Welcome to our Online Intake Form
In order to complete the form you will need to provide the following:
1. 2018, 2017, 2016 tax returns & W2’s or (1099 if applicable) (must be signed)
2. Most recent pay stubs (at least 30 days)
3. Name, address, phone number, and dates for all EMPLOYERS for the last 2 yrs.
4. Name, address, phone number, and dates for LANDLORDS for the last 2yrs.
5. Resident Status:(photocopies)
- Resident Alien Card/Birth certificate/Vote registration or US Passport. (choose one)
- Social security cards (all household members)
- Driver license or State ID (for all adults)
6. List of all monthly household expenses
7. $18.40 (individual) or $36.80 (married couple) for credit report (this is non-refundable)
8. Last 2-months bank statements for all accounts
8. 6-months bank statements for all accounts (all pages, single sided copies please).
9. Report cards for all school–aged children
10. Immunization record for non–school–aged children