Homeownership Interest Questionnaire

First Name

Last Name

Phone

Address (If applicable- include unit or apt #)

City

State

Must be a resident of Texas.

Postal Code

How did you hear about this program?

I am interested in homeownership opportunities in...

How many people (including applicant and co-applicant) would be living in the house?

What is the total annual income of all household members?

Include income from these sources:

Wages (before taxes and deductions)

Social Security

Alimony

Child support

Any other regular income

Please be advised this is not a mortgage loan application.

Austin Habitat for Humanity will provide to all applicants, equal opportunity to obtain housing regardless of religion, race, color, gender, physical or mental disabilities, national origin or familial status. AHFH will not discriminate in providing opportunity for sale or financing of housing and will assist all persons who feel they have been discriminated against because of religion, race, color, gender, physical or mental disabilities, national origin, or familial status to seek equity under federal and state laws by providing information on how to file a complaint with the Texas Commission on Human Rights.

Changes to your Contact Information - You should keep us informed of any change in your electronic mailing address. Please notify us immediately of any changes to your email address or your system capabilities that enable you to receive electronic notification and disclosures.

I Agree

Contact Information