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Housing Service Intake Form
Welcome to the Detroit Housing Network's Housing Service Intake Form. This intake form helps Detroit residents access various housing services provided by a group of housing agencies called the Detroit Housing Network. Continue to page two to see examples of housing services provided.

Intake Form Instructions

1. Choose the housing services you want.

2. Tell us about your home and upload intake documents.


3. Submit your intake form and we'll contact you in two to three business days.

Frequently Asked Questions

What do I do if I need support completing this intake form?

Call 866-313-2520 to be connected to the Detroit Housing Resource Helpline. A housing specialist will work with you to choose the services you are interested and direct you to a Detroit Housing Network Member who provides access to that service. 

Continue onto the next page of the form.

Choose the housing services you want.
To learn more about each service, visit DetroitHousingNetwork.org/Services

Housing Counseling and Education

One on one meetings with housing counselors to develop a plan and budget that will help you reach your housing goals. Select this service to see types of Counseling.

Learning opportunities in a classroom setting where you can explore housing topics with a certified housing counselor. This includes homebuyer education workshops, a requirement of down payment assistance programs. Select this service to see types of Workshops. Once selected, you can register for a workshop on page 3.

Housing Programs and Services

Home repair and maintenance services help homeowners invest in and repair their homes. Select this service to see types of housing programs.


For some services, the Detroit Housing Network acts as an intermediary between you and the organization that provides the service. The Detroit Housing Network and its Members are not responsible for the approval, denial or other potential determination of your service application.












Choose the housing services you want. 

Select the group educational workshop you are interested in attending below. Available workshops for the next 30 days are displayed below. Select only one workshop. Selecting multiple workshops may cause delays in service delivery.  

Homebuyer Education Workshop










Homebuyer Education Workshop










Homebuyer Education Workshop










Homebuyer Education Workshop










Homebuyer Education Workshop










Homebuyer Education Workshop










Homebuyer Education Workshop










Homebuyer Education Workshop










Self-Paced Homebuyer Education Workshop








Renters Rights and Responsibilities Workshop










Financial Literacy, Budgeting, and Credit Workshop










Financial Literacy, Budgeting, and Credit Workshop










Financial Literacy, Budgeting, and Credit Workshop










Financial Literacy, Budgeting, and Credit Workshop










Detroit HOPE Property Tax Workshop










Detroit HOPE Property Tax Workshop










Estate Planning Workshop










Fair Housing Workshop










Tell us about your home. 

Please enter your contact and demographic information for the applicant and co-applicant (if applicable). The Applicant (and Co-Applicant, if applicable) should be an adult member of your household that will be able to represent, provide information for, and make decisions on behalf of your household. 

Detroit Housing Network (DHN) is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. Please carefully review this notice as it describes our policy regarding the collection and disclosure of your nonpublic, personal information:  DHN's Privacy Policy. 

Applicant Information



Please enter in the format ##########.

Please enter in the format ##########.

You may receive text messages from DHN and/or DHN housing counselors about the services you are interested in. You can reply "STOP" to stop receiving text messages from that specific number at any time.





Unit number or second address line



Enter date in MM/DD/YYYY format










Please enter in the format #########.











Co-Applicant Information



Please enter in the format ##########.



Enter date in MM/DD/YYYY format








Please enter in the format #########.






Documents



Home Repair Documents
The following sections are not required. If you need support finding and uploading these documents, leave the sections below blank.


If you have dependents or visiting children:


If you own your home:



If you are self-employed:



Tell us about your home. 


Please enter information for anyone who lives in your household including children, dependents and other family members. Use the Add Additional Household Member link to add as many as you need.

All children should be included. Do not include yourself or the co-applicant.

Household Member Details



Enter date in MM/DD/YYYY format

Please enter in the format #########.




















Tell us about your home. 


Property Tax Information
We collect information about your property taxes because many residents have been impacted by property tax foreclosure. We may use this information to connect you to a property tax program.





Home Repair Information









Hold down Control key to select more than one.

Ownership Information


Rental Information



Please enter in the format ##########

Please enter in the format ##########










Utility Information
We may use this information to determine eligible to connect you to utility related programs.












Tell us about your home. 

Please provide information about your assets, debts and income. 

Income

Please report the Income Type and Gross Annual Income for each member of your household.  


To add another income record, select "Add Another Income" (blue link in the bottom right).



$
Assets
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)

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

To add an additional asset, select "Add Another Asset" (blue link in the bottom right)


$
Debts

To add an additional Debt, select "Add Another Debt" (blue link in the bottom right)


$

Submit your intake form.

I/we certify that all provided information is correct to the best of my knowledge and have received a copy of DHN's Privacy Policy. I/we authorize DHN Housing Network to verify all information contained in this online form.

By typing my full name below, I hereby authorize DHN 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".

Penalty For False or Fraudulent Statement

U.S.C. Title 18, Sec. 1001, provides: “Whosoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies or make any false, contain any false, fictitious or fraudulent statements or
representation, makes or uses any false writing response or document knowing the same to contain any false , fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than five years, or both.” The undersigned certifies under penalty of law that all statements made in this intake/application form and supporting documents are true and accurate, correct and complete. If any of the information provided by the CLIENT(s) is untrue, inaccurate or incomplete, regardless of when this is discovered by the City, the City may, in its sole discretion, immediately terminate the CLIENT(s)’s participation in the Loan Program without liability.

Home Repair 
Authorization to Release Information
The Applicant(s) gives permission to the Intake Center to release the City of Detroit Single Family Home Repair Programs Application and supporting documentation to the CITY/LISC Detroit/Lender for the purposes of: 1) Obtaining a credit report in my name; 2) Verifying my income, asset and employment information; 3) Verifying any and all other information necessary to establish the Applicant(s) eligibility to receive assistance through the City of Detroit Single Family Home Repair Programs. The Applicant(s) understand that the information obtained will remain confidential and will be used solely for the purpose of determining eligibility to receive home repair assistance.

Notice of Non-Discrimination

The City of Detroit does not discriminate on the basis of age, color, creed, handicap, national origin, race, sex or sexual orientation. Persons or groups with discrimination complaints may file those complaints with the City of Detroit Human Rights Department, 2 Woodward Avenue, Suite 1026, Detroit, Michigan, 48226.

Right now or any time in the past 12 months, I, an immediate family member, or business associate has been employee, agent, consultant, elected, or appointed official of the City of Detroit.