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Single Applicant

Single Applicant

First Name *
Middle *
Last Name *
Date of Birth
Marital Status – Please select all that apply
Total number of household members.
List all dependent(s) Full name, age, sex and amount of monthly income they receive if applicable.
Contact Information
Primary Phone Number
Alternative Contact Information
Current Address
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
If you have not lived at this address for 2 years, list any previous addresses:
I am interested in becoming a homeowner within the next 12 months.
I understand that NeighborWorks Lincoln's Homebuyer Education Course certificate of completion is valid for one (1) year after receipt. If I do not purchase a home within that year, I will need to take the course again in order to qualify for NWL assistance.
What is the your job status?
If Part-Time, how many hours do you work in a typical week?
Employer/Company Name
Start Date
Gross Monthly Income (before taxes are taken out)
No file selected
If at current employer less than 2 years – list previous employment and dates employed for past 2 years
Business Owner or Self-Employed
If Business Owner or Self-Employed please upload your two most recent years of federal tax forms, including all schedules.
No file selected
Income from Other Sources

 (Fill out all that apply to applicant ONLY)

Alimony Received
Alimony has been current and regular for the past 12 months
Child Support Received
Child Support has been current and regular for the past 12 months
Foster Care
Public Assistance
Retirement (Pension, IRA) Frequency
Social Security
Unemployment Benefits
VA Compensation
List where other income is coming from and when did it start
List how much you have saved for the down payment
Where are funds for the down payment?
Alimony Paid
Alimony payments are current and have been made regularly for the past 12 months
Child Support Paid
Child Support payments are current and have been made regularly for the past 12 months
Current Rent Payment
Do you use Section 8 Voucher to pay rent?
Please note: Section 8 assistance is not available for homeowners.
Maximum Mortgage Realistic House Payment
Have you ever owned a home before?
If Yes, when?
Type of Education
(Select one)
Other Education Explanation
Military Service of Applicant #1
Currently Active Military
Type of Citizenship (check all that apply)
No file selected
How did you hear about this program?
Check all that apply.
Demographics Opt-in

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below. 

Does anyone in your household have a disability?
Language(s) Spoken
ASL Interpretation
If you selected ASL above, do you need an ASL interpreter?
Notes – Is there anything else we should know?

Consent to Receive Documents Electronically

By signing below, I consent to receive documents electronically.

Authorization for Use and Sharing of Information

By signing below, I expressly authorize the Lender and Other Loan Participants to obtain, use, and share with each other (i) the loan application and related loan information and documentation, (ii) a consumer credit report on me, and (iii) my tax return information, as necessary to perform the actions listed below, for so long as they have an interest in my loan or its servicing: (a) process and underwrite my loan; (b) verify any data contained in my consumer credit report, my loan application and other information supporting my loan application; (c) inform credit and investment decisions by the Lender and Other Loan Participants; (d) perform audit, quality control, and legal compliance analysis and reviews; (e) perform analysis and modeling for risk assessments; (f) monitor the account for this loan for potential delinquencies and determine any assistance that may be available to me; and (g) other actions permissible under applicable law.

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