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LETTER OF AUHORIZATION

The information in this application will not in any way impact your eligibility to use Coastal Housing Partnership financial assistance programs. You are eligible for our programs if you are an employee of a member company. It is necessary for us to collect this data to provide our funding sources with an overall picture of whom we are serving. Coastal Housing Partnership will not link your name with any of this information. Or, click here to download a .pdf letter of authorization.


Application for:
Home Purchase
Mortgage Refinance
Rental Assistance Program

Name:

Email:

Employer:

Job title:

Length of employment: years

Home address:

Home City State and Zip:

Phone number:

Fax number:

(Please let us know whether you would like your letter of authorization faxed or mailed to you)

Faxed to me Mailed to me

How long have you lived in the area? years

Annual individual Income:
$10,000 – $25,000
$26,000 – $40,000
$41,000 – $60,000
$61,000 – $80,000
$80,000 – $110,000
$111,000 – $135,000
$136,000 – $175,000
Over $175,000

Annual household income:

$10,000 – $25,000
$26,000 – $40,000
$41,000 – $60,000
$61,000 – $80,000
$80,000 – $110,000
$111,000 – $135,000
$136,000 – $175,000
Over $175,000

Gender: female male

Ethnicity:

Age:

Marital Status: single married divorced widowed
living with partner

Number of children under 18:

Voices for Housing
Coastal Housing Partnership
PO BOX 50807 • Santa Barbara, CA 93150
t: 805-969-1025 • f: 805-882-1496
 
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