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  • Client Intake
    Family Housing Advisory Services, Inc.
    Our mission is to improve housing opportunities and eliminate poverty

  • Application Date
     / /

  • Thank you for your interest in Family Housing Advisory Services (FHAS)

    Please complete the forms below in its entirety. If you think there is already an application on file for you, please search for your name and birthdate in the format shown below, and update any information as needed.

    We look forward to working with you!

  • How can we assist you today?*
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  • About You

  • Are you completing this form with another adult, or spouse who lives in your household?*

  • Please Note: If you have a live-in partner, and are not legally married, you and your partner will need to fill out separate tax applications.

  • Do you have an APO Address?*
  • Mailing address*
  • Is this a rural area?*
  • Is it okay to text this number about FHAS workshops & events?*

  • Is it okay to email tax-related information and/or newsletter?*
  • How long have you lived at your current address?*
  • Date of Birth:*
     - -
  • Co-Applicant's Date of Birth:*
     - -
  • Are you disabled?*
  • Co-applicant disabled?
  • What is your ethnicity?*
  • Co-applicant's ethnicity?*
  • Are you a student?*
  • Co-applicant - Are you a student?
  • What is your primary language?*
  • Limited English proficiency?*
  • Co-applicant's primary language?
  • Co-applicant - Limited English proficiency?

  • About Your Household

  • Please review the Household Types below

    and select yours from the dropdown

    Single Male/Female = No children, living alone

    Female or Male headed household = One adult with children (no partners)

    Married with Dependents = Two married adults with children

    Married without children = Two married adults with no children

    Cohabitating = Living with unmarried partner(s), may have children or not

    Two or More Unrelated Adults = Living with roommate(s), may have children or not

  • Please enter information for ALL dependents 18 & under, or adult dependents 19 & older. Click on "Add Row" to enter information for more than one dependent.

  • Rows

  • About Your Income

  • Do you receive unemployment benefits?*
  • Please enter the names of all employers: (Enter "NA" if no 3rd job)*
  • Co-applicant - Do you receive unemployment benefits?*
  • Co-applicant - names of all employers? (Enter "NA" if no 3rd job)*
  • Do you receive any of the following? (Please check all that apply)*
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  • Omaha EITC Coalition

    A program of Family Housing Advisory Services, Inc

  • Please enter information for you and your spouse, if filing jointly.

  • Tax Year Information

  • What tax year(s) are you filling? (Please select all that apply):*

  • If a prior year(s) is selected, please answer the following questions.

  • Did your marital status change in any of the years you are filing?*
  • Did your dependents change in any of the years you are filing?*
  • Has your ITIN number been used on a tax return for the last 3 consecutive years?*
  • Has your ITIN number been renewed?*
  • When was your ITIN number renewed?*
     / /
  • Has your spouse's ITIN number been used on a tax return for the last 3 consecutive years?*
  • Has your spouse's ITIN number been renewed?*
  • When was your spouse's ITIN number renewed?*
     / /
  • Are you legally blind?*
  • Is your spouse legally blind?*
  • Have you, your spouse, or dependent been a victim of tax-related identity theft or issued an Identity Protection PIN (IPPN)? (Please select all that apply):*
  • Have you or your spouse, if filing jointly, received a letter from the IRS or state Department of Revenue?*
  • Can anyone else claim you or your spouse as a dependent on their tax return?*
  • If divorced, date of final divorce decree:
     - -
  • If widowed, date of spouse's death:
     - -
  • Did you get married during the tax year?*
  • If married, did you live with your spouse during any part of the last 6 months of the tax year?*

  • Please enter tax information for ALL dependents

  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?
  • Do you have another dependent?
  • Is the dependent totally & permanently disabled?
  • Is the dependent over 18 and a full time student?
  • Is the dependent over 18 & income is less than $5,200?

  • NOTE: The IRS will not mail checks anymore.

  • Do you have a bank account?

  • Please enter a bank account to receive your refund. Enter a 2nd bank account if you want to split your refund:

  • *
  • Is this a checking or savings account?*
  • Use this account for (Select all that apply):*
  • Do you have a 2nd bank account you want to enter?
  • Is this a checking or savings account?
  • Use this account for (Select all that apply):

  • Taxpayers, please have your Driver’s License, Social Security Card, and All Tax Documents (W2's, 1099s, etc.) for your tax preparer.

    If you are self-employed please ask your preparer for a Schedule C Readiness form.        

    If you own a rental property, please ask for a Schedule E Readiness form.

  • Privacy Act and Paperwork Reduction Act Notice: The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for the information, why we are asking for it, how it will be used, what could happen if we do not receive it, and whether your response is voluntary. Our legal right to ask for information is 5 U.S.C. 301. We ask for information to assist us in contacting you for the IRS VITA program, furnish to others who coordinate activities and staffing at volunteer return preparation sites or outreach activities, be used to establish effective controls, and send correspondence and recognize volunteers. Your response is voluntary. However, if you do not provide the information, the IRS may not be able to use your assistance in these programs. The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests (OMB Number 1545-1964). if you have any comments regarding the time estimates associated with this study or suggestion on making this process simpler, write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, Washington, DC 20224

  • During tax season (January-April 15th), please call 2-1-1 or go to https://www.fhasinc.org/tax-services.html to schedule an appointment.  For the rest of the year, please call 402-934-6750 for assistance.  We also have an online filing option, Tax360 SecureDrop, where you can upload your tax documents for us to prepare. (Use the link to take you to there).

    It may be necessary to copy and paste the link provided above.

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  • Tenant Services

    A program of Family Housing Advisory Services, Inc

  • Please be sure to attach all required documents. Incomplete applications will not be reviewed for assistance.

  • We offer tenant education workshops to help educate you on tenant matters. Below is a description of the workshops:

    Housing Matters workshops alternate between evening and morning times every other month. Morning workshop time: 10:00am-2:00pm. Evening workshop time: 5:00pm-7:00pm. This is a virtual workshop.

    The following topics are covered:

    • Tenant's rights and responsibilities
    • Essentials of housing affordability
    • Eviction process

    RENTWISE workshop is offered every 3rd Wednesday, 9:00am-3:00pm. This is an in-person class and helps tenants become successful renters through interactive classes focused on the following topics:

    • Communicating with Landlords and Neighbors
    • Managing Your Money
    • Finding a Place to Call Home
    • Getting Through the Rental Process
    • Taking Care of Your Home
    • When You Move Out
  • Are you interested in taking a tenant education workshop?*

  • Tenant Education Workshop

    If you are interested in registering for a workshop, please select a date from the pull-down menu.
  • At the end of the workshop would you like to schedule a one on one with a Housing Client Advocate?*
  • Have you completed an application for rental assistance with another agency?*
  • Subsidized housing?*
  • If yes, please select one:*
  • How long?*
  • Please select utility bill(s) you need assistance with:*
  • Format: (000) 000-0000.
  • Do you have or are you at risk for any of the following (select all that apply):*
  • Do you have a section 8 voucher?*
  • Do you have or are you at risk for any of the following (select all that apply):*
  • Do you have any of the following (select all that apply):*
  • What other services do you think you will benefit from?*
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  • Please submit all supporting documents using the browse option below.

    For all Housing Search Request and Education Registration DO NOT upload any documents. Both requests do not require documentation to attend our class or to recieve a housing search list.

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
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  • Foreclosure Prevention

    A Division of Family Housing Advisory Services, Inc
  • What is the reason for your application?*
  • What is the current status of your loan?*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • My/our signature(s) below certify that all information provided on this Intake Form is accurate and complete to the best of my/our knowledge.

  •  *   

  •  *   

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  • Financial Education

    A Division of Family Housing Advisory Services, Inc
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  • Are you currently a member of a bank/credit union?*
  • Are you interested in an IDA program?*

  • IDA Client Agreement

    Financial Education – IDA 2025

    I/We, agree to maintain my/our savings account with the monthly $50.00 deposit into the account. I/We agree to provide on a monthly basis to FHAS a copy of such statement to track my/our savings to adhere to the Community IDA Program. I will also provide to my counseloradvocate the following documents or items;

    • Monthly Statement from Custodial Account

    • Quarterly Meetings

    • Budget Updates

    • Action Plan Completion and Steps

    • Home Purchase Goal

    To remain in the program, I/We will need to reach my/our cap, goal, or submit in writing to closewithdraw from program. If for any reason I/We am/are unable to continue to save or have not met my/our savings requirement by the time I/we am/are able to purchase I/We am/are fully aware that my/our match will not be honored. I/We also agree that Iwe have or will have completed within 90 days the following actions;

    • Completed a Financial Education ClassWorkshop (with certificate or proof of completion)

    • Completed the IDA program application and all required documents

    • Setup of Custodial Account, if not already established

    • Deposit of $50.00 to open account via ACH, Cash, or certified funds and minimum of 50.00 every month to remain in program

  •  *   

  •  (if applicable)*   

  • What are your current assets? (Please select all that apply)*
  • What are your current debts? (Please select all that apply)*

  • Financial Education workshops are designed to teach the fundamentals of personal finance. After completing the class, you can meet with a counselor one-on-one to devise an action plan that will help you reach your goal. Come and learn how your tax refund can put you on the road to improving your credit rating.

  • Are you interested in taking a financial education workshop?*

  • Financial Education Workshop

    If you are interested in registering for a workshop, please select a date from one or more of the pull-down menu below.

  • Bank On It! 2026

    Please select the date below

  • My/Our signature(s) certify that all the information provided on this intake form is accurate and complete to the best of my/our knowledge.

    Failure to attend a scheduled Financial Education workshop, OR, rescheduling a workshop  3 consecutive times within a calendar year, will result in ineligibility to schedule a workshop until the following calendar year.

  •  *   

  •  (if applicable)   

  • Are there any other financial services you are interested in?
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  • Home Buyer Education

    A program of Family Housing Advisory Services, Inc
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  • Are you a first-time home buyer?*
  • Are you pre-approved for a home loan?*
  • Are you interested in information on Deferred Loan Payments (DLP)?*

  • We offer in-person workshops to help educate you in buying a home, or offer more information to those who have already purchased a home. Below is a description of each workshop:

         Pre-purchase Education Workshop provides the knowledge, steps, and resources needed to make the dream of homeownership a reality.  After completing the class, you can meet with a counselor one-on-one for personalized services that will set you up for success in meeting your goal of getting into homeownership. 
         Come learn the key professionals involved in the homebuying process, what a lender requires to qualify a mortgage, what affordable housing programs are available, and much more.
         Post-purchase Education Workshop provides education designed to help you and your family build and maintain wealth through equity in your home.  The workshop provides resources and education to help make homeownership work for you - Keep costs manageable and build a future that lasts.

  • Are you interested in taking a home buyer, or homeowner education workshop?*
  • What workshop(s) are you interested in taking?*

  • Pre-Purchase Workshop

    If you are interested in registering for a workshop, please select a date from the pull-down menu below.

  • Post-Purchase Workshop

    *Please note: this class is meant for AFTER your home has been purchased. If you are interested in registering for a workshop, please select a date from the pull-down menu below.

  • Home Purchase Information

    Please complete to the best of your ability
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  • Please select all that apply:*
  • Are you already in the process of foreclosure?*
  • Loan status:*
  • Loan product type:*

  • My/Our signature(s) certify that all the information provided on this intake form is accurate and complete to the best of my/our knowledge.

    Failure to attend a scheduled Pre-Purchase Education, or Post-Purchase Education workshop, OR, rescheduling a workshop  3 consecutive times within a calendar year, will result in ineligibility to schedule a workshop until the following calendar year.

  •  *   

  •  (If applicable)   

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  • Client Assessment

  • Section 1: Financial Knowledge

  • 1. I am comfortable making financial decisions*
  • 2. I know what assets are and how to build them*
  • 3. I understand how credit works*
  • 4. I am satisfied with the amount of money I'm able to save monthly*
  • 5. I know what benefits I am entitled to and how to access them (ex: TANF benefits, Medicaid, etc.)*

  • Section 2: Financial Behavior

  • 6. I have a clear vision about where I want to be in life, and have WRITTEN goals*
  • 7. I use a budget or budgeting app to manage income and expenses*
  • 8. I am currently enrolled in school*
  • 9. I worry about how much money I owe*
  • 10. I am employed and have a steady source of income (6 months or longer, union, contract)*
  • 11. I have a savings account at a bank/credit union and save EVERY month*
  • 12. I have access to reliable transportation (car/bus/rideshare)*
  • 13. I have access to safe, stable, affordable housing*
  • 14. I have enough money every month to cover our regular expenses*
  • 15. I pay my bills online*
  • 16. I have an investment account that I regularly save in (401k, 403b, Roth IRA)*

  • Section 3: Financial Challenges in the Last 6 Months

  • 17. Did you pay a late fee for a bill or service in the last 6 months?*
  • 18. Were any of your bills past due in the last 6 months?*
  • 19. Have you borrowed money from family/friends in the last 6 months?*
  • 20. Did you use a credit card in the last 6 months?*
  • 21. Did you use a check cashing service in the last 6 months?*
  • 22. Did you use a Payday Lender in the last 6 months?*
  • 23. Did you use a pawn shop in the last 6 months?*
  • 24. Did you use a pre-paid debit card in the last 6 months?*
  • 25. Have you had any banking problems in the last 6 months (overdrafts)?*
  • 26. Have you purchased from a Rent-to-Own business in the last 6 months (overdrafts)?*
  • 27. Have you purchased from a Buy Here Pay Here business in the last 6 months (overdrafts)?*
  • 28. Do you have any unpaid medical bills?*
  • 29. Do you have any unpaid student loans?*
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  • Financial Education - Pre-Workshop Test

  • The purpose of the Pre-workshop test is to measure the effectiveness of our training. You will be asked the same set of questions before and after the training, to see whether your understanding and knowledge have increased as a result of this training. You will not receive a grade or pass/fail mark for how you answer these questions. Please answer the questions to the best of your knowledge.

     

    For each of the following questions, please select the best choice:

  • 1. A "Goal" is something you want to do:*
  • 2. Money available after taxes and other deductions is "Net Income":*
  • 3. Only income and expenses matter when you're making a budget:*
  • 4. Savings are:*
  • 5. To have enough money for an emergency, you must save at least 3-6 months' worth of living expenses:*
  • 6. Using a bank or credit union is important because:*
  • 7. For what dollar amount do the FDIC and NCUA guarantee each account at a bank or credit union?*
  • 8. "Interest" is what you pay when you borrow money AND what you earn when you invest your money:*
  • 9. Which of the following is an asset:*
  • 10. "Credit" is money you borrow:*
  • 11. A poor credit history can keep you from getting an apartment, job, a loan, and in some states even insurance:*
  • 12. Your total monthly debt payments may affect your ability to borrow money:*
  • 13. Equifax, TransUnion, and Experian are credit reporting agencies:*
  • 14. Credit scores are directly related to your credit history:*
  • 15. As a consumer, you have almost no rights when it comes to financial products:*
  • 16. The Truth in Lending Act requires financial institutions to disclose in writing the true costs of credit, especially the yearly rate of interest charges (APR-Annual Percentage Rate):*
  • 17. If you can't pay all of your bills and debt collectors are calling, just pay the one that calls the most:*
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  • Home Buyer - Pre-Workshop Test

  • 1. Which expense is considered a closing cost?*
  • 2. Which is the following are elements of a mortgage payment:*
  • 3. What does PMI stand for?*
  • 4. An FHA appraisal and a home inspection are the same thing*
  • 5. When applying for a loan, you must bring all of the following documentation EXCEPT:*
  • 6. The approval process can be expedited by all of the following EXCEPT:*
  • 7. A typical example of a contingency that may appear on an offer to purchase are:*
  • 8. The Mortgage Note includes:*
  • 9. A final walk-through of the property is necessary because it:*
  • 10. The Closing Disclosure includes the following information EXCEPT:*
  • 11. The Deed of Trust is:*
  • 12. Your loan will always be serviced by the mortgage company that took your application:*
  • 13. The Commitment for Title Insurance isn't the actual Title Insurance policy, but it guarantees that the policy will be issued when conditions specified in the commitment are met:*
  • 14. What is the Debt to Income (DTI) ratio?*
  • 15. It's important to have a home maintenance allowance because:*
  • 16. Your grocery bills are not necessary to include in your budget because they must be purchased anyway*
  • 17. Title Insurance protects the legal ownership of the property the buyer is purchasing. Without this document, the buyer runs the risk of:*
  • 18. Which is the best method when periodically reviewing the homeowners' insurance coverage levels to ensure it is adequately protected?*
  • 19. In the event of unexpected financial difficulty that would cause a missed mortgage payment, the borrower should:*
  • 20. How many days prior to closing must a borrower receive the closing disclosure to review?*
  • 21. Points are a one-time fee from lenders that covers their cost of doing business. One-point equals:*
  • 22. Homeowner's insurance protects you and the lender from loss in the event the house is damaged or destroyed by fire or storm:*
  • 23. Which of the following is NOT true concerning a counteroffer proposal:*
  • 24. What approach is used when the appraiser analyzes a Single Family, owner occupies, existing property:*
  • 25. What is a good practice on finding a professional to work on a home:*
  • 26. How much can you save if you lower your thermostat in the wintertime?*
  • 27. The following is NOT an acceptable source of funds for closing:*
  • 28. In order to avoid foreclosure, you must do the following:*
  • 29. Which is NOT true about homeowner's insurance?*
  • 30. The Agency Disclosure Information is given to buyers and sellers explaining the Realtor's responsibilities:*
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  • Household Finances

    Financial Summary & Budget

  • Please fill in your MONTHLY income and outgoing expenses below.

    If you have no income or are not spending money in categories below please enter 0 (zero).

  • Part 1: Financial Summary

    Please fill in your MONTHLY income below (incoming)
  • Rows
  • Rows

  • Part 2: Budget Worksheet

    Please fill in your MONTHLY expenses below (outgoing)

  • Financial Summary & Budget Worksheet Results

  • By signing below, I/we certify that all information provided on this Household Finance Worksheet is accurate and complete to the best of my/our knowledge; I/we also authorize the use of this information by FHAS to assist in completing my/our one-on-one counseling session.

  •  *   

  •  *   

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  • Credit Report Release Form

    Family Housing Advisory Services, Inc
  • Do you agree to have a soft pull credit report?*

  • I/We understand that my signature allows Family Housing Advisory Services, Inc. to request information from CSC Credit Services, Inc., regarding my credit.

  •  *   

  •  If applicable:   

  • If applicable:   

  • I/We elect to not have a soft pull credit report.

  •  *   

  •  If applicable:   

  • If applicable:   

  • Today's date:
     / /
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  • Authorization to Obtain & Release Information

    Family Housing Advisory Services, Inc.

  • I/we,  * ,   (if applicable) do hereby:

    Authorize Family Housing Advisory Services, Inc. (hereafter "FHAS, Inc."), to share information about me/us, but not limited to, information provided pursuant to the terms of this Authorization to Obtain & Release Information and to speak with any person/organization, its agents and employees solely for the purpose of assisting me/us. FHAS, Inc. does not release information to any third-party agencies for the purpose of marketing.

    *      (if applicable)

    Authorize the release of any and all required information regarding each of my/our accounts and loans to any representative of FHAS, Inc. I/we understand that the information released may include, but is not limited to, verbal, written, or printed information relating to my/our account(s) and payment transactions, copies of loan documents and any record of communication history associated with my/our account(s) and loan(s). I/we further authorize verbal communication and consultation with any representative of FHAS, Inc. regarding all aspects of my/our account(s) and account history, including information provided by any other party.

    *    (if applicable)

    Authorize FHAS, Inc. to consult with others and obtain from others or provide to others any and all information deemed necessary to assist me with my housing needs including, but not limited to: Information from any State or Federal agency, information regarding my income, all health, medical, and educational information.

    *    (if applicable)

    Agree to hold FHAS, Inc. harmless as a result of their good faith attempt to assist me/us and understand that FHAS, Inc. will maintain the confidentiality of my/our non-public personal information in accordance with its policies and applicable federal and state law.

  • Refusal to sign this Authorization to Obtain and Release Information will NOT result in a denial of services, but FHAS will not be able to negotiate or obtain information on your behalf. A copy or scan of this document will be considered an original for all intents and purposes.

  •  *   

  •  *   

  • FHAS Employee (for office use only):

     ___________________________

     Family Housing Advisory Services, Inc.

    MAIN OFFICE

    2401 Lake Street

    Omaha, NE 68111

    402.934.7921/Fax 402.934.7928

     Increasing Affordable Housing Opportunities for All

    Certified by the United States Department of Housing and Urban Development (HUD) to provide comprehensive Housing Counseling Service. TTD Access via the Nebraska

    Relay System.       Rev.2022

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  • Privacy Policy

    Family Housing Advisory Services, Inc (FHAS)

  • Privacy Policy - Opt Out

    If your account is active, and you are not comfortable with this level of information sharing, please contact us to inactivate your account. If your account is inactive, your information is no longer used internally or externally, except for record keeping, governmental, and audit purposes.

     Direct Mail: Family Housing Advisory Services, Inc.

    2401 Lake Street

    Omaha, NE 68111

    Phone: 402-934-6471

    Attn: Donna (Foreclosure Prevention) or, Sharena Marrs (Tenant Services)

  • Privacy Policy

    You are receiving this statement to comply with federal laws regarding the disclosure of non-public information. FHAS is committed to fully protecting and preserving the privacy of our clients. For your protection, please take a few moments to read this statement:

    As part of our committment to your privacy, FHAS will only disclose the information that it must in order to serve you in the most effective manner possible. Hence, FHAS will not distribute client information to third parties, except where it is necessary to perform quality services or its clients, as described below.


    This Applies To

    This statement applies to those individuals who have received education and/or one-on-one counseling assistance, and with whom there is a continuing counselor/client relationship.


    Information Collected

    Through telephone, fax, mail, and electronic communication, personal information will be gathered, including address, social security number, telephone number, email address, and other demographic information. Through the aforementioned channels, financial information will also be collected, including information related to your debts, income, expenses, and checking/savings accounts on an as-needed basis. Please be assured that we carefully train all of our counselors to carefully protect all client information. In order to do this effectively, we will ask for information that only you should know when you contact us. No one else can call in and access your information without your written authorization. If you find, at any time, that our records contain inaccurate or incomplete records, please let us know immediately.


    Internal Sharing

    Information may be shared with FHAS as needed to assist with situations that may arise.


    External Sharing

    A necessary portion of your personal and financial information will be used to communicate with your creditors and/or lender to coordinate with them on your behalf. Information will not be sold to corporations. FHAS does not report any information to credit bureaus.


    Other Applicable Laws

    The practices described above are in accordance with federal privacy law. You may have other protections under applicable state laws. To the extent that these state laws apply, we will comply with them when we share information about you.


    Protections for Information

    Physical and electronic files are only kept within the confines of the FHAS offices and at approved secure backup sites. Access is restricted to authorized personnel only.


    Information Storage

    The information you supply FHAS will remain in corporate files for as long as it is necessary to provide services, and for a reasonable period of time following the completion or termination of services.

    Online Privacy

    Information may be gathered when you visit the FHAS website, including Internet Protocol (IP) addresses, Uniform Resource Locator (URL) tags, and basic operating system and browser information. Electronic security is maintained through use of firewalls (which are designed to protect systems from intrusion). All information collected through the Jotforms website is encrypted upon submission and is not sold to third-party affiliates per a licensed BAA between both parties.

    Notes

    FHAS refers to the Family Housing Advisory Services, Inc. a Housing and Urban Development (HUD) Housing Counseling Agency. FHAS is also an agency of United Way of the Midlands.

    How You Can Help Protect Your Privacy

    Do not share your account information, passwords, user IDs, PINs, your SSN, code words or other confidential information with others.

    Do not provide confidential information to unknown callers.
    Do not provide confidential information online unless YOU initiated the contact, know the party with whom you're dealing, and can provide the information through a secure line (https://).
    When conducting business over the internet, always use a secure browser & exit onlineapplications as soon as you finish using them.
    If you believe you have been the victim of identity theft or fraud, please call the Social Security Administration Fraud Hotline at 800-397-0271 to report fraudulent use of your identification information.
    File a complaint with the Federal Trade Commission (FTC) by contacting the FTC's Identity Theft Hotline: 877-ID-THEFT (877-438-4338).
    File a police report and retain the police report number and officer's name and badge number that took the report.
     

    Credit Bureau Fraud Lines:

    Experian: 888-397-3742

    Equifax: 800-525-6285

    TransUnion: 800-680-7289 

    I/we acknowledge that I/we received, read, and agree to Family Housing Advisory Services, Inc.'s Program Privacy Policy.

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  • HUD Program Disclosure Form

    Family Housing Advisory Services, Inc

  • Note: If you have an impairment, diability, language barrier, or otherwise require an alternative means of completing this form or accessing information about arranging alternative accommodations, please talk to your housing counselor about arranging alternative accommodations. In the designated areas on this form, please initial, sign, and date.

     

    About FHAS and Program Purpose:

    Family Housing Advisory Services, Inc. (FHAS) is a nonprofit, Housing and Urban Development (HUD) approved comprehensive housing counseling agency and also an agency of the United Way of the Midlands. We provide education workshops and a full-spectrum of housing counseling services including: Pre-Purchase, Post-Purchase, Foreclosure Prevention, Financial Education, Individual Development Account (IDA), Earned Income Tax Credit, Rental, Homeless Prevention, Utility Assistance, and Family Support.

    We serve all clients regardless of income, race, religion/creed, national origin, age, family status, disability, or sexual orientation/gender identity. We administer our programs in conformity with local, state, and federal anti-discrimination laws. The roles and responsibilities of the Client and Counselor are listed below.

  • Client & Counselors Roles & Responsibilities

  • Counselor Roles & Responsibilities  Client's Roles & Responsibilities
    • Review housing goals and finances. May include income, debt, assets, and credit history
    • Prepares Client Action Plan that list steps to take to acheive your goals
    • Prepare budget to help you manage expenses and savings
    • Your counselor will provide guidance, education, and information in support of your goals
    • Your counselor can provide guidance to goals and access to resources
    • Your counselor will not provide any legal advice in any aspect(s)
    • Complete the steps assigned to complete the goals that is set up
    • Provide accurate information on expenses, income, employment, and other household assets
    • Attend scheduled meetings, return calls, and provide requested information in a timely manner
    • Update your goals with your counselor
    • Complete education workshops/classes (pre-purchase workshop, financial education workshop, etc)
    • For legal inquiries please seek legal advice outside of FHAS

  • Termination of Services: Failure to work or cooperate with your assigned housing counselor will result in the immediate termination and removal of counseling services. This includes missing three (3) scheduled meetings. A FHAS staff employee will make three (3) attempts to contact you before the file is closed. Your file will be reopened if you choose to resume service with FHAS at a later date.
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  • Family Housing Advisory Services Program Disclosure

  • Agency Conduct: No FHAS personnel, officer, director, volunteer or agent shall undertake any act that might result in, or create the appearance of, administering counseling operations for personal or private gain, provide preferential treatment for any person, organization, agency, or engage in conduct that will compromise our agency's compliance with federal, state, and local laws & regulations and our committment to serving the best interests of our clients and their families.

    Agency Relationships: FHAS also has financial affiliation with HUD, the City of Omaha and other funders to administer pre-purchase, post-purchase, and financial education and counseling. FHAS also receives education fees from the Federal Home Loan Bank down payment asistance program. As a housing counseling participant, you are not obligated to use any of the products, service, or partners discussed in our workshops, counseling sessions will still be provided. As a client, you are entitled to seek and choose your own real estate professional, lender, and lending products that you qualify for and that best fit your needs. A list of our partner relationships and workbook fees are posted in the classrom, (at select areas).

    Referrals and Community Resources: FHAS can provide a community resource list which outlines services to meet a variety of needs. FHAS staff can provide you with a list of organizations and agencies that provide similar services to those offered by FHAS, outside services might be a cost to you, and such resource list can be found in the lobby of FHAS located at 2401 Lake Street, 2nd Floor Receptionist Area.

    Privacy Policy: Please see our privacy policy statement. FHAS does not share your information without written or verbal consent, any shared information will be in violation of this policy.

    Quality Assurance: To assess client satisfaction, a FHAS Staff Member, Employee, or Intern may contact you during or after the completion of your counseling service. You may be asked to complete a survey to evaluate your client experience with your housing counseling, ease of resource referral, and other experiences throughout your time with FHAS.

    Home Inspection (if applicable): Home inspection materials are provided at the workshop and also during your one-on-one housing counseling.

    I/we acknowledge that I/we received, reviewed, and agree to the Family Housing Advisory Services Program Disclosures.

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  • Household Data Survey

    Family Housing Advisory Services, Inc
  • Household ethnicity*
  • Are there any disabled children (ages 0-18) in the household?*
  • Are there any disabled adults (ages 19 or older) in the household?*
  • Is this a Female-headed household? (Single parent)*
  • Is anyone in the household elderly (aged 62+)?*

  • The assistance for which you are applying for is in whole or in part funded by the City of Council Bluffs and the City of Omaha Development Block Grant (CDBG) Program funds. In order to qualify for assistance under the City of Council Bluffs and the City of Omaha CDBG Program, participants must meet certain income qualifications. The City of Council Bluffs and the City of Omaha utilized the Part 5 annual income (as defined in 24 CFR Part 5) to calculate annual [gross] income. The Part 5 definition of annual income is the gross amount of income of all adult household members that is anticipated to be received during the coming 12 month period and includes the following:

    1. The full amount, before any payroll deductions, of wages and salaries, overtime pay, commissions, fees, tips, and bonuses.
    2. Net income from operation of a business or profession, interest, dividends and other net income from real or personal property (requires asset calculation).
    3. Income from assets such as: amounts in savings and checking accounts, retirement savings accounts, and cash value of life insurance policies (If less than $5,000 in assets utilize actual income from assets. If assets are more than $5,000, then calculate assetincome utilizing a 3% passbook rate).
    4. Full amount of periodic amounts received from Social Security, annuities, insurance policies, retirement funds, pensions, disability or death benefits, regular pay, special pay and allowances of a member of the Armed Forces.
    5. Payments in lieu of earnings (unemployment, disability compensation, worker's compensation and severance pay) and government assistance and other need-based payments to families or individuals, periodic and determinable allowances (alimony, child support payments, regular contributions or gifts).

    Please complete the following Anticipated Annual Income table to the best of your ability. *Please note, family member names on the left will be added by your counselor after this form has been submitted*

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  • Once the Annual Income is calculated, please find your Household Size below and select the appropriate box based off of your Annual Income:

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  • I hereby certify that the information I have provided is complete and accurate to the best of my knowledge.

    I acknowledge information gathered to demonstrate eligibility to participate in the program shall be made available to the City of Council Bluffs and the City of Omaha, or its agents and/or the U.S. Department of Housing and Urban Development (HUD), or its agents, or other authorized federal officials for purposes of investigation to ascertain compliance with the rules, regulations, and provisions of the CDBG Program.

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  • US Citizenship Attestation Form

    Family Housing Advisory Services, Inc
  • PRIMARY APPLICANT: For the purposes of complying with Neb. Rev Stat. §§ 4-108 through 4-114, I attest as follows:*

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  • CO-APPLICANT: For the purposes of complying with Neb. Rev Stat. §§ 4-108 through 4-114, I attest as follows:*

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  • Submit

    You will receive a confirmation email for the workshop(s) you've registered for one week prior to the workshop start date.
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