Senior Housing Application

1People

2Income

3Info

4Make a Budget

5Certification

6Disclosure

Which senior housing are you applying for?*
List each person who would live with you if you receive housing assistance. (Start with yourself.)
Name*
First Last
Date of Birth*
Month
Day
Year
Sex
Annual Income
Social Security*
Add a person?
- Yes
- No
Name
First Last
Date of Birth
Day
Month
Year
Sex
Relationship
Annual Income
Social Security
Add another person?
- Yes
- No
Name
First Last
Date of Birth
Month
Day
Year
Sex
Relationship
Annual Income
Social Security

Putnam County Housing Corporation Comprehensive Housing Counseling Program Disclosure
Consent
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.
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.
Signature
Date

Senior Housing Application

List each person who would live with you if you receive housing assistance. (Start with yourself.)

List Annual Income

Information

Check one box each “a” and “b” (For statistical purpose only)

Make a Budget

My income this month

My expenses this month

Food

Transportation

Health

Personal & Family

Finance

Other

Applicant Certification

Services

Office Hours