Sacramento Neighborhood Housing Services, Inc. (SNHS)
Foreclosure 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
Did you own a home during the 3 years prior to purchasing your current home? *
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 — Mortgage Information
Received payment assistance from COVID-19 moratoria? *
Sale Date (if applicable)
Home Purchase Date *
Type of Mortgage *
Is your mortgage loan made, insured, guaranteed, or held by HUD, VA, or USDA? *
Current on Property Taxes? *
Current on Home Insurance? *
Do you have a secondary loan? *
Is your secondary loan current? *
Do you intend to retain the home, or sell/transfer? *
I/We authorize Sacramento Neighborhood Housing Services, Inc. (SNHS) to release and receive account information related to my/our mortgage loan, including name, address, SSN, credit score, income, loan status, account balances, and payment activity. This authorization is valid when signed by all borrowers and remains in effect until revoked in writing.
⚠ BEWARE OF FORECLOSURE RESCUE SCAMS — verify HUD-approved agencies at apps.hud.gov. Never pay a fee for counseling or loan modification services.
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Date:
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Date:
Section 8 — 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.
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Date:
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Date:
Section 10 — 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 in or facing foreclosure, 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. *
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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.
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Date:
Section 11 — 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.
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Date:
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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.
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 — 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 Foreclosure 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
Please keep this confirmation for your records.