Application

I understand that Step Up Acadiana provides foreclosure mitigation counseling and housing counseling; after which I will receive a written action plan consisting of recommendations for handling my finances, possibly including referrals to other housing agencies as appropriate.

I understand that there is a fee for my credit report. If I am at risk for closure, there is no charge for counseling. If my household income is below 50% of the Area Median Income there is no charge for counseling.

I may be referred to other housing services of the organization or another agency or agencies as appropriate that may be able to assist with particular concerns that have been identified. I understand that I am not obligated to use any of the services offered to me.

A counselor may answer questions and provide information, but not give legal advice. If I/we want legal advice, I will be referred for appropriate assistance.

I understand that counselors may discuss information about my/our credit history, financial situation, employment, or other family problems. I authorize Step Up Acadiana to release Credit, financial, employment, and other information to other agencies or firms as may be essential to the solving of our housing problem.

I understand that smile may refer me to lenders I may understand that smile may refer me to lenders so that I may submit an appropriate loan understand that Step Up Acadiana may refer me to lenders so that I may submit an appropriate loan application, where applicable. I hereby explicitly give lenders or potential lenders permission to share my application with Step Up Acadiana for the reporting purposes hereby waiving any prohibition of such disclosure under GLBA privacy provisions and regulation P of the Code of Federal Regulations.

I understand that if any information provided by me is found to be falsified, legal action can and will be taken against me.

I understand by signing this document that I am not guaranteed assistance.

Step Up Acadiana is committed to ensuring the privacy of individuals and/or families with contact us for assistance. We realize that the concerns you bring to us are personal in nature. We are sure you got all the information shared both orally and in writing will be managed within legal and ethical considerations. Your “non-public personal information”, such as your total information, income, living expenses, and personal information concerning your financial circumstances, will be provided to creditors, program monitors, and others only with your authorization and signature on the Client Counseling Authorization Form. We may also use anonymous aggregated case file information for the purpose of evaluating our services, gathering value will research information, and designing future programs.

Types of information that we gather about you:
* Information we received from you orally, on applications or other forms, such as your name, address, Social Security number, assets, and income
* Information about your transactions with us, your creditors, or others, such as your account balance, payment history, parties to transaction, and credit card usage;
* Information we received from a credit-reporting agency, such as your credit history
You may opt-out of certain disclosures
* You have the opportunity to opt-out of disclosures of your non-public personal information to third parties (such as your creditors), that is, direct us not to make those disclosures.
* If you choose to “opt-out”, we will not be able to answer questions from your creditors. If is anytime you wish to change your decision with regard to your opt-out, you may call or email us.
Release of your information to third parties
* So long as you have not opted out, we may disclose some or all of the information that we collect, as described above, to your creditors or third parties where we have determined that it would be helpful to you, would eat us in counseling you, or is the requirement of grant awards which make our services possible.
* We may also disclose any non-public personal information about you or former customers to anyone as permitted by law (for example, if we are compelled by legal process).
* Within the organization, we restrict access to non-public 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 non-public personal information.

NOTE: If you have an impairment, disability, language barrier, or otherwise require an
alternative means of completing this form or accessing information about housing
counseling, please talk to your housing counselor about arranging alternative
accommodations.
About Us and Program Purpose: Step Up Acadiana is a nonprofit housing counseling
agency.
Our agency provides the following one-on-one housing counseling services:
 pre-purchase/home buying – preparing for the home purchase
 post-purchase non-delinquency – counseling after the home purchase
 foreclosure prevention counseling – assisting those at risk of losing their home to
foreclosure
Our agency also provides the following group education workshops:
 Financial literacy – budgeting, credit repair, increasing savings
 pre-purchase/home buyer education – workshops to prepare for the home
purchase in a group setting, either online or in-person
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.).
Termination of Services: Failure to work cooperatively with your housing counselor
and/or Step Up Acadiana will result in the discontinuation of counseling services. This
includes, but is not limited to, missing two consecutive appointments.
Agency Conduct: No Step Up Acadiana 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: Step Up Acadiana has financial affiliation (if funded by HUD) or
professional affiliations with HUD, USDA Rural Development, SMILE Community Action
Agency, Southern University and Lafayette Habitat for Humanity; and banks including
Home Bank, Cadence Bank, Red River Bank, Community First Bank and Cottonport
Bank. Step Up Acadiana was founded by Kevin Davis, a licensed real estate broker and
owner of Sky Universal Realty.

As a housing counseling program participant, you are not obligated to use the products
and services of Step Up Acadiana or our industry partners.
Alternative Services, Programs, and Products & Client Freedom of Choice: Step Up
Acadiana has a first-time homebuyer program. However, you are not obligated to
participate in this or other Step Up Acadiana programs and services while you are
receiving housing counseling from our agency. You may consider seeking alternative
products and services from entities including the Federal Housing Administration (FHA)
for first-time homebuyer loan programs, and Lafayette Consolidated Government for
other first-time homebuyer programs. You are entitled to choose whatever real estate
professionals, lenders, and lending products that best meet your needs.
Referrals and Community Resources: If necessary, you will be provided a community
resource list which outlines the parish and regional services available to meet a variety
of needs, including utilities assistance, emergency shelter, transitional housing, food
banks, and legal aid assistance.
Errors and Omissions and Disclaimer of Liability: I agree Step Up Acadiana, 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 Step Up Acadiana
counseling; and I hereby release and waive all claims of action against Step Up
Acadiana and its affiliates. I have read this document 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, Step Up Acadiana 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 Step Up Acadiana grantors such as HUD or NeighborWorks
America.
I acknowledge that I have reviewed and agree to Step Up Acadiana’s Program
Disclosures.