications to Be Provided in Electronic Form. 
When you use a product or service to which this disclosure applies, you agree that we may provide you with any communications in electronic format, and that we may discontinue sending paper communications to you, unless and until you withdraw your consent as described below. 

Your consent to receive electronic communications and transactions includes, but is not limited to:
    • All legal and regulatory disclosures and communications associated with the product or service available through Habitat for Humanity of Wake County.
    • Notices or disclosures about a change in the terms of your account or associated payment feature and responses to claims.
    • Privacy policies and notices.
  1. Method of Providing Communications to You in Electronic Form. All communications that we provide to you in electronic form will be provided either (1) via e-mail, (2) by access to a web site that we will designate in an email notice we send to you at the time the information is available, or (3) to the extent permissible by law, by access to a web site that we will generally designate in advance for such purpose.
  2. How to Withdraw Consent. You may withdraw your consent to receive communications in electronic form by contacting us at homeownershipp@habitatwake.org or 2420 North Raleigh Blvd, Raleigh NC 27604. At our option, we may treat your provision of an invalid email address, or the subsequent malfunction of a previously valid email address, as a withdrawal of your consent to receive electronic communications. We will not impose any fee to process the withdrawal of your consent to receive electronic communications. Any withdrawal of your consent to receive electronic communications will be effective only after we have a reasonable period to process your withdrawal.
  3. How to Update Your Records. It is your responsibility to provide us with true, accurate and complete email address, contact, and other information related to this E-Sign Act disclosure and your account, and to maintain and update promptly any changes in this information. You can update information (such as your email address) by contacting us at homeownershipp@habitatwake.org or 2420 North Raleigh Blvd, Raleigh NC 27604
  4. Hardware and Software Requirements. To access, view, and retain electronic communications that we make available to you, you must have:
    • an Internet browser that supports 128-bit encryption.
    • sufficient electronic storage capacity on your computer’s hard drive or other data storage unit.
    • an email account with an Internet service provider and e-mail software to participate in
    • our electronic communications programs.
    • a personal computer, operating system, and connection to the Internet capable of receiving, accessing, displaying, and either printing or storing communications received from us in electronic form via a plain text-formatted e-mail or by access to our web site using one of the browsers specified above.
    • Current Version of a program that accurately reads and displays PDF files (such as Adobe® Acrobat® Reader)
  1. Requesting Paper Copies. We will not send you a paper copy of any communication, unless you request it, or we otherwise deem it appropriate to do so. You can obtain a paper copy of an electronic communication by printing it yourself or by requesting that we mail you a paper copy, provided that such request is made within a reasonable time after we first provided the electronic communication to you. To request a paper copy, contact via homeownershipapp@habitatwake.org or 919.833.2459. We may charge you a reasonable service charge for the delivery of paper copies of any communication provided to you electronically pursuant to this authorization. We reserve the right, but assume no obligation, to provide a paper (instead of electronic) copy of any communication that you have authorized us to provide electronically.
  2. Communications in Writing. All communications in either electronic or paper format from us to you will be considered “in writing.” You should print or download for your records a copy of this disclosure and any other communication that is important to you.
  3. Federal Law. You acknowledge and agree that your consent to electronic communications is being provided in connection with a transaction affecting interstate commerce that is subject to the federal Electronic Signatures in Global and National Commerce Act, and that you and we both intend that the Act apply to the fullest extent possible to validate our ability to conduct business with you by electronic means.
  4. Termination/Changes. We reserve the right, in our sole discretion, to discontinue the provision of your electronic communications, or to terminate or change the terms and conditions on which we provide electronic communications. We will provide you with notice of any such termination or change as required by law.
  5. Consent. By checking “I agree” below, you agree that you have read, understand, and agree to the E-Sign Act. You hereby give your affirmative consent to provide electronic communications to you as described herein. You further agree that your computer satisfies the hardware and software requirements specified above and that you have provided us with a current e-mail address at which we may send electronic communications to you.


STOP. This application must be submitted electronically by clicking the 'Submit' button below. Do not print out this application and bring it into the office.
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, gender, or age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Washington, DC 20580.
Equal Housing Opportunity symbol