Survey - Dream Makers Application Form

1.

Contact Information:

*

Name:

Title	First Required	Middle Required	Last Required

*

Email: Required

*

Street 1: Required

Street 2:

*

City/State/ZIP:

City Required	State Required	ZIP Required

Country:

*

Phone Number: Required

Yes, I would like to receive e-mail from PenFed Foundation

Yes, I would like to receive postal mail from PenFed Foundation

*2.

Question - Required - What is the best time & way to contact you?

(Maximum response 255 chars, approx. 5 rows of text)

*3.

Question - Required - Amount of Grant Requested:

*4.

Question - Required - Amount of Mortgage Loan:

*5.

Question - Required - How much money are you putting down? (NOT including the funds from the grant) Note: You must put down at least $1,667 to receive maximum $5,000 grant. See Contribution Chart on main page for details.

*6.

Question - Required - Service Branch/Agency: Note: To be eligible, you must be active or veteran military personnel or current employee of Department of Defense or Department of Homeland Security

7.

Question - Not Required - Rank (if any):

*8.

Question - Required - Current Status: Active
Reserve/Guard
Veteran
Government Employee

9.

Question - Not Required - Check below if you or your spouse served in or will be deployed to: Operation Iraqi Freedom
Operation Enduring Freedom

*10.

Question - Required - Total Gross Monthly Household Income: Note: Income cannot exceed program's maximum income limits. See eligibility requirements on main page for details.

11.

Question - Not Required - Total Monthly Allowances: (If active duty military)

*12.

Question - Required - Ownership status:

*13.

Question - Required - Have you applied for a mortgage loan?

14.

Question - Not Required - IF YES, with whom?

*15.

Question - Required - Are you scheduled to close on your home in the next 30 days?

16.

Question - Not Required - IF YES, what date are you scheduled to close?

17.

Question - Not Required - Name of Loan Officer:

18.

Question - Not Required - Loan Officer's Phone Number:

19.

Question - Not Required - Loan Officer's e-mail address:

20.

Question - Not Required - What type of mortgage loan did you apply for?

21.

Question - Not Required - Property Address:

(Maximum response 255 chars, approx. 5 rows of text)

*22.

Question - Required - I am submitting a request for disbursement of the Dream Maker Program grant reference above. By entering my initials in the box below, I certify that: This household income falls within program guidelines. This grant can only be used for a 30-year fixed-rate mortgage, maximum of 97% financed, with a 3% down payment. Please initial below.

If you have not applied for a mortgage and are looking for a lender that will accept the Dream Makers grant, you can consider a VA or FHA mortgage from the Pentagon Federal Credit Union. For more information on PenFed mortgages, visit www.penfed.org. You are not required to use a PenFed mortgage in order to receive a grant. Dream Makers grants can be used in conjunction with any mortgage lender.