Application

Pre-Application Whatcom-Skagit Housing

Step 1 of 5 – Personal Information

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This field is for validation purposes and should be left unchanged.

Applicants Information

TO BE INCLUDED WITH THIS APPLICATION

Current pay stubs from ALL household income showing one month’s current earnings as well as award letters for any assistance programs you are involved with
Copies of the last 2 years Federal Income Tax returns (including W-2’s and all attachments). Individuals who do not have copies should obtain them by writing to the IRS.
Immigration status, if applicable (copy of Alien registration card).

Applicant

Name(Required)

First Last

Social Security(Required)

Date of Birth(Required)

YYYY dash MM dash DD

U.S. Citizen(Required)

Yes

If "no", what is your residency status?(Required)

Are you:(Required)

Married

Separated

Unmarried

If separated provided legal documentation.

Unmarried Classification (If applicable)

Single

Divorced

Widowed

If divorced, please provide a copy of your Divorce decree and all accompanying documents.

Email(Required)

Enter Email Confirm Email

Home Phone

Cell Phone

Current Address(Required)

Street Address City State ZIP Code

Mailing Address

If different from above

IF AT ABOVE ADDRESS IS LESS THAN 2 YEARS

Previous Address

Street Address City State ZIP Code

Co-applicant?(Required)

Yes

Co-Applicant

Name(Required)

First Last

Social Security(Required)

Date of Birth(Required)

YYYY dash MM dash DD

U.S. Citizen(Required)

If no, what is your residency status?

Yes

If "no", what is your residency status?(Required)

Are you:(Required)

Married

Separated

Unmarried

If separated provided legal documentation.

Unmarried Classification (If applicable)

Single

Divorced

Windowed

If divorced, please provide a copy of your Divorce decree and all accompanying documents.

Email(Required)

Enter Email Confirm Email

Home Phone

Cell Phone

Current Address(Required)

Street Address City State ZIP Code

Mailing Address

If different from above

IF AT ABOVE ADDRESS IS LESS THAN 2 YEARS

Previous Address

Street Address City State ZIP Code

List all children and other members of your household that will be living with you in the home.
Excluding applicant and co-applicant

Household Members

Name

Birthday

Employment History

Applicant

Present Employer(Required)

(If self-employed you will need to provide a YTD Profit & Loss)

Employer Address

Street Address City State ZIP Code

Phone Number(Required)

Seasonal Work(Required)

Yes

Have you worked for this company for less than 2 years?(Required)

Yes

IF EMPLOYMENT IS LESS THAN TWO YEARS

Previous Employer(Required)

Employer Address(Required)

Street Address City State ZIP Code

Phone Number(Required)

Seasonal Work(Required)

Yes

Co-Applicant

Present Employer(Required)

(If self-employed you will need to provide a YTD Profit & Loss)

Employer Address(Required)

Street Address City State ZIP Code

Phone Number(Required)

Seasonal Work(Required)

Yes

Have you worked for this company for less than 2 years?(Required)

Yes

IF EMPLOYMENT IS LESS THAN TWO YEARS

Previous Employor(Required)

Address(Required)

Street Address City State ZIP Code

Phone Number(Required)

Seasonal Work(Required)

Yes

Do you receive any commission(Required)

Yes

Do you receive any tips(Required)

Yes

If yes, how much tip income per month?(Required)

Do you receive any child support(Required)

Yes

If yes, how much child support income per month?(Required)

Do you receive any social security(Required)

Yes

If yes, how much social security income per month?(Required)

Do you receive any TANF(Required)

Yes

If yes, how much TANF income per month?(Required)

Do you receive any WIC(Required)

Yes

If yes, how much WIC income per month?(Required)

Do you receive any unemployment(Required)

Yes

If yes, how much unemployment income per month?(Required)

Do you receive any Child tax credit(Required)

Yes

If yes, how much Child tax credit per month?(Required)

Do you receive any VA Benefits(Required)

Yes

If yes, how much VA Benefit income per month?(Required)

Do you receive any SNAP(Required)

Yes

If yes, how much SNAP income per month?(Required)

Additional Questions

Applies to both applicant and co-applicant

Do you have any outstanding debts?(Required)

Including installment debts, school loans, automobile loans revolving charge accounts, child support, alimony, etc.

Yes

List outstanding debts(Required)

CREDITOR

MONTHLY PAYMENT

BALANCE OWING

Do you presently rent?(Required)

Yes

Rent Amount(Required)

Do you own any real property or manufactured home?(Required)

Yes

If yes what is the value(Required)

Is your current housing substandard?(Required)

(Is your current housing poor quality or have inferior electrical, plumbing or heating)

Yes

Has applicant or co-applicant ever filed bankruptcy?(Required)

Yes

Discharge Date?(Required)

If yes, please include copies of all documents relating to the bankruptcy

MM slash DD slash YYYY

Does applicant or co-applicant have any tax liens or civil judgments filed against them?(Required)

Yes

Has applicant or co-applicant had any collections?(Required)

Yes

Dates Paid(Required)

Do you have cash or assets (other than your car) over $15,000.00 or $20,000.00 if 62 and over?(Required)

Yes

Please List(Required)

List all Checking and/or Savings account CURRENT balances(Required)

Applicant Checking

Applicant Savings

Co-Applicant Checking

Co-Applicant Savings

Do you have reliable transportation to and from the job site?(Required)

Yes

Are you physically able to do light construction work?(Required)

Yes

Are you able to arrange for consistent childcare for your children during the construction of your home? Per Washington State Law Children under the age of 16 are not allowed on the job site.(Required)

Yes

Can you realistically work a minimum of 35 hours per week to build your home as well as the other homes in your building group?(Required)

Yes

Would your family have a problem living in a two story house?(Required)

Yes

How did you hear about our program?

Are there any additional circumstances or information you think we should know about? Please explain:

Required Documentation

4 Recent Pay Stubs(Required)

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 5 MB, Max. files: 10.

2 Most Recent Bank Statements(Required)

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 5 MB, Max. files: 10.

Credit Report(Required)

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 5 MB.

Final Steps

I/We authorize Whatcom-Skagit Housing to check my/our credit through their credit-reporting agency.

I/We understand that all information provided herein is private and confidential and is for program use only.

The above information, along with any other information provided by me/us is warranted to be true and complete to the best of my/our knowledge and belief.

Account Password(Required)

Enter Password Confirm Password

Your account will be created upon submission. Please activate your account by clicking on the link in your email.

Applicant's Signature(Required)

Applicant Date Signed(Required)

MM slash DD slash YYYY

Co-Applicant's Signature

Co-Applicant Date Signed

MM slash DD slash YYYY

“The following information is requested by the Federal Government in order to monitor compliance with Federal Law prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of the individual application on the basis of visual observation or surname.”

Applicant(Required)

American Indian or Alaska Native

Black, or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

Pacific Islander

White

I do not wish to furnish this information

Other

Co-Applicant(Required)

American Indian or Alaska Native

Black, or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

Pacific Islander

White

I do not wish to furnish this information

Other

Applicant's Gender(Required)

Male

Female

Co-Applicant's Gender(Required)

Male

Female

This institution is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html or call 866-632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at US Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue SW, Washington, DC 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov.