Sacramento Neighborhood Housing Services, Inc. (SNHS)
Rental 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
Are you in a lease or month-to-month tenancy? *
Have you been served a notice to vacate? *
Are you involved in an unlawful detainer trial? *
Enrolled in a rental assistance program? *
Are you looking to transition from renting to owning? *
If looking to own, in what zip codes are you looking? *
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? *
Co-Applicant Full Name
Co-Applicant Date of Birth
Co-Applicant Gender
Co-Applicant Race
Co-Applicant Ethnicity
Co-Applicant Primary Language
Relation to Applicant
Co-Applicant Citizenship Status (We collect citizenship status solely to help match you with assistance programs and resources you may be eligible for.)
Co-Applicant — Yes / No Questions
Question
Answer
Head of Household
Foreign Born
Veteran
Disabled
Co-Applicant Active Military / Armed Forces Service?
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.
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
1.I understand that SNHS provides housing counseling and a written action plan.
2.I understand a credit report is required to review my credit file for housing counseling and agree to provide it per the Credit Report Authorization.
3.I understand SNHS receives Congressional funds and must submit client data for program compliance.
4.I may be referred to other agencies. I am not obligated to use any services offered.
Sign here
Date:
Sign here
Date:
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. If you are facing foreclosure or homelessness, there is NO CHARGE to pull your report.
Would you like a credit verification? *
Credit Report Authorization — Applicant
I choose to provide SNHS with my credit report prior to my housing counseling appointment. I authorize SNHS to pull my credit report via CoreLogic Credco. I agree to pay $33.50 per person, per report at the time of my appointment. I will provide a copy of my photo ID and social security number prior to my appointment. *
Sign here
Date:
Credit Report Authorization — Co-Applicant
If you do not have a Co-Applicant, you may skip this authorization.
I choose to provide SNHS with my credit report prior to my housing counseling appointment. I authorize SNHS to pull my credit report via CoreLogic Credco. I agree to pay $33.50 per person, per report at the time of my appointment. I will provide a copy of my photo ID and social security number prior to my appointment.
Sign here
Date:
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
1.I understand that SNHS provides housing counseling. A written action plan will be provided consisting of recommendations for handling my situation, possibly including referrals to other housing agencies as appropriate.
2.I understand that a credit report is recommended for SNHS to provide the best assessment for clients.
3.I understand that SNHS receives Congressional funds for housing counseling. As such, it is required to submit client-level information through the online reporting system with program administrators or their agents for program monitoring, compliance, and evaluation.
4.I may be referred to other housing services or agencies as appropriate. I understand that I am not obligated to use any of the services offered to me.
5.I can "opt-out" of disclosures of my non-public personal information to third parties (such as my creditors).
6.If I choose to "opt-out," SNHS will not be able to answer questions from my creditors. To change my decision, I may call (916) 452-5356.
Applicant to opt-out initial here:Co-Applicant:
Third-Party Release Information
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.
We may also disclose any nonpublic personal information about you as permitted by law (e.g., if compelled by legal process).
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.
Sign here
Date:
Sign here
Date:
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.
I have read and acknowledge this section. Applicant initials:Co-Applicant initials:
Addendum C — Financial Partnerships
Sacramento Neighborhood Housing Services, Inc. (SNHS) has financial partnerships with the following organizations:
BALANCE
Bank of America
CalHFA
Cathay Bank Foundation
City of Folsom
City of Stockton
eHome America
El Dorado Savings Bank
Fannie Mae
HUD
NeighborWorks America
Sacramento Housing and Redevelopment Agency (SHRA)
Wells Fargo Inc.
Yolo Federal Credit Union
I have read and acknowledge this section. Applicant initials:Co-Applicant initials:
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):
Refuse to make a mortgage loan
Refuse to provide information regarding loans
Impose different terms or conditions on a loan, such as different interest rates, points, or fees
Discriminate in appraising property
Refuse to purchase a loan or set different terms or conditions for purchasing a loan
Discriminate in providing other financial assistance for purchasing, constructing, improving, repairing, or maintaining a dwelling
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.
I have read and acknowledge this section. Applicant initials:Co-Applicant initials:
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:
Evaluate the physical condition: structure, construction, and mechanical systems
Identify items that need to be repaired
Estimate the remaining useful life of major systems, equipment, structure, and finishes
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.
I have read and acknowledge this section. Applicant initials:Co-Applicant initials:
Addendum F — Ten Important Questions to Ask Your Home Inspector
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.
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.
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.
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.
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.
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.
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.
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.
Do you maintain membership in a professional home inspector association? Request to see their membership ID and perform appropriate due diligence.
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.
I have read and acknowledge this section. Applicant initials:Co-Applicant initials:
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
Do your research: Shop around and compare offers from several lenders. Research current interest rates.
Know your credit history: Request a free credit report every 12 months from AnnualCreditReport.com.
Stay in control: Your lender should not make you feel rushed or unnecessarily delay action on your application.
Be sure before signing: You should never feel pressured to sign. Make sure the terms work for you.
Ask questions: Do not focus only on the monthly payment. Ask about rates and the total amount of interest and fees.
Warning Signs of Discrimination
Treated differently in person than on the phone
Discouraged from applying for credit
Hearing the lender make negative comments about race, national origin, sex, or other protected factors
Refused credit even though you qualify based on advertised requirements
Offered credit with a higher interest rate than the one you qualify for
If You Believe You Are the Victim of Credit Discrimination, Seek Help
I have read and acknowledge this section. Applicant initials:Co-Applicant initials:
SNHS Rental Counseling Intake Form
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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
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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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