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)

MIAMI Clients:

8.  Last 2-months bank statements for all accounts

BROWARD Clients:

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

 

 

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