VHDA Down Payment Grants Online Pre-Enrollment

Thank you for your interest in the VHDA $0 Down Payment program. Upon completion of this form, one of our Agents will contact you to discuss the approval process, finding a home that qualifies and what to expect during the process. Pre-enrolling for help with VHDA here does not mean you are approved for Down Payment Assistance. This Buyer Information Worksheet provides the information needed to start the Application Process with a Mortgage Lender.

* First Name:
* Last Name:
* Your Email Address:
* Cell Phone:
*Occupation (Position & Title):
* Place of Employment:
*# of Years Employed:
* Base Salary:
*Overtime Income:
*Bonus Income:
*Commission Income:
*Savings:
*Stocks & Bonds:
*Retirement Fund:
*Other Assets:
* Monthly Housing Expense:
* Car Loan Payment:
* Student Loan Payment:
* Credit Card Payment:
Other Monthly Expenses:
*Have You Ever Declared Bankruptcy:
*Are there any outstanding Judgements, Lawsuits or Tax Liens?:
*Are you aware of any factors or adverse conditions that could restrict your ability to obtain a loan?:
* I hereby authorize an agent to disclose this information to a mortgage lender::
* Date:
* Contact Me By:
Comments & Questions: