Pathways to Homeownership

Eligibility Information

Do you require language translation assistance?*

Yes
No

Were you living in a rental unit that was impacted by the Memorial Day Tornadoes (May 27, 2019)*

Yes
No

Was your (or your co-applicant's) name on the lease for the rental property at that time (May 27, 2019)*

Yes
No

Was the unit the primary residence of the applicant on the date of the disaster (May 27, 2019)*

Yes
No

Was your (or your co-applicant's) name on the accounts for DP&L/AES or Vectren/Centerpoint for the rental property at that time (May 27, 2019)*

Yes
No

Are you currently receiving subsidized housing assistance? (Section 8, Housing Choice Voucher, or any other subsidized housing)*

Yes
No

I acknowledge that this program is based on household income. Eligible households are at or below 120% Area Median Income. Household income will be calculated by program staff.*

Yes
No

Applicant Information

Applicant’s Last Name*

Applicant’s First Name/Middle Initial*

Is there a co-applicant?*

Yes
No

Co-Applicant’s Last Name

Co-Applicant’s First Name/Middle Initial

Address*

Street Address City State ZIP Code

County*

Phone*

Alternate Phone

Email*

Family Type*

Single Parent/Female
Single Parent/Male
Two-Parent Household
Single Person
Two Adults/No Children
Non-related Adults with children
Multigenerational Household

Marital Status*

Married
Not Married

Are you a US Citizen or is anyone in your household (including a child under age 18) a US Citizen?*

Yes
No

Gender*

Female
Male
Other

Education*

0-8
9-12 (non-grad)
HS Grad/GED
Post-Secondary (non-grad)
Associate/Bachelor's Degree
Graduate Degree

Do any household members have a disability?*

Yes
No

Military Status*

Veteran
Active Military
N/A

How many people are in your household?*

List all household members living with you. List yourself first.

Last Name	First Name, Middle Initial	Relationship to Applicant	Date of Birth	Race	Ethnicity	# Months Live in Household

How did you learn about the Pathways to Homeownership Program?*

Sources of Income for the household: Check all that apply for the last 30 days*

Please provide details about your income for each source:*

Type of Income	Who receives it?	Amount Recieved in the last 30 Days?	Years at Job

Tornado Impact

Address at Time of Disaster- Provide basic information concerning the property you were residing in on May 27, 2019.*

Street Address City State ZIP Code

Were there any other names on the lease for the property at this time?*

Yes
No

Are you currently living in the disaster impacted property?*

Yes
No

Please provide a brief explanation on how your household was impacted by the Memorial Day Tornados:

Certification and Authorization Please read the following carefully and in acknowledgement of this policy, please sign your name and date where indicated. I certify the following:

I certify the following by checking each statement:

Select All
All the information contained and submitted in support of this application is true and complete to the best of my/our knowledge and belief
I/We are aware that any misrepresentation will result in the forfeiture of my/our right to participate in the Tornado Survivor Pathway to Homeownership Program and may result in legal action agains me/us.
I/We understand that completion of this application does not guarantee that my/our eligibility for the Tornado Survivor Pathway to HomeOwnership Program
I/We certify that I/we were living in the disaster property address I/we provided on our application and that it was my/our primary residence on May 27, 2019
I/We authorize the staff of the County Corp to obtain specific reports, such as credit reports, which said staff deems necessary to perform its functions. I/We understand that information in this application may be shared with funders for the purpose of 3rd Party verification and funding compliance.

Applicants Authorization: I acknowledge that a photocpy of this form is as valid as the original; I have the right to review information received using this form; I have the right to a copy of information provided to the HomeOwnership Center of Greater Dayton and to request correction of any information I believe to be inaccurate; AND All adult household members will sign this form and cooperate with the HomeOwnership Center of Greater Dayton in the eligibility verification process.

Applicant Signature*

Co-Applicant Signature*

The following documents MUST be submitted before The HomeOwnership Center can evaluate eligibility:

Lease in the applicant's name for the appropriate time period
Driver's license listing the impacted dwelling address valid at the time of the storm.

Occupancy Documents (One of the following):

Copy of a utility bill- electric (DP&L/AES) or natural gas bill (Vectren/Centerpoint) in the applicant's name that encompasses service for May 27, 2019. The bill must match a name and address on the program application. See "How to Get a copy of Your Utility Bill" on our website.
Other documents may be considered on a case by case basis.

Please call us if you have questions about the program or required documents: 937-853-1600.

Upload the required documents now.*

Drop files here or

Max. file size: 32 MB.

Equal Opportunity: In accordance with the provisions of the Equal Opportunity Act and the Tornado Survivor Pathway to Homeownership Program (PTHO) policies, there will be no discrimination against an applicant for these benefits on the basis of age, source of income, sex, race, marital status, sexual orientation, national origin, religion or handicap. If you or a member of your household is an individual with a disability, you have the right to request reasonable accommodation for that disability. The PTHO Program Grantees and subcontractors are committed to assuring that each individual has an equal opportunity to the use and enjoyment of the benefits of this program.

Confidentiality: In order to process an application, the County Corp may supply and receive information as detailed in the "Consent to Release" clause that you will execute. Information may also be released to comply with the auditing requirements of program funders. With these two exceptions, all personal and identifying information on an application remains fully confidential.

Eligibility Information

Applicant Information

Tornado Impact

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The HomeOwnership Center is an Equal Opportunity Lender

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