Housing Allowance Form | Freedom in Christ Ministries

FICM Housing Allowance Request Form

Name *

First

Last

Starting Date *

Ending Date *

Type of Living Quarters *

Please provide Annual values for the categories below. Enter 0 for expenses that do not apply.

1. Housing Rental Payments (Estimated) *

1. Housing Rental Payments (Actual)

2. Down payment on housing purchase (Estimated) *

2. Down payment on housing purchase (Actual)

3. Housing loan principle and interest payments (Estimated) *

3. Housing loan principle and interest payments (Actual)

4. Real estate commission, escrow fees (Estimated) *

4. Real estate commission, escrow fees (Actual)

5. Real property taxes (Estimated) *

5. Real property taxes (Actual)

6. Personal property taxes on contents (Estimated) *

6. Personal property taxes on contents (Actual)

7. Homeowner's Insurance (Estimated) *

7. Homeowner's Insurance (Actual)

8. Personal property insurance on contents (Estimated) *

8. Personal property insurance on contents (Actual)

9. Umbrella liability insurance (Estimated) *

9. Umbrella liability insurance (Actual)

10. Structural maintenance and repair (Estimated) *

10. Structural maintenance and repair (Actual)

11. Landscaping, gardening, pest control (Estimated) *

11. Landscaping, gardening, pest control (Actual)

12. Furnishings (Estimated) *

12. Furnishings (Actual)

13. Decoration and redecoration (Estimated) *

13. Decoration and redecoration (Actual)

14. Utilities and trash collection (Estimated) *

14. Utilities and trash collection (Actual)

15. Cleaning (Estimated) *

15. Cleaning (Actual)

16. Condominium/HOA fees (Estimated) *

16. Condominium/HOA fees (Actual)

17. Estimated Subtotal

18. 10% allowance for unexpected expenses (Estimated)

19. Estimated Total

Total ANNUAL housing allowance requested *

Agreement *

By checking this box I agree that the data entered here is correct to the best of my knowledge. The form will automatically save the date of your submission.

Email *