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Putnam Housing
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Homebuyer Intake Form

1 Applicant
2 Co Applicant
3 Additional Info
4 Worksheet
5 Privacy Policy
6 Opt-Out Election Form
7 Disclosure
8 Authorization
  • *Please be sure to fill out all questions and fields.
  • Please enter a number from 1 to 100.
  • Date Format: MM slash DD slash YYYY
  • Specify Company, Balance Owed, Minimum Required Payment, & Status of Account for Each.
  • *Please be advised this is NOT an application to apply for financing or grant assistance. This is used for registration and demographics purposes only. ** The following questions are being asked for statistical purposes. Your answer will not affect, in any way, your enrollment for our programs.
  • Complete Budget

    Use this worksheet to see how much money you spend this month. Then, use this month’s information to help you plan next month’s budget. Some bills are monthly and some come less often. If you have an expense that does not occur every month, put it in the “Other expenses this month” category.

    Be sure to fill out all fields
  • My income this month

  • My expenses this month

  • Housing
  • Food
  • Transportation
  • Health
  • Personal and Family
  • Personal and Family
  • Personal and Family
  • Putnam County Housing Corporation is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations. Your "non-public personal information," such as your total debt information, income, living expenses and personal information concerning your financial circumstances, will be provided to creditors, program monitors, and others only with your authorization and signature. We may also use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable research information and designing future programs.

    Types of information that we may gather about you:

    1. Information we receive from you orally, on applications or other forms, such as your name, address, social security number, assets and income;

    2. Information about your transactions with us, your creditors, or others, such as your account balance, payment history, parties to transactions and credit card usage; and

    3. Information we receive from a credit reporting agency, such as your credit history.

    You may Opt-out of certain disclosures:

    1. You have the opportunity to "opt-out" of disclosures of your nonpublic personal information to third parties.

    2. If you choose to 'opt-out," we will not be able to answer questions from your creditors. If at any time you wish to change your decision with regard to your "opt-out," you may contact us.

    Release of your information to third parties:

    1. So long as you have not opted-out, we may disclose some or all of the information that we collect, as described above, to your creditors or third parties where we have determined that it would be helpful to you, would aid us in counseling you, or is a requirement of grant awards which make our services possible.

    2. We may also disclose any nonpublic personal information about you or former customers to anyone as permitted by law.

    3. Within the organization, we restrict access to nonpublic personal information about you 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.

    I understand that my name and telephone number will not be shared with other parties, but that other information gathered may be used for research, program or policy development, or other legitimate purposes by the New York State Office of the Attorney General and parties with which it contracts (such as the Center for New York City Neighborhoods and Empire Justice Center), the City of New York, or other relevant funders of foreclosure prevention services.
  • 1. I understand that Putnam County Housing Corporation (PCHC) provides Housing Counseling with funding from the U.S. Department of Housing and Urban Development (HUD) and other state and federal agencies.

    2. I understand as a part of funding requirements, some of my person information will be shared with program administrators or their evaluators

    3. 1. I acknowledge that I have received a copy of Putnam County Housing Corporation’s Privacy Policy. I have elected to OPT-OUT of disclosures of my nonpublic personal information to third parties.
  • I/We understand that the purpose of the housing counseling program is to provide one-on-one
    counseling to assist me/us with our counseling needs. The counselor will analyze my/our financial
    situation, identify those barriers preventing me/us from resolving our current situation, and develop
    a plan to remove those barriers. I/We further understand that it will not be the responsibility of the
    counselor to fix the problem for me/us but rather to provide guidance and education to empower
    me/us in fixing those issues. Type of services we provide are:
    Mortgage Delinquency and Default Resolution Counseling
    Provides counseling to homeowners at risk or in foreclosure
    Pre-purchase Counseling
    Preparing clients to become first time homebuyers
    Rental Housing Counseling
    Assists clients with their housing and financial situation
    Reverse Mortgage Counseling
    Provides statutory-required counseling to clients age 62 or older who are interested in
    obtaining an FHA-insured HECM.
    Services for Homeless Counseling
    Counseling is provided to individuals needing information regarding emergency
    shelters, transitional housing and referrals.
    Pre-purchase Homebuyer Education
    Partners with EHomeAmerica to provide online homebuyer education for a fee of $99.00

    Funders include U.S. Department of Housing and Urban Development, New York State Attorney
    General’s Office, the New York State Division of Housing and Community Renewal and the State
    of New York Mortgage Agency.

    Putnam County Housing Corporation offers the following services and has financial relationships
    with following industry partners:
    HUD Housing Choice Voucher Program (Section 8)
    HUD Comprehensive Housing Counseling Program
    NYS Attorney General’s Home Ownership Protection Program (HOPP)
    SONYMA/NCC Restart Program
    Family Self-Sufficiency Program (FSS)
    Federal Home Loan Bank (FHLB) Homebuyer Dream Program with local partners:
    Tompkins Mahopac Bank; M & T Bank; PCSB Bank; and Hudson Valley Federal Credit Union.
    Lakeview Housing Development Fund
    Gleneida Housing Development Fund
    Gleneida Senior Apartments
    Senior Housing at Mahopac Hills

    I/We understand that Putnam County Housing Corporation provides information and education
    on alternative services, programs and products. I/We further understand that we are not obligated to
    receive any other services offered by the organization or its exclusive partners.
  • I/We are working with the Putnam County Housing Corporation in Carmel, New York (a HUD certified counseling agency) (PCHC). I/We hereby authorize you to release any and all information concerning our account to the PCHC at their request. I/We further authorize you to discuss our case with Margherita Diaz or Suzanne Brought.

11 Seminary Hill Road
Carmel, New York 10512
845-225-8493

Services

  • Free Foreclosure Help
  • Reverse Mortgage
  • Free Housing Counseling
  • Home Ownership
  • Home Improvement
  • Housing Choice Voucher
  • Maintenance Department

Office Hours

8:30 am to 4:30 pm
Monday – Friday

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