CLASS REGISTRATION FORM - Home Ownership Center of Greater Cincinnati

Homebuyer Information

Homebuyer's Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Cell Phone

Email *

Co-Homebuyer Information

Co-Homebuyer's Name

First

Last

Is the Co-Homebuyer's address different then the homebuyer's?

Yes
No

Co-Homebuyer Phone

Co-Homebuyer's Email

The following information is requested by the federal government in order to monitor compliance with federal statutes that prohibit discrimination in housing. You are not required to furnish this information but are encouraged to do so. The law provides that a lender/servicer or counseling agency may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, the lender/servicer or counseling agency is required to note the information on the basis of visual observation or surname if you have made this request for a loan or counseling assistance in person. If you do not wish to furnish the information, please check the box below

Homebuyer's Race and ethnic information

Yes I will furnish this information
No I will not furnish this information

Co-Homebuyer's Race and ethnic information

Yes I will furnish this information
No I will not furnish this information

Homebuyer Education

Co-Homebuyer Education

Please select highest level of education of the co-homebuyer

Total Household Size

How many dependents

Dependent's Ages

Are there non-dependents who will be living in the home?

Yes
No

Marital Status

Single
Married
Divorced
Separated

Household Type

Widowed
Male headed single parent
Female headed single parent
Two or more unrelated adults

Additional Household Type

Homebuyer Employment Information

Homebuyer's Primary Employer

Homebuyer's Position/Title

Homebuyer's Date Hired

Homebuyer's Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Homebuyer's Employer Phone

Full Time
Part Time

Homebuyer's Gross Monthly Income

How is the Homebuyer Paid?

weekly
monthly
every two weeks
twice a month

Co-Homebuyer Employment Information

Co-Homebuyer's Primary Employer

Co-Homebuyer's Position/Title

Co-Homebuyer's Date Hired

Co-Homebuyer's Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Co-Homebuyer's Employer Phone

Is the Co-Homeowner

Full Time
Part Time

Co-Homebuyer's Gross Monthly Income

How is the Co-Homebuyer Paid?

weekly
monthly
every two weeks
twice a month

Other Income Sources

Child Support

Yes
No

Social Security

Yes
No

Retirement Income

Yes
No

Self-Employment

Yes
No

Disability

Yes
No

Alimony

Yes
No

Other Income

Yes
No

Are you a FIRST-TIME homebuyer: (currently you do not own a home nor have you owned a home in the last three (3) years)?

Yes
No

Current Housing Arrangement (Select One)

Phone

Homebuyer Education Class

Homebuyer Information

Co-Homebuyer Information

Homebuyer Education

Co-Homebuyer Education

Total Household Size

Homebuyer Employment Information

Co-Homebuyer Employment Information

Other Income Sources

2820 Vernon Place
Cincinnati, OH 45219

Quick Links

Homebuyer Education Class

Homebuyer Information

Co-Homebuyer Information

Homebuyer Education

Co-Homebuyer Education

Total Household Size

Homebuyer Employment Information

Co-Homebuyer Employment Information

Other Income Sources

2820 Vernon PlaceCincinnati, OH 45219

Quick Links

2820 Vernon Place
Cincinnati, OH 45219