Apply for a Home Site Visit - HomeShare Vermont

Household Information

Name of homeowner(s)*

Physical Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different)

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Why do you want to add an ADU to your home?*

I am interested in:*

General Information
The Burlington Guidebook
Sample detached home designs
Free site visit
Finding a tenant
Grants or deferred loan products
Other

Other

To help us determine if an ADU is feasible for you, please tell us:

Are you the sole owner(s) of the home at the above listed address?*

Yes
No

Is the home above your primary residence?*

Yes
No

Is the home a single-family residence?*

Yes
No

Give us a sense of where your project is at:

Have you explored financing for the project through savings, loan or credit?*

Yes
No

Do you have a design or concept for the project?*

Yes
No

Do you have a builder selected?*

Yes
No

When do you plan to start construction?*

To help us report to our funders and assess if you might be eligible for future loan/grant products: (optional)

What is your household size?

Is your annual household income less than $51,350?

Yes
No

Is your annual household income less than $58,650?

Yes
No

Is your annual household income less than $66,000?

Yes
No

Is your annual household income less than $73,300?

Yes
No

Is your annual household income less than $79,200?

Yes
No

Is your annual household income less than $85,050?

Yes
No

Are you current with mortgage, taxes and insurance for the home?

Yes
No

Is the home now or expected to be on the market for sale?

Yes
No

Name*

First Last

Today's Date*

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