Sacramento Neighborhood Housing Services, Inc. (SNHS)

Pre-Purchase Counseling
Intake Form

HOW TO COMPLETE THIS FORM: Fill in all required fields by typing directly into the form. For multiple-choice questions, select your answer from the dropdown menu. Fields marked with * are required. For language assistance, please ask your intake coordinator.
Section 1 — Applicant Information
Applicant Full Name *
Date of Birth *
Gender *
Race *
Ethnicity *
Primary Language Spoken *

Section 2 — Contact Information
Primary Address *
Rural Area Status *

Section 3 — Household Questions
Where are you looking to purchase? *
Are you currently working with a real estate agent? *
Are you currently working with a lender? *
Do you have a loan offer? *
Do you have a pre-approval letter? *
Do you have savings for a home purchase? *
What down payment assistance program are you interested in? *
Have you been denied home loan financing? *
Have you owned a home in the last 3 years? *
Are you the Head of Household? *
Are you a single parent? *
Marital Status *
Foreign Born? *
Highest Level of Education *
Disability Status *
Do you have a disabled dependent? *
Veteran? *
Active Military / Armed Forces Service? *
Citizenship Status * (We collect citizenship status solely to help match you with assistance programs and resources you may be eligible for.)

Section 4 — Income
Source(s) of Income — select all that apply *
Gross Annual Income by Household Member

Section 5 — Co-Applicant (if applicable)
Do you have a Co-Applicant? *

Section 6 — Monthly Spending Worksheet

Enter your monthly average amount per category. This section is required. Write $0 if a category does not apply to you; any box left blank will be recorded as $0.

Debt Payments (if credit report unavailable)
Housing
Transportation
Personal Care
Entertainment
Other Expenses
Savings & Investments (Monthly Contribution)

Section 7 — Housing Counseling Disclosure & Acknowledgment

Services Offered: SNHS offers HUD-approved one-on-one counseling and group education: Pre-Purchase, Foreclosure Prevention, Rental, Post-Purchase Counseling, Homeownership Workshops, and Financial Capability Classes.

Privacy Statement: Your information is kept confidential per HUD requirements and is not disclosed without written consent except as required by law or for program auditing purposes.

No Client Obligation: There is no obligation to use any product or service offered by this agency or its industry partners in exchange for receiving HUD housing counseling services.

Acknowledgments — Please Initial Each Item
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Section 8 — Credit Report Authorization

A credit report is required for SNHS to review your credit file for housing counseling purposes. You may submit your own report from AnnualCreditReport.com or allow SNHS to pull one for a fee, as described below.

Would you like a credit verification? *

Section 9 — How Did You Hear About Us?
Read and Acknowledge the Following Disclosures

Addendum A — Housing Counseling Disclosure

Services Offered

SNHS offers the following HUD one-on-one counseling and group education services: Pre-Purchase Counseling, Foreclosure Prevention Counseling, Rental Counseling, Non-Delinquent Post-Purchase Counseling, Group Education Workshops, Financial Capability Classes, and Reverse Mortgage / HECM Counseling. See Addendum B for full descriptions.

Privacy Statement

SNHS values your privacy. We collect personal information to provide requested services and support our housing counseling program. We take precautions to keep your information confidential and secure per HUD requirements. SNHS may not use or disclose your information without written consent except: as necessary to provide services, as required by law or in response to a subpoena, or to outside auditors such as HUD or NeighborWorks America who have agreed to keep the information confidential.

Relationships with Industry Partners

SNHS has financial relationships with several partners in the industries of lending, real estate, insurance, and other related fields. See Addendum C, "Financial Partnerships," for a list of partnering organizations.

No Client Obligation

There is no obligation to receive, purchase, or use any product or service offered by this agency or any services of its industry partners in exchange for receiving HUD housing counseling and/or education services.

Acknowledgments

Applicant to opt-out initial here:    Co-Applicant:

Third-Party Release Information

  1. So long as you have not opted out, SNHS may disclose some or all of the information we collect to creditors, where determined to be helpful to you, aid us in counseling you, or is a requirement for grant awards.
  2. We may also disclose any nonpublic personal information about you as permitted by law (e.g., if compelled by legal process).
  3. Within the organization, we restrict access to nonpublic personal information to those employees who need to know that information to provide services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
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Addendum B — Services

Pre-Purchase Counseling

Clients receive comprehensive one-on-one counseling covering the entire home-buying process. Counselors assist with creating a sustainable budget and spending plan, and a clear action plan is developed to achieve homeownership. Clients also receive material on home inspections, pre-foreclosure, and other homeownership topics.

Foreclosure Prevention Counseling

If you are late on mortgage payments or worried that payments are not affordable, counselors are ready to offer assistance. Your counselor will evaluate your situation, explain your options, and help identify appropriate next steps.

Rental Counseling

Our rental counseling service helps renters who would like to improve their rental situation or avoid eviction. Your counselor will discuss your credit report, income and budget, and create an action plan for your housing goals.

Non-Delinquency Post-Purchase Counseling

If you are already a homeowner with questions about what to do next, our housing counselors are available to help with maintaining and refinancing a home. Clients are assessed for individual needs and assisted with tools and services to successfully maintain a home.

Reverse Mortgage (HECM) Counseling

HECM counseling is designed to ensure that homeowners 62 and over fully understand the terms, costs, benefits, and risks of a reverse mortgage before committing. It provides unbiased guidance so borrowers can make an informed decision and consider alternatives.

Group Education Workshops

8-hour workshops where attendees receive information to prepare prospective homebuyers to make informed purchase decisions. Topics include: homebuyer readiness, money management, understanding credit, getting a mortgage loan, shopping for a home, keeping your home, and maintaining a home.

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Addendum C — Financial Partnerships

Sacramento Neighborhood Housing Services, Inc. (SNHS) has financial partnerships with the following organizations:

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Addendum D — Fair Lending Practices

Source: HUD

Discrimination

Discrimination in mortgage lending is prohibited by the federal Fair Housing Act. HUD's Office of Fair Housing and Equal Opportunity actively enforces these provisions. The Fair Housing Act makes it unlawful to engage in the following practices based on race, color, national origin, religion, sex, familial status, or handicap (disability):

Filing a Complaint

HUD investigates complaints at no cost to you. If you believe you have experienced lending discrimination, visit: hud.gov/program_offices/fair_housing_equal_opp/online-complaint

Subprime Lending

Subprime loans play a significant role in mortgage lending, making homeownership possible for families with blemished credit histories. While subprime loans serve a legitimate role, they tend to cost more and sometimes have less advantageous terms than prime market loans. Many have expressed fair lending concerns about the subprime market due to disparate impacts on minority communities.

Predatory Lending

Some lenders saddle borrowers with loans that come with outrageous terms and conditions, often through deception. The typical predatory loan: (1) carries costs in excess of those available from other lenders, (2) is not justified by the creditworthiness of the borrower, and (3) is secured by the borrower's home. HUD is working to fight against predatory lending.

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Addendum E — For Your Protection: Get a Home Inspection

HUD Form HUD-92564-CN | U.S. Department of Housing and Urban Development (FHA) | OMB Approval No: 2502-0538

CAUTION — Your Action is Required Soon

You must make a choice on getting a Home Inspection. It is not done automatically.

You have the right to examine carefully your potential new home with a professional home inspector. A home inspection is not required by law and will occur only if you ask for one and make the arrangements. You may schedule the inspection for before or after signing your contract. You may be able to negotiate with the seller to make the contract contingent on the results of the inspection. In a home inspection, a professional home inspector takes an in-depth, unbiased look at your potential new home to:

The Appraisal is NOT a Home Inspection and does not replace an inspection.

An appraisal estimates the market value of the home to protect the lender. It does not examine or evaluate the condition of the home to protect the homebuyer. An appraisal only verifies the home meets FHA or your lender's minimum property standards. A home inspection provides much more detail.

FHA and Lenders may not Guarantee the Condition of your Potential New Home

If you find problems with your new home after closing, neither FHA nor your lender may give or lend you money for repairs, and neither may buy the home back from you. Ask a qualified home inspector to inspect your potential new home and give you the information you need to make a wise decision.

Your Home Inspector may test for Radon, Health/Safety, and Energy Efficiency

EPA, HUD, and DOE recommend that houses be tested and inspected for radon, health and safety, and energy efficiency. For more information: Radon — call 1-800-SOS-Radon; Health and Safety — see HUD's Healthy Homes Program at HUD.gov; Energy Efficiency — see DOE's EnergyStar Program at energystar.gov.

Selecting a Trained Professional Home Inspector

Seek referrals from friends, neighbors, other buyers, realtors, and local licensing authorities. Consult the American Society of Home Inspectors (ASHI) at ashi.org or 1-800-743-2744.

I/We have read this document and understand that if I/we wish to get a home inspection, it is best to do so as soon as possible. The appraisal is not a home inspection. I/we will make a voluntary choice whether to get a home inspection. A home inspection will be done only if I/we ask for one and schedule it. Your lender may not perform a home inspection and neither FHA nor your lender may guarantee the condition of the home. Health and safety tests can be included in the home inspection if I/we choose.

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Addendum F — Ten Important Questions to Ask Your Home Inspector

  1. What does your inspection cover? The inspector should ensure their inspection meets all applicable state requirements and complies with a recognized standard of practice and code of ethics. Request to see a copy of these items ahead of time and identify any specific areas you want inspected.
  2. How long have you been practicing and how many inspections have you completed? The inspector should provide their history in the profession and references. Newer inspectors can be qualified and often work with more experienced partners.
  3. Are you specifically experienced in residential inspection? Related experience in construction or engineering is helpful, but is no substitute for training and experience in home inspection.
  4. Do you offer to do repairs or improvements based on the inspection? Some associations and state regulations allow this; others strictly forbid it as a conflict of interest.
  5. How long will the inspection take? The average on-site time for a single inspector is two to three hours for a typical single-family house. Significantly less may not be enough for a thorough inspection.
  6. How much will it cost? Costs vary by region, size, age, scope, and other factors. A typical range is $300–$500. Cost does not necessarily reflect quality. HUD does not regulate home inspection fees.
  7. What type of inspection report do you provide and how long will it take? Ask to see samples. Most inspectors provide their full report within 24 hours of the inspection.
  8. Will I be able to attend the inspection? An inspector's refusal should raise a red flag. Never pass up this opportunity to see your prospective home through the eyes of an expert.
  9. Do you maintain membership in a professional home inspector association? Request to see their membership ID and perform appropriate due diligence.
  10. Do you participate in continuing education programs? An inspector's commitment to continuing education is a good measure of professionalism, especially important for older homes or unique elements.

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Addendum G — CFPB Know Your Rights: Credit Discrimination is Illegal

Consumer Financial Protection Bureau (CFPB)

Credit Discrimination is Illegal

Under federal law, lenders are not allowed to discriminate against you based on: Race or Color, Religion, National origin, Sex (including gender identity and sexual orientation), Marital status, Age, or Receiving money from public assistance. The ECOA applies to all forms of credit: car loans, credit cards, home loans, student loans, and small business loans.

You are protected under the Equal Credit Opportunity Act (ECOA)

Enacted in 1974, ECOA makes credit discrimination illegal and holds lenders responsible. Enforcement agencies include the CFPB, Office of the Comptroller of Currency, Federal Reserve Board, FDIC, NCUA, Department of Justice, and Federal Trade Commission.

Protect Yourself from Discrimination

Warning Signs of Discrimination

If You Believe You Are the Victim of Credit Discrimination, Seek Help

Contact the CFPB

Online: consumerfinance.gov  |  Phone: (855) 411-CFPB (2372)  |  TTY/TDD: (855) 729-CFPB (2372)
Mail: Consumer Financial Protection Bureau, P.O. Box 4503, Iowa City, Iowa 52244

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Addendum H — Protect Your Family From Lead in Your Home

Source: U.S. Environmental Protection Agency, U.S. Consumer Product Safety Commission, and U.S. Department of Housing and Urban Development. EPA-747-K-12-001. March 2021. This document is in the public domain.

The following information is provided for your reference. Please review it carefully as it contains important health and safety information relevant to your home purchase.

Are You Planning to Buy or Rent a Home Built Before 1978?

Many homes built before 1978 have lead-based paint. Lead from paint, chips, and dust can pose serious health hazards.

Before renting or buying a pre-1978 home or apartment, federal law requires:

If undertaking renovations, repairs, or painting (RRP) projects in your pre-1978 home or apartment:

Simple Steps to Protect Your Family From Lead Hazards

If you think your home has lead-based paint:

How Lead Gets into the Body

Adults and children can get lead into their bodies if they:

Lead is especially dangerous to children under the age of 6. At this age, children's brains and nervous systems are more sensitive to the damaging effects of lead. Children's growing bodies absorb more lead. Babies and young children often put their hands and other objects in their mouths, which can have lead dust on them.

Women of childbearing age should know that lead is dangerous to a developing fetus. Women with a high lead level in their system before or during pregnancy risk exposing the fetus to lead through the placenta during fetal development.

Health Effects of Lead

Lead affects the body in many ways. It is important to know that even exposure to low levels of lead can severely harm children.

In children, exposure to lead can cause:

While low-level lead exposure is most common, exposure to high amounts of lead can have devastating effects on children, including seizures, unconsciousness, and in some cases, death.

In adults, exposure to lead can cause:

Check Your Family for Lead

Get your children and home tested if you think your home has lead. Children's blood lead levels tend to increase rapidly from 6 to 12 months of age, and tend to peak at 18 to 24 months of age. Consult your doctor for advice on testing your children. A simple blood test can detect lead. Blood lead tests are usually recommended for:

Your doctor can explain what the test results mean and if more testing will be needed.

Where Lead-Based Paint Is Found

In general, the older your home or childcare facility, the more likely it has lead-based paint. Many homes, including private, federally-assisted, federally-owned housing, and childcare facilities built before 1978 have lead-based paint. In 1978, the federal government banned consumer uses of lead-containing paint. Lead can be found:

Learn more about where lead is found at epa.gov/lead.

Identifying Lead-Based Paint and Lead-Based Paint Hazards

Deteriorated lead-based paint (peeling, chipping, chalking, cracking, or damaged paint) is a hazard and needs immediate attention. Lead-based paint may also be a hazard when found on surfaces that children can chew or that get a lot of wear and tear, such as windows and window sills, doors and door frames, and stairs, railings, banisters, and porches.

Lead-based paint is usually not a hazard if it is in good condition and if it is not on an impact or friction surface like a window. Lead dust can form when lead-based paint is scraped, sanded, or heated, or when painted surfaces containing lead bump or rub together.

EPA currently defines the following levels of lead in dust as hazardous:

EPA currently defines the following levels of lead in soil as hazardous:

The only way to find out if paint, dust, or soil lead hazards exist is to test for them.

Checking Your Home for Lead

You can get your home tested for lead in several different ways:

Be sure to read the report provided to you after your inspection or risk assessment is completed, and ask questions about anything you do not understand. Contact your state or local agency for more information, visit epa.gov/lead, or call 1-800-424-LEAD (5323).

What You Can Do Now to Protect Your Family

If you suspect that your house has lead-based paint hazards, you can take some immediate steps to reduce your family's risk:

Reducing Lead Hazards

Disturbing lead-based paint or removing lead improperly can increase the hazard to your family by spreading even more lead dust around the house.

Always use a certified contractor who is trained to address lead hazards safely. Hire a Lead-Safe Certified firm to perform renovation, repair, or painting (RRP) projects that disturb painted surfaces. To correct lead hazards permanently, hire a certified lead abatement contractor. This will ensure your contractor knows how to work safely and has the proper equipment to clean up thoroughly. Certified contractors will employ qualified workers and follow strict safety rules as set by their state or by the federal government.

If your home has had lead abatement work done or if the housing is receiving federal assistance, once the work is completed, dust cleanup activities must be conducted until clearance testing indicates that lead dust levels are below the following levels:

Renovating, Repairing, or Painting a Home with Lead-Based Paint

If you hire a contractor to conduct renovation, repair, or painting (RRP) projects in your pre-1978 home or childcare facility (such as pre-school and kindergarten), your contractor must:

RRP contractors working in pre-1978 homes and childcare facilities must follow lead-safe work practices that:

To learn more about EPA's requirements for RRP projects, visit epa.gov/getleadsafe.

Other Sources of Lead

Lead in Drinking Water: The most common sources of lead in drinking water are lead pipes, faucets, and fixtures. Lead pipes are more likely to be found in older cities and homes built before 1986. You cannot smell or taste lead in drinking water. To find out for certain if you have lead in drinking water, have your water tested.

Important steps you can take to reduce lead in drinking water:

Other sources of lead exposure include:

For More Information

The National Lead Information Center: Learn how to protect children from lead poisoning and get other information about lead hazards at epa.gov/lead and hud.gov/lead, or call 1-800-424-LEAD (5323).

EPA's Safe Drinking Water Hotline: For information about lead in drinking water, call 1-800-426-4791, or visit epa.gov/safewater.

Consumer Product Safety Commission (CPSC) Hotline: For information on lead in toys and other consumer products, or to report an unsafe consumer product or a product-related injury, call 1-800-638-2772, or visit cpsc.gov or saferproducts.gov.

State and Local Health and Environmental Agencies: Some states, tribes, and cities have their own rules related to lead-based paint. Check with your local agency to see which laws apply to you. Most agencies can also provide information on finding a lead abatement firm in your area and on possible sources of financial aid for reducing lead hazards. Visit epa.gov/lead for up-to-date contact information, or contact the National Lead Information Center at 1-800-424-LEAD.

Hearing- or speech-challenged individuals may access any of the phone numbers above through TTY by calling the toll-free Federal Relay Service at 1-800-877-8339.

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SNHS Pre-Purchase Counseling Intake Form

Thank You for Your Submission

We have received your intake form, and we appreciate you taking the time to complete it.

Please watch your inbox for an email from counseling@nwsac.org with the next steps in your process. Be sure to check your spam or junk folder if you do not see it shortly.

We look forward to connecting with you soon.

Sacramento Neighborhood Housing Services, Inc.
2411 Alhambra Blvd., Suite 200  |  Sacramento, CA 95817
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