Enrollment Online Application: Foreclosure Prevention

1. Instructions

PLEASE READ CAREFULLY BEFORE STARTING SURVEY.

Thank you for providing Prosperity Unlimited the opportunity to partner with you in reaching your goal for foreclosure prevention, home retention, and/or increasing your long-term financial sustainability.

You have taken the First Step by requesting the Enrollment Application Package.

Listed below is the process:

Step Two: Complete Online Application and provide the Required Documents that was emailed to you. They are needed to complete your assessment.

Please read carefully the instructions on the delivery of the required documents to Prosperity.

Documents can be delivered via:

Fax: 704-938-7431
Email: helpdesk@prosperitycdc.org (must be in “PDF” format) Do not send pictures, zipped files or use Google Docs or Dropbox
Mailing Address: Prosperity Unlimited, Inc.; P. O. Box 1095; Concord, NC 28026
Hand delivered by appointment only – Please call 704-933-7405

1660 Garnet Street, Kannapolis, NC 28083

Do not mail your information to the physical address – UPS or FedEX only.

Step Three: Once you have provided the required documents, the Counselor will assess your case and may pull a tri-merge “soft hit” credit report if necessary for the evaluation. Through this your file will be assessed for the following:

Foreclosure Prevention and/or Relief Assistance (if available):
Stage of delinquency;
Housing affordability;
Types of loan retention option (if applicable);

Other Services:
Credit Enhancement Education;
Money Management and Budgeting;

Step Four: Attend the appointment that will be scheduled for you to meet with a Counselor via Zoom or Phone Session for a detailed counseling session and a review of your assessment.

NOTE: A session will not be scheduled until you provide all the required documentation.

After this step you will be guided through which program best fits your housing and financial goal. Once you have provided the required documents, the Counselor will pull a tri-merge “soft hit” credit report and along with the documents you provided will assess your information for the following:

a) Eligibility for Submission of Application for Servicer (Lender) programs.

Should you have any questions, about the process you may email sconley@prosperitycdc.org or helpdesk@prosperitycdc.org.

Question Title

* 1. Applicant (Borrower)

First & Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Co-Applicant (co-borrower), Partner or other adult whom will be living in the house

First & Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 3. Will the person in Question 2 be included on the determination?

Yes - (include all documentation on the Required Documentation Checklist)

No - (include all documentation on the Required Documentation Checklist)

Not Applicable

Question Title

* 4. Do you have a pending eviction date?

Yes

If Yes, please enter the date and provide a copy of the documentation.

Question Title

* 5. Do you have a pending Foreclosure Hearing date?

Yes

If Yes, please enter the date and provide copy of the documentation.

Question Title

* 6. Do you have a pending Foreclosure Sale date?

Yes

If Yes, please enter the date and provide copy of the documentation.

Question Title

* 7. What county do you live in?

Question Title

* 8. Rural Area Status

Household lives in a rural area

Household does not live in a rural area

Question Title

* 9. Residency Status

Own

Rent

Other (please specify)

Question Title

* 10. What is your monthly rent or house payment?

Question Title

* 11. Are you current on your monthly rent or house payment?

Yes

If no, how many months behind and what is the dollar amount?

Question Title

* 12. How long have you live at current address?

Question Title

* 13. Race - Borrower/Applicant:

White or Caucasian

Black or African American

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Choose not to respond

Other (please specify)

Question Title

* 14. Race - Co-Applicant/Co-Borrower/Partner:

White or Caucasian

Black or African American

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Choose not to respond

Other (please specify)

Question Title

* 15. Ethnicity - Borrower/Applicant:

	Hispanic/Latino	Not Hispanic/Latino	Choose not to response	N/A
Applicant/Borrower	Applicant/Borrower Hispanic/Latino	Applicant/Borrower Not Hispanic/Latino	Applicant/Borrower Choose not to response	Applicant/Borrower N/A
Co-applicant/Borrower	Co-applicant/Borrower Hispanic/Latino	Co-applicant/Borrower Not Hispanic/Latino	Co-applicant/Borrower Choose not to response	Co-applicant/Borrower N/A

Question Title

* 16. Date of Birth - Borrower/Applicant:

Enter below:

Date

Question Title

* 17. Date of Birth - Co-Borrower/Co - Applicant:

Enter below:

Date

Question Title

* 18. What is your gender?

	Female	Male	N/A
Borrower/Applicant	Borrower/Applicant Female	Borrower/Applicant Male	Borrower/Applicant N/A
Co-borrower/Co-Applicant	Co-borrower/Co-Applicant Female	Co-borrower/Co-Applicant Male	Co-borrower/Co-Applicant N/A

Question Title

* 19. Marital Status:

	Married	Separated	Divorced	Never been married	Domestic Partners	Not Applicable
Applicant	Applicant Married	Applicant Separated	Applicant Divorced	Applicant Never been married	Applicant Domestic Partners	Applicant Not Applicable
Co-applicant	Co-applicant Married	Co-applicant Separated	Co-applicant Divorced	Co-applicant Never been married	Co-applicant Domestic Partners	Co-applicant Not Applicable

Question Title

* 20. Citizenship:

	Non-Resident Alien - Please provide documentation	US Citizen - Please provide Social Security Card & Driver's License	Permanent Resident - Please provide documentation	DACA - - Please provide Social Security Card & Driver's License
Applicant	Applicant Non-Resident Alien - Please provide documentation	Applicant US Citizen - Please provide Social Security Card & Driver's License	Applicant Permanent Resident - Please provide documentation	Applicant DACA - - Please provide Social Security Card & Driver's License
Co-Applicant	Co-Applicant Non-Resident Alien - Please provide documentation	Co-Applicant US Citizen - Please provide Social Security Card & Driver's License	Co-Applicant Permanent Resident - Please provide documentation	Co-Applicant DACA - - Please provide Social Security Card & Driver's License

Other (please specify)

Question Title

* 21. List Dependent(s) - Birth dates (MM/DD/YYYY) and Age
Example: Jane Doe - 01/01/2015 - 5 add N/A if not applicable

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* 22. Preferred Language:

	Applicant/Borrower	Co-applicant/Co-Borrower
English	English Applicant/Borrower	English Co-applicant/Co-Borrower
Spanish	Spanish Applicant/Borrower	Spanish Co-applicant/Co-Borrower
Other	Other Applicant/Borrower	Other Co-applicant/Co-Borrower

Other (please specify)

Question Title

* 23. What is the highest level of education you have completed?

	Choose Highest Level of Education
Applicant/Borrower	Applicant/Borrower Choose Highest Level of Education menu
Co-applicant/Co-Borrower	Co-applicant/Co-Borrower Choose Highest Level of Education menu

Question Title

* 24. Have you been affected by COVID-19?

	Yes - Job Loss with no unemployment	Yes - Loss of Hours	Yes - Job Loss with unemployment	No longer receiving unemployment	N/A
Participants	Participants Yes - Job Loss with no unemployment	Participants Yes - Loss of Hours	Participants Yes - Job Loss with unemployment	Participants No longer receiving unemployment	Participants N/A
Co-Participants	Co-Participants Yes - Job Loss with no unemployment	Co-Participants Yes - Loss of Hours	Co-Participants Yes - Job Loss with unemployment	Co-Participants No longer receiving unemployment	Co-Participants N/A

Other and if still receiving unemployment how much?

Question Title

* 25. Disabled:

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A

Question Title

* 26. Veteran/Military:

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A

Question Title

* 27. Are you currently in a IRS or State tax repayment plan?

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
If the answer is yes, what is the monthly amount?
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A
If the answer is yes, what is the monthly amount?

Question Title

* 28. Do you receive child support?

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
If the answer is yes, what is the monthly amount?
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A
If the answer is yes, what is the monthly amount?

Question Title

* 29. Do you pay child support?

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
If the answer is yes, what is the monthly amount?
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A
If the answer is yes, what is the monthly amount?

Question Title

* 30. Do you receive Disability/Social Security Benefits?

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
If the answer is yes, what is the monthly amount?
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A
If the answer is yes, what is the monthly amount?

Question Title

* 31. Do you receive Retirement/Other Income?

	Yes	No	N/A
Borrower/Applicant	Borrower/Applicant Yes	Borrower/Applicant No	Borrower/Applicant N/A
If the answer is yes, what is the monthly amount?
Co-Borrower/Co-Applicant	Co-Borrower/Co-Applicant Yes	Co-Borrower/Co-Applicant No	Co-Borrower/Co-Applicant N/A
If the answer is yes, what is the monthly amount?

Question Title

* 32. What is Borrower/Applicant employment history?

Employer/Income Source:

Position/Title:

Start Date:

End Date:

Hourly Rate:

# of hours per week:

Question Title

* 33. What is Borrower/Applicant employment history if less than two years in Question 32 or second job?

Employer/Income Source:

Position/Title:

Start Date:

End Date:

Hourly Rate:

# of hours per week:

Question Title

* 34. How often are you paid?

Weekly

Bi-weekly (every other week)

Semi-Monthly ( twice a month)

Monthly

Question Title

* 35. Does Borrower/Applicant work for a school system?

Yes

Not Applicable

Question Title

* 36. If the answer to Question 35 is yes, Is Borrower/Applicant a 10 or 12 month employee?

10 month employee

12 month employee

None of the above

Question Title

* 37. What is Co-Borrower/Co-Applicant employment history?

Employer/Income Source:

Position/Title:

Start Date:

End Date:

Hourly Rate:

# of hours per week:

Question Title

* 38. What is Co-Borrower/Co-Applicant employment history if Question 37 is less than two years or second job?

Employer/Income Source:

Position/Title:

Start Date:

End Date:

Hourly Rate:

# of hours per week:

Question Title

* 39. How often is Co-Borrower/ Co- Applicant paid?

Weekly

Bi-weekly (every other week)

Semi-monthly (twice a month)

Monthly

Not Applicable

Question Title

* 40. Does Co-Borrower/Co-Applicant work for a school system?

Yes

Not Applicable

Question Title

* 41. Is the answer to question 40 is yes, is co-borrower/co-applicant a 10 or 12 month employee?

Yes, 10 month employee

Yes, 12 month employee

None of the above

Question Title

* 42. PLEASE READ CAREFULLY - APPLICANT CERTIFICATION: All of the information that I/We provided in this application for assistance is correct, complete and factual. No information has been withheld. We understand the necessity for accurate and complete information and we will provide any needed information to complete this application. We understand that deliberately providing inaccurate information or an unwillingness to timely provide the counselor with the necessary information or documents to assist us will result in a closing of our file.

	Yes	No	No. I realize that some services may not be available.
Applicant/Borrower	Applicant/Borrower Yes	Applicant/Borrower No	Applicant/Borrower No. I realize that some services may not be available.
Co-applicant/Co-borrower	Co-applicant/Co-borrower Yes	Co-applicant/Co-borrower No	Co-applicant/Co-borrower No. I realize that some services may not be available.

Enrollment Online Application: Foreclosure Prevention

1. Instructions

Question Title

* 1. Applicant (Borrower)

Question Title

* 2. Co-Applicant (co-borrower), Partner or other adult whom will be living in the house

Question Title

* 3. Will the person in Question 2 be included on the determination?

Question Title

* 4. Do you have a pending eviction date?

Question Title

* 5. Do you have a pending Foreclosure Hearing date?

Question Title

* 6. Do you have a pending Foreclosure Sale date?

Question Title

* 7. What county do you live in?

Question Title

* 8. Rural Area Status

Question Title

* 9. Residency Status

Question Title

* 10. What is your monthly rent or house payment?

Question Title

* 11. Are you current on your monthly rent or house payment?

Question Title

* 12. How long have you live at current address?

Question Title

* 13. Race - Borrower/Applicant:

Question Title

* 14. Race - Co-Applicant/Co-Borrower/Partner:

Question Title

* 15. Ethnicity - Borrower/Applicant:

Question Title

* 16. Date of Birth - Borrower/Applicant:

Question Title

* 17. Date of Birth - Co-Borrower/Co - Applicant:

Question Title

* 18. What is your gender?

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* 19. Marital Status:

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* 20. Citizenship:

Question Title

* 21. List Dependent(s) - Birth dates (MM/DD/YYYY) and AgeExample: Jane Doe - 01/01/2015 - 5 add N/A if not applicable

Question Title

* 22. Preferred Language:

Question Title

* 23. What is the highest level of education you have completed?

Question Title

* 24. Have you been affected by COVID-19?

Question Title

* 25. Disabled:

Question Title

* 26. Veteran/Military:

Question Title

* 27. Are you currently in a IRS or State tax repayment plan?

Question Title

* 28. Do you receive child support?

Question Title

* 29. Do you pay child support?

Question Title

* 30. Do you receive Disability/Social Security Benefits?

Question Title

* 31. Do you receive Retirement/Other Income?

Question Title

* 32. What is Borrower/Applicant employment history?

Question Title

* 33. What is Borrower/Applicant employment history if less than two years in Question 32 or second job?

Question Title

* 34. How often are you paid?

Question Title

* 35. Does Borrower/Applicant work for a school system?

Question Title

* 36. If the answer to Question 35 is yes, Is Borrower/Applicant a 10 or 12 month employee?

Question Title

* 37. What is Co-Borrower/Co-Applicant employment history?

Question Title

* 38. What is Co-Borrower/Co-Applicant employment history if Question 37 is less than two years or second job?

Question Title

* 39. How often is Co-Borrower/ Co- Applicant paid?

* 21. List Dependent(s) - Birth dates (MM/DD/YYYY) and Age
Example: Jane Doe - 01/01/2015 - 5 add N/A if not applicable