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CHC Counseling Intake Form

Lacasa provides homeownership counseling services for CHC participants. If you were referred to Lacasa by CHC for homeownership counseling, please complete the form below to get started.

The information you provide will help your Lacasa housing counselor learn more about your household, finances, and homeownership goals before your counseling session.

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Applicant Information















Personal Information






Applicant Employment Status and Education Level



Household Information






Employment







Income Status

List current MONTHLY gross income for ENTIRE household.


Availability

What is your availability to attend required meetings or appointments?


Credit Score



Question 1

 Do you currently or have you ever had any of the following?




Question 2

Do you regularly keep any of the following?



Applicant Earned Income Documents

Upload primary applicant paystubs for the past 4 weeks.




Additional income information including 2nd or 3rd jobs


Tax Returns


Other Household Member Earned Income Documentation

Upload other household members: Paystubs for the past 4-weeks
















Additional Documents

Documentation of unearned income for all household members over 18.
(Child Support, SSI, SSDI, pensions, TANF, etc.)








Bank Statements

Upload your most recent checking and savings account bank statement.










Acknowledgements

Link for Privacy Policy and Program Disclosure are found here: https://lacasainc.net/fec-privacy-and-program-disclosure/ I/We hereby certify that the above information is true and complete to the best of my/our knowledge. Lacasa is a HUD approved agency and member of NeighborWorks America Network. It is extremely important for us to track the number of class participants that purchase a property. The information we collect allows us to report the impact that our services have in our community as well as to fulfill grant requirements. Data collected in this intake is for informational purposes ONLY. Lacasa does not send marketing or publicity material of any kind.



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