Barry County HOMES Application (128998)

The Barry County HOMES committee will be reviewing all offers for homes in our program. The purchase price will not drive who is selected.

We are looking for someone who is just starting out or who wants to start over. This is a community program, so the ideal candidate would choose to be involved in our Barry County Community and will be dedicated to participating in our homeownership educational program. Because of the nature of this project, there will be many candidates applying for each home in the HOMES program. The selection process will be done by a panel of community minded individuals, including but not limited to: representatives of the Barry County United Way, Barry Community Foundation and the Barry County Chamber and EDA. Please share any information that you are comfortable sharing to help us in the selection process. If you are not selected for this particular home, please feel free to apply in the future.

We are here to help you in your journey to homeownership. Please connect with either Lani at the United Way (269-945-4010, Lani@bcunitedway.org) or Bonnie at Barry Community Foundation (269-945-0526, bonnie@barrycf.org)

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Applicant Applicant First Last
Co-Applicant (if any) Co-Applicant (if any) First Last
Date of Birth Date of Birth / MM / DD YYYY
Phone Phone - ### - ### ####
Email
Current Address Current Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please provide information about your employment over the past 5 years:
1. Employer Name & City
Position & title
Length of Employment
Monthly Income
2. Employer Name & City
Position & title
Length of Employment
Monthly Income
3. Employer Name & City
Position & title
Length of Employment
Monthly Income
4. Employer Name & City
Position & title
Length of Employment
Monthly Income
5. Employer Name & City
Position & title
Length of Employment
Monthly Income
Address of Property to Purchase Address of Property to Purchase
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Which home is this application for?
Listed Purchase price
Down Payment You have to work with
This section will explore your financial position.
Explain any preapproved loans you have. Also let us know if you have experiences working with any local banks.
Total Savings
Monthly Household Income
Total Debt (credit cards, loans, etc)
Monthly Debt Payments
Are you a first time home buyer?

Are you a first time home buyer? Yes No
Are you working with a Realtor

Are you working with a Realtor No Yes Name of Realtor Name of Realtor
To select the buyer with the greatest potential to succeed with this purchase, you may submit information here explaining how this home would be beneficial to you. This field is not mandatory to be considered but will be helpful in choosing the buyer for the home.

This information will assist the committee that will be reviewing the letter to ensure that the buyer meets the following criteria:
1. The buyer will not be overburdened with the costs associated with the home.

2. Fits the HUD Criteria of monthly income (between 80% & 120% of the area median income) and can document with proof of income.

3. What is your credit score? If your credit score is below 670, what impacted your credit score?

We are looking for someone who is just starting out or who wants to start over. This is a community program so the ideal candidate would choose to be involved in our Barry County Community and will be dedicated to participating in our homeownership educational program. Because of the nature of this project, there will be many candidates applying for each home in the HOMES program. The selection process will be done by a panel of community minded individuals, including but not limited to: representatives of the Barry County United Way, Barry Community Foundation and the Barry County Chamber and EDA. Please share any information that you are comfortable sharing to help us in the selection process.
Background & Credit Check Authorization

I, as noted in the application here, hereby authorize the Barry County United Way and/or the Barry Community Foundation, its agents, representatives, or any third-party consumer reporting agency (CRA), to obtain and review my consumer report, investigative consumer report, or credit report for TENANCY/HOME PURCHASE purposes. This includes pulling information regarding:
- Criminal history
- Public records
- Credit reports
- Education and employment verification
- Government watch-lists
- Motor vehicle records if applicable

I understand that this information may be obtained for use in making a decision regarding my application for the Barry County HOMES program or current standing. I acknowledge receipt of the 'Summary of Rights Under the Fair Credit Reporting Act.' I further understand that if adverse action is taken based on this report, I will be notified, provided a copy of the report, and given a summary of my rights.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Consent to Release Financial and Lien Information

I, [Full Name], [Date of Birth], [Social Security Number], authorize all banks, financial institutions, creditors, credit-reporting agencies, and any other entities with knowledge of my financial status or liens to provide all records concerning my financial condition, outstanding liens, credit history, account balances, and payment history to [Barry County United Way].

I understand this information may be used to assess my eligibility for [loan, tenancy, employment, legal disposition, etc.]. This authorization is valid for 90 days or until revoked in writing. A copy of this release is as effective as the original.
Full Legal Name Full Legal Name First Middle Last
Date of birth Date of birth / MM / DD YYYY
Last 4 digits of Social Security Number
Privacy Policy & Notice

The Barry Community Foundation & United Way are committed to protecting the privacy and confidentiality of the personal and financial information you share with us. Although we are not a financial institution governed by the Gramm-Leach-Bliley Act (GLBA), we voluntarily follow GLBA-aligned best practices to safeguard sensitive information.
This policy explains:
• What information we collect
• How we use it
• When we share it (if ever)
• How we protect it
1. Information We Collect
We may collect the following types of information to determine eligibility for our housing programs:
Personal Information
• Name, address, phone number, email
• Date of birth
• Identification documents
Financial Information
• Income sources (pay stubs, benefit letters, tax documents)
• Limited bank statements or asset information
• Monthly expenses
• Housing payment history
We do not collect unnecessary data such as full bank transaction histories, medical information, or immigration documentation unless required by law.
2. How We Use Your Information
We use your information only for the following purposes:
• Determining eligibility for housing programs
• Assessing affordability and financial stability
• Complying with grant, regulatory, or audit requirements
• Communicating with you regarding services
• Maintaining accurate program records
We do not sell or rent your personal information.
3. How We Share Information
We only share your information when necessary and allowed:
We may share information with:
• Funding partners, but only in required formats
• Auditors evaluating program compliance
• Service partners that assist with housing stabilization (with your permission)
We do NOT share information with:
• Marketing companies
• Unaffiliated third parties
• Any organization not directly tied to service delivery
You may revoke permission to share information at any time, unless sharing is required by law or necessary for program participation.
4. How We Protect Your Information
We use administrative, physical, and technical safeguards to keep your information secure, including:
• Locked filing cabinets
• Password-protected electronic systems
• Staff training on confidentiality
• Limited access to sensitive data
• Regular review of data-handling procedures
5. Your Rights
You have the right to:
• Access your records
• Request corrections to inaccurate information
• Withdraw consent for information sharing (where applicable)
• Receive a copy of this privacy policy at any time
6. How Long We Keep Your Information
We keep records only as long as required by law, funders, or nonprofit best practices. Records no longer needed are securely destroyed.
7. Contact Us
If you have questions or concerns about this policy, please contact:
Privacy Officer / Program Director
Bonnie Gettys Lani Forbes
269-945-0526 269-945-4010
bonnie@barrycf.org Lani@bcunitedway.org
BCF, 231 S Broadway, Hastings MI 49058 BCUW, 231 S Broadway, Hastings MI 49058

Barry County HOMES Application (128998)

Barry County HOMES Application (128998)

Please provide information about your employment over the past 5 years:

This section will explore your financial position.

Background & Credit Check Authorization

Consent to Release Financial and Lien Information

Privacy Policy & Notice