HOUSING CREDIT REPORT AUTHORIZATION AND PRIVACY DISCLOSURE FORM

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					HOUSING CREDIT REPORT AUTHORIZATION AND PRIVACY DISCLOSURE FORM


I hereby authorize and instruct the Urban League of Southern Connecticut, Inc. hereinafter
“Urban League” to obtain and review my credit report. My credit report will be obtained from a
credit-reporting agency chosen by the Urban League. I understand and agree that the Urban
League intends to use the credit report for the purpose of evaluating my financial readiness to
purchase a home and/or to engage in post-purchase counseling activities.

My signature below also authorizes the release to credit reporting agencies of financial or other
information that I have supplied to the Urban League in connection with such evaluation.
Authorization is further granted to the credit-reporting agency to use a copy of this form to obtain
information the credit reporting agency deems necessary to complete my credit report.

In addition, in connection with determining my ability to obtain a loan, I
               ________Authorize                                ________Do not authorize

the Urban League to share with potential mortgage lenders and/or counseling agencies my
credit report and any information that I have provided, including any computations and
assessments that have been produced based upon such information. These lenders may
contact me to discuss loans for which I may be eligible, and these counseling agencies may
contact me to discuss counseling services.

I understand that I may revoke my consent to these disclosures by notifying the Urban League
in writing.
___________________________________                   ______________________________________
Applicant Signature                                   Co-Applicant Signature

___________________      _____________                ___________________       ____________
Social Security Number   Date                         Social Security Number    Date




*Program fees may apply                                                              Rev. 1.13.2009
                            HOUSING SERVICE AGREEMENT


By completing the Urban League’s Homeownership Workshop you become eligible for
mortgage products available for low to moderate-income families. After completing the ten (10)
hours of classroom instruction, the Urban League’s Housing Counselor agrees to support you
through the home purchasing process in a one-on-one environment including but not limited to;

   1. Assisting in creating a budget to determine your housing needs and affordability,

   2. Review credit history to determine credit worthiness,

   3. Pre-qualify you to determine loan eligibility,

   4. Refer pre-approved candidates to a non-predatory lending Institution,

   5. And if needed, refer a realtor, attorney and home inspector

As a potential homeowner you agree to;

   1. Pay the program fee to cover program materials and credit report fees

   2. Attend ten (10) hours of Homebuyers education and any additional seminars as deemed
      necessary by the Housing Counselor or lender,

   3. Secure requested financial documents in a timely manner,

   4. Keep scheduled appointments (cancellation requires 24 hour notice) and,

   5. If applying for HOME/HUD funds for down payment assistance, you agree to pay a
      processing fee payable to the “Urban League of Southern CT, Inc.”, at closing.


Applicant_______________________________________       Co-Applicant___________________________

Housing Counselor_______________________________       Date___________________________________




*Program fees may apply                                                          Rev. 1.13.2009