Kiosk Mode
Housing Counseling Program

Hello and Welcome!

!!!!!!!!!!!!!! READ THESE INSTRUCTIONS!!!!!!!!!!!!!

PLEASE HAVE THE DOCUMENTS THAT APPLY TO CLIENT 1 AND CLIENT 2. DOCUMENTS MUST BE UPLOADED OR YOUR INTAKE WILL NOT BE PROCESSED UNTILL RECEIVED. (See Instructions below)

IF YOU ARE UNABLE TO UPLOAD DOCUMENTS, ONCE YOU COMPLETE THE INTAKE, EMAIL THE DOCUMENTS TO rleitschuh@irchabitat.org. OR drop them off at our administration bld. If you have any questions, please contact me via email or phone: Ray Leitschuh, rleitschuh@irchabitat.org
772-562-9860 Ext. 227

ONLY ADD HOUSEHOLD MEMBERS WITH INCOME. DO NOT ADD DEPEENDENTS AT THIS TIME.

Proof of Income •
• Employment One month most recent paystubs, each applicant. All jobs.
• Self Employed: Copies of most recent tax returns (including 1099 and Schedule C)
• Social Security, Disability, Retirement, Pension if applicable: Copy of most recent award letter.
• Alimony/Child Support income: Highlight this income on most recent bank statements or schedule of received payments from oversight agency.
• Most Recent Months Bank Statements for all applicants: ALL bank accounts! (Checking, savings, Chime, Cash app, Venmo etc.) Be sure to include EVERY page in your statement, even if they are blank.





Let's get started with
a simple verification step.

This security measure ensures that
your information will be submitted correctly
and prevents unauthorized entries.



Additional Language Support


English

Spanish

Questions? Contact Housing Counseling Program at 772-562-9860
LOADING