Owner-Occupied Housing Rehab Loan Request for Services

Thank you for applying for an owner-occupied rehabilitation loan from One Roof Community Housing.  

This application is intended for current homeowners only.  If you have questions about or this program, please contact One Roof Community Housing at (218) 727-5372 or stop by the Central Hillside Community Center at 12 E. 4th Street, Duluth MN 55805.

Before you start filling it out, please gather the following documents so that you are well-prepared:

  • Most recent paystubs (covering the last 30 days)
  • Income Documentation if other than employment (award letters, pension information)
  • Employment history for the last 2 years (employer’s name, address and telephone number)
  • Most recent 2 years of W-2’s
  • Bank statements for the last 90 days (all pages) for all deposit accounts (checking and savings)
  • Copy of property tax statement
  • Hazard/Property Insurance Declaration Page with Agent Name & Contact Number
The following only if applicable:
  • If self-employed, commissioned, or bonus income, tax returns for the last 2 years
  • Copy of Current Mortgage Statement if applicable
  • Information regarding any 2nd mortgage/home equity loan/grants if applicable
  • Complete copy of Divorce Decree/Child Support Court Order, if there is a current order of maintenance or child support (whether receiving it or not)
  • Complete copy of Bankruptcy papers (Petition including Schedule of Debts and Discharge), (if filed within last 2 years

Collecting all of this information before beginning the application should allow you to complete the forms quickly and easily.  However, if you need to, you can save the form at any time and resume it later.  Just click on the link at the top of the form "save this form and resume later," enter your email address, and create a password.  You will then receive an automatic email with a link that you can follow to resume the form. 

Please note that this is not a permanent User-ID so you will not be able to access your application after you submit it.  

Thank you and we look forward to working with you.

Application Info

Main Applicant's Info

e.g. 07/01/1980

Please enter a valid email address.  If you don't have one, please enter "noemail@noemail.com".

Co-Applicant's Info

e.g. 03/07/1980

Other Household Members

If you have additional household members, please enter their information here.  Click "Add another person" to create more fields.

e.g. 01/08/2001

e.g. 01/08/2001

e.g. 10/29/2001

e.g. 01/08/2001

e.g. 01/08/2001

e.g. 01/08/2001

e.g. 01/08/2001

Please indicate for each piece of information that we ask for below if you either have it (by selecting Yes) or if it is not applicable, if you believe something is applicable, but you do not have it, please call us at (218) 727-5372.

Income and Employment Information

Please give employment information and list ALL sources of income expected for ALL household members over the next 12 months.  Give GROSS monthly amounts (the amount received before tax or deductions).  Include income from employment, child support, spousal support, pension, social security, disability, investment, assets, etc.  If necessary, click "Add Income Source" to create new fields.  

Please enter all numbers WITHOUT dollar signs.


e.g. 2/09/2006


e.g. 2/09/2006

Other Household Members

Debt Information

Please enter all numbers WITHOUT dollar signs.

Applicant's Debts

Application: Owner-Occupied Rehabilitation Loan (Continued)

Please download and print our information disclosure authorization form by clicking HERE.  Please do not e-mail this document to us, either bring it into the office or mail it to us as 12 E. 4th St, Duluth, MN, 55805.  Once you have downloaded this form, please proceed to the next page to submit your application to us. 

Combined Funder Tennessen Warning , Privacy Act Notice and Applicant Certification

The Housing Resource Connection collects financial and demographic information about the families/individuals that apply for its programs.  This information is required to determine eligibility for our different programs and lending products.  The information is in turn shared with our funding partners to assist them in managing their programs. After we receive your application, you will be asked to sign a release that authorizes One Roof to share your information with the following funders: Minnesota Housing Finance Agency, Greater Minnesota Housing Finance Agency, NeighborWorks America and the Housing Resource Connection Partner Agencies.  

Financial information, such as credit reports, financial statements and net worth calculations, is classified as private data on individuals by Minnesota Statutes 462A.065.  You are not required to provide this information, but without it we will be unable to determine your eligibility and approve your application.  Certain individual demographic information, including but not limited to disability status, race, and ethnicity, is also private data and is being requested for the purpose of evaluating the effectiveness of the program(s) in achieving specific goal(s).  The information will be shared with our funders.  Where access to the data is authorized by state statute or federal law, it may be made available to others as so authorized.

By submitting this application, the applicant/household member(s) certify that all information in this application, and all information furnished in support of this application, is given for the purpose of participating in one or more of the Housing Resource Connections’ programs.  All information provided is true and complete to the best of my/our knowledge and belief. 

Please click the submit button only ONCE.  It may take a few moments to process.