Housing Program Interest Form

Please complete this application if you are interested in any of Placer County's Housing Programs. Please note that this program only applies to properties located in unincorporated Placer County.

Information about the program and applicant eligibility can be found here.

First Name

Middle Name

Last Name

Current Address

Current Address line 2

Current City

Current State Value is not selected

Current Zip

Phone Number

Email Address

Household Size Total number of all (adults and children) persons residing in the household

Have you ever filed for bankruptcy?

Yes

If so, when (Date)

Do you have a family member who works for the county?

Yes

If so, name and title

Past Two Years of Tax Returns

Past Two Years of W2 Tax Returns for All Jobs

Pre Approval Letter from Lender

Most recent 30 days paystubs for each adult household member (PDF)

Your session has timed out.

Click here to access the application.

First Time Home Buyer Application

Housing Program Interest Form

Demographic Information (For Reporting Purposes Only)