INTAKE FORM

We appreciate your interest in meeting with us! Please select the service that best meets your needs below and complete the information requested.


If you have any questions please contact us at 805-273-7800.

If you require special accommodations for mobility impairment, visual or hearing impairments or other disabilities please contact us before your appointment at (805) 273-7800. If you have a hearing or speech impairment you can communicate with us via the CA Relay Service: 1-866-934-4288.


Once you submit this intake packet you will be automatically redirected to the appointment page.

Select the service that best meets your needs.
For further information regarding each service click here.

Please note we are currently not offering foreclosure prevention/home preservation counseling nor do we have access to financial assistance programs to help homeowners become current on their mortgage/property taxes/HOA payments/insurance. 

If you are having trouble making your mortgage payment or are behind on your mortgage, please click here to view a list of agencies that may be able to assist with providing free counseling.

Per HUD regulations, your Loan Officer cannot have any contact with VCCDC regarding your counseling session, this includes completing these forms, scheduling your appointment, using their email as the point of contact, and being present during your session. HUD is very clear about these regulations in order to ensure a neutral session for the client. This is for YOUR protection.

If you are the Lender for this client please STOP and do not proceed with completing this form for your client. As a HECM lender your only responsibility for the counseling process is to provide your client with a list of housing counseling agencies that the client will need to contact on their own to complete the intake and appointment process.

In the event, VCCDC determines the lender and/or client failed to comply VCCDC will stop/cancel the appointment and will not proceed, possibly delaying your transaction. 

What language do you prefer for your session?
If you select a language other than the ones listed, please allow us at least 7 business days to secure an interpreter.
Is the homeowner legally competent to understand the nature of Reverse Mortgage counseling? For borrowers lacking legal competency, the counseling session may be conducted with an “agent” holding a power of attorney.
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Would you like to receive emails from VCCDC regarding our programs, additional services, & special events? (you can unsubscribe at any time)
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Gender
Military status
Are you a first-time homebuyer?
Any individual who has not owned a home in the prior three years
Are you a first generation homebuyer?
Any individual whose parents or guardians never owned a home during the homebuyer's lifetime (excluding heir property) and whose spouse has not owned a home in the last three years.
Hispanic Ethnicity
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Head of Household
a head of household is generally an unmarried taxpayer who has dependents and paid for more than half the costs of the home.
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If you are unsure, please provide an estimate
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ADDITIONAL HOUSEHOLD MEMBERS

Please note if you have more than 2 people in your session it may take more than one session to conduct a full financial assessment.
Is your address the same as client #1
Please select
Would you like to receive emails from VCCDC regarding our programs, additional services, & special events? (you can unsubscribe at any time)
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Gender
Hispanic Ethnicity
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INCOME INFORMATION

If you have more than one income source click on "add more" below
Income Source
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REFERRAL SOURCE

How did you hear about VCCDC (check all that apply)
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Reverse Mortgage Counseling

The current fee for Reverse Mortgage Counseling can be found at vccdc.org/resources at “Fee Schedule” or call 805-273-7800. Counseling fee is due at the time of your session via debit/credit card on the day of your session. If paying by check, please make it payable to VCCDC and mail it to 2231 Sturgis Road, Suite A, Oxnard, CA 93030 in advance to ensure it arrives before your session.

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Is there a mortgage on this property?
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Please tell us the reason for you are interested in a reverse mortgage (please check all that apply):
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MONTHLY BUDGET

Please complete each income and expense category below. We appreciate your cooperation as it will help us provide you with better guidance during your session. If something doesn't apply to you please skip that box. Thank you!

MONTHLY INCOME

If you don't know the exact amount, an estimate is okay
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MONTHLY EXPENSES

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gas, water, electricity, sewage, trash
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Hulu, Netflix, Apple, Google, etc.
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Groceries, dining out, work/school lunch, etc.
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Out of pocket health insurance, co-payments, medications
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Car payment, fuel, insurance, maintanance
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Clothing, gym, nails, hair, toiletries, etc.
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Daycare, tuition, tutoring, clothing, sports, supplies etc.
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Home, renters, health
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food, veterinarian, grooming, supplies, etc.
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Movies, hobbies, concerts, travel, etc.
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Only include monthly payments, not full balance
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Student loan, personal loan, etc.
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Emergency, stocks/investments, other savings
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STATEMENT OF COUNSELING SERVICES

Please read the statements below and sign to indicate your understanding of each statement:
1.) I understand that Ventura County Community Development Corporation (VCCDC) provides confidential pre-purchase, post-purchase, financial capability, reverse mortgage, and foreclosure prevention housing counseling/coaching after which I will receive a written Action Plan that is designed to help me understand what steps to take in order to reach my homeownership or financial goal, possibly including referrals to other agencies as appropriate. I understand that this session is NOT a loan approval or loan modification request.
2.) I understand that my Homeownership Specialist (counselor) may answer questions and provide information, but not give legal advice.
3.) I agree to hold VCCDC, its employees, agents, volunteers, officers and directors harmless from any claim, suit, action or demand, or any other person resulting from counseling.
4.) I understand that I may be referred to other housing services offered by VCCDC or other agency/agencies as appropriate that may be able to assist with concerns that have been identified. I also understand that I am not obligated to use any of the services offered to me.
5.) I understand that VCCDC provides information and education on numerous loan products and housing programs and I understand that the housing counseling I receive from VCCDC in no way obligates me to choose any of these loan products or housing programs.
6.) I understand that no representative of VCCDC has any authority to enter into any agreement for any specified period, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
7.) I understand that in the event I am dissatisfied, I can request a copy of the Complaint Resolution Process, a copy of which is available upon request.
8.) I acknowledge receiving the following documents prior to or at the time of my session (click on links to view documents or visit www.vccdc.org/resources and click on "HUD Documents"):
VCCDC Privacy Policy (section 7 of this intake form), VCCDC Program Disclosure (section 8 of this intake form), 10 Questions to Ask a Home Inspector, For Your Protection Get a Home Inspection, CA Fair Housing Brochure, CRLA Fair Housing, CRLA LGBT Fair Housing, Lead Based Paint Fact Sheet, Community Resource Guide, List of Alternative Service Providers, & VCCDC’s Fee Schedule.
Reverse Mortgage Counseling - I acknowledge receiving and reviewing the Reverse Mortgage Information Packet as required by HUD prior to my appointment. Click here to access the Reverse Mortgage Counseling reading material.
Reverse Mortgage Counseling - If funding is not available to offer Reverse Mortgage Counseling free of charge, I agree to pay the current fee to VCCDC for the Reverse Mortgage Counseling session which can be found at vccdc.org/resources at “Fee Schedule” or call 805-273-7800. Counseling fee is due at the time of your session via debit/credit card on the day of your session. If paying by check, please make it payable to VCCDC and mail it to 2231 Sturgis Road, Suite A, Oxnard, CA 93030 in advance to ensure it arrives before your session.
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AUTHORIZATION

Please read the statements below and sign to indicate your authorization of each statement:
1.) If applicable to my housing/financial counseling need, I authorize VCCDC to pull my credit report which will be a soft credit report that will not have any effect on my credit score. In lieu of a credit pull, I agree to provide VCCDC with a copy of my credit report dated within 30 days of my first session (click here for “Fee Schedule” or visit vccdc.org/resources and click on "Fee Schedule"). NOT APPLICABLE FOR REVERSE MORTGAGE COUNSELING.
2.) I authorize VCCDC to close my counseling file for any of the following reasons: I fail to follow the agreed upon action plan, it is determined that further housing counseling will not resolve my housing need, I cannot be contacted, or do not show up to appointments.
3.) I understand that VCCDC receives various funds to be able to provide the service I am going to receive at low or no cost. This includes Federal funds from HUD/RCAC, State funds through CalHFA/BALANCE, and funding from other entities, and as such, is required to submit client-level information to the funding entity including CalHFA/BALANCE/HUD/RCAC and/or other funders and their agents for purposes of program monitoring, compliance and evaluation. I give permission for CalHFA/BALANCE/HUD/RCAC and other VCCDC funders  and/or their agents to follow-up with me for the purposes of program evaluation.
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PRIVACY POLICY

Ventura County Community Development Corporation (VCCDC) is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations. Your “nonpublic personal information” will be provided to creditors, program monitors, and others only with your authorization. We may also use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable research information, and designing future programs. 

What is nonpublic, personal information?
• Information that identifies an individual personally and is not otherwise publicly available information, such as your Social Security Number or demographic data such as your race and ethnicity

• Includes personal financial information such as credit history, income, employment history, financial assets, bank account information, financial debts and personal information concerning your financial circumstances.

What personal information does VCCDC collect about you?
• Information we receive from you orally, on applications or other forms, such as your name, address, social security number, assets and income; and

• Information about your transactions with us, your creditors, or others, such as your account balance, payment history, parties to transactions and credit card usage; and

• Information we receive from a credit reporting agency, such as your credit history.

• We do not sell or rent your personal information to any outside entity. 

Release of your information to third parties
1. So long as you have not opted out, we may disclose some or all of the information that we collect, as described above, to other third parties, ONLY when THE COUNSELOR and YOU have determined it would be helpful to you, would aid us in counseling you, or is a requirement of grant awards which make our services possible. Funders do not require VCCDC to disclose social security numbers and therefore will not release this information to any third party. In most cases data submitted to funders is provided anonymously and is only identified with a case number.

2. We may also disclose any nonpublic personal information about you as required by law (e.g., if we are compelled by legal process).

3. Within the organization, we restrict access to nonpublic personal information about you to those employees who need to know that information to provide services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information. 

Opting Out of Certain Disclosures
1. You have the opportunity to “opt-out” of disclosures of your non-public personal information to third parties (such as your creditors), other than to program funders and those required by law.

2. If you choose to “opt-out,” we will not be able to answer questions from your creditors. If at any time, you wish to change your decision with regard to your “opt-out,” you may call us at 805-273-7800 and do so. If you choose to opt out, you may limit VCCDC’s ability to provide services to you such as communicating with your mortgage servicer/lender or your creditors.

If you choose to opt out, you may limit VCCDC’s ability to provide services to you such as communicating with your mortgage servicer/lender or your creditors.
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VCCDC PROGRAM DISCLOSURE STATEMENT

About Us and Program Purpose: Ventura County Community Development Corporation (VCCDC) is a nonprofit, HUD approved housing counseling agency. We provide educational workshops and housing counseling including:


Pre-purchase Education & Counseling: Provides potential homebuyers with advice regarding readiness and preparation for homeownership. Topics covered include: advantages and disadvantages of buying; money management; budgeting and credit; fair housing and fair lending; loan product comparison; purchase procedures and closing costs; selecting a real estate agent; home inspection; home insurance; down payment assistance; and referrals to community services and regulatory agencies. For individual counseling, counselors provide a review of the client’s income, credit, household budget and home affordability resulting in a custom action plan to help the client achieve their housing goal.


Non-Delinquency Post-purchase Education & Counseling: Provides homeowners with advice on various homeownership topics including budgeting; home maintenance tips; taxes and insurance; refinance options; home equity; home improvement; utility costs; energy efficiency improvements; property taxes; working with a contractor; estate planning; avoiding foreclosure and rights and responsibilities of homeowners.


Reverse Mortgage/HECM Counseling: Provides required HUD counseling for senior homeowners who are 62 years old and are interested in possibly obtaining a HECM/reverse mortgage. The objective of HECM counseling is to education clients on: how HECMs and reverse mortgages work; the implications of and alternatives to a HECM or other reverse mortgage; and the appropriateness of a HECM or other reverse mortgage for the clients being counseled considering their unique personal and financial situation.


VCCDC also offers mortgage lending services. We serve all clients regardless of income, race, color, religion/creed, sex, national origin, age, family status, disability, or sexual orientation/gender identity. We administer our programs in conformity with local, state, and federal anti-discrimination laws, including the federal Fair Housing Act (42 USC 3600, et seq.). As a housing counseling program participant, please affirm your roles and responsibilities along with the following disclosures and sign & date the form on the following page.

Client and Homeownership Specialist Roles & Responsibilities:

Homeownership Specialist Roles and Responsibilities
• Review your housing goal and your finances; which include your income, debts, assets, and credit history.
• Prepare a Client Action Plan that lists the steps that you and your Homeownership Specialist will take in order to achieve your housing goal.
• Prepare a household budget that will help you manage your debt, expenses, and savings.
• Your Homeownership Specialist is not responsible for achieving your housing goal, but will provide guidance and education in support of your goal.
• Neither your Homeownership Specialist nor VCCDC employees, agents, nor directors may provide legal advice. 

Client’s Roles and Responsibilities
• Complete the steps discussed in your Client Action Plan.
• Provide the requested documents and accurate information about your income, debts, expenses, credit, and employment.
• Attend appointments, return calls and provide requested paperwork in a timely manner.
• Notify your Homeownership Specialist when changing housing goal.
• Attend Homebuyer Education Workshop and other educational workshop(s) as recommended.
• Retain an attorney if seeking legal advice and/or representation in matters such as foreclosure or bankruptcy protection. 

Termination of Services: Your success will be determined by your commitment to the goals set during the session. Failure to communicate with your Homeownership Specialist including missing three consecutive appointments will result in VCCDC closing your file. 

Agency Conduct - Conflict of Interest: No VCCDC employee, officer, director, contractor, volunteer, or agent shall undertake any action that might result in, or create the appearance of, administering counseling operations for personal or private gain, provide preferential treatment for any person or organization, or engage in conduct that will compromise our agency’s compliance with federal regulations and our commitment to serving the best interests of our clients.

Agency Relationships: VCCDC has financial affiliation and/or professional affiliations with: U.S. Department of Housing and Urban Development (HUD), BALANCE, Bank of America, Bank of the Sierra, Bank of the West, California Bank & Trust, CalFHA, CDFI Fund, CIT Bank, Citibank, City of Bakersfield, City of Oxnard, City of Simi Valley, City of Thousand Oaks, City National Bank, Comerica Bank, County of Ventura, Housing Authority of the City of Oxnard, Housing Authority of the City of San Buenaventura, Housing Authority of the County of Ventura, Housing Authority of the County of Santa Barbara, Housing Trust Fund of Santa Barbara County, JP Morgan Chase, Limoneira Foundation Fund, Local Initiatives Support Corporation, Mechanics Bank, National Association for Latino Community Asset Builders, National Housing Resource Center, NeighborWorks America, Premier America Credit Union, Pacific Western Bank, Rabobank, Rural Community Assistance Corporation, S. Mark Taper Foundation, Silicon Valley Bank, So Cal Gas Co, State of California, UnidosUS, Union Bank, U.S. Bank, Ventura County Credit Union, Wells Fargo. As a housing counseling program participant, you are not obligated to use the products and services of VCCDC or our industry partners.

Alternative Services, Programs, and Products & Client Freedom of Choice: You are not obligated to participate in VCCDC’s other programs and services while you are receiving housing counseling from our agency. Receiving housing counseling services is not contingent on the use of any service or product. You may consider seeking alternative products and services from entities including the Federal Housing Administration (FHA) for first-time homebuyer loan programs, and Centro Familia Esperanza and Money Management International, Los Angeles (contact information available at www.hud.gov) for other first-time homebuyer programs (please note VCCDC is not affiliated with the aforementioned organizations). You are entitled to choose whatever real estate professionals, lenders, and lending products that best meet your needs. 

Referrals and Community Resources: You will be provided a community resource list which outlines the county and regional services available to meet a variety of needs, including utilities assistance, emergency shelter, transitional housing, food banks, and legal aid assistance. This list also identifies alternative agencies that provide services, programs, or products like those offered by VCCDC and its exclusive partners and affiliates.

Errors and Omissions and Disclaimer of Liability: I/we agree VCCDC, its employees, agents, and directors are not liable for any claims and causes of action arising from errors or omissions by such parties, or related to my participation in VCCDC housing counseling; and I hereby release and waive all claims of action against VCCDC and its affiliates. I have read this document, understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. If any provision of this document is unenforceable, it shall be modified to the extent necessary to make the provision valid and binding, and the remainder of this document shall remain enforceable to the full extent allowed by law. 

Quality Assurance: In order to assess client satisfaction and in compliance with grant funding requirements, VCCDC, or one of its partners, may contact you during or after the completion of your housing counseling service. You may be requested to complete a survey asking you to evaluate your client experience. Your survey data may be confidentially shared with VCCDC grantors such as HUD.
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Document Upload

To provide you with the most accurate financial review please upload the following documents. 

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Reviewing your credit is a key part of the financial analysis we will provide. In order to provide you the needed guidance to help you meet your housing/financial goal please select one of the following options.

Click here to view our current credit report fee


Please note: The credit report VCCDC pulls through Credco is a tri-merge soft pull report meaning you will get your FICO scores and summary of all accounts for all the three credit bureaus (Equifax, TransUnion and Experian) and it will NOT affect you credit score since it is being pulled for informational purposes only.


The credit report from www.annualcreditreport.com does not contain your scores and has a limited view of your accounts and will therefore limit the credit analysis we can provide.

Once you click on "Preview Submission", click on "Submit Form" and you will be automatically redirected to our appointment booking page. If you are not automatically redirected please follow the instructions on the screen.

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