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Empty Nester Eligibility Form

This is NOT a loan application or a guarantee of a loan for a Habitat for Humanity of Omaha house. This is an eligibility questionnaire for Habitat Omaha's Empty Nester program.

Please note: Habitat for Humanity of Omaha reserves the right to refuse a home purchase based on the condition of the property.

Please allow 30-45 days to evaluate your Empty Nester questionnaire. We will contact you via email or phone with additional information after we have assessed your completed questionnaire.

How many adults (18 and over) live in your household?

How many children (under 18) live in your household?

Co-Applicant Information

Co-Applicant First Name

Co-Applicant Last Name

Co-Applicant Phone Number

Co-Applicant Email Address

Co-Applicant date of birth (mm/dd/yyyy)

Co-Applicant gender identity

Co-Applicant: Are you currently, or have ever been a member of the U.S. Armed Forces?

Income Information

*Proof of income will be required

Enter your household's individual earner information as applicable.

Individual 1 (required)

Employment type:

Years at current employment

Who is your current employer?

Co-Applicant (if applicable)

Employment type:

Years at current employment

Who is your current employer?

Additional Information

Would you feel comfortable communicating with Habitat Omaha staff in English?

What is your preferred language?

Which race do you identify as?

Which ethnicity do you identify as?

Are you an immigrant to the U.S.?