Help for Homes Program

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1 The Help for Homes program is the City of Thornton s minor home repair/improvement program. Qualified homeowners are eligible to have minor repairs performed on their home, free of charge. The program is brought to you by a partnership between the City of Thornton and Brothers Redevelopment, Inc. (BRI). The goal of the Help for Homes program is to improve the health, safety and accessibility of the homes of lowincome Thornton homeowners that are seniors and/or disabled who do not have the financial and/or physical ability to make the needed repairs themselves. The program is available during regular business hours Monday through Friday, between 8:00 am and 5:00 pm, excluding holidays. Repair costs are limited to $3,500 per household and per property. How do I qualify? All homeowners must meet the following criteria and provide proof of their eligibility: Criteria Description Proof Required Low-Income Based on the size or number of people in your household, you must make less than a certain amount of money each year. Family Size / Income must be less than: Age or Disability Homeownership Status 1 person / 2 people / 3 people / 4 people / 5 people / 6 people / 7 people / 8 people / $44,750 $51,150 $57,550 $63,900 $69,050 $74,150 $79,250 $84,350 Must be 55 years or older or have a disabled person living in the home. Must own and live in the home, be current on mortgage payments, cannot have outstanding code violations or property tax or mechanical liens. Most current year s tax statements for all people living in the home; and Current verification for all sources of income (i.e. two most current consecutive paystubs for all people living in the home, Social Security award letter, Old Age Pension award letter, unemployment award letter, child support or alimony award letters, etc.); and Most current statement of any retirement distributions. A photo ID is required for all applicants, regardless of age. If disabled, applicant must provide verification such as recent statement of SSDI/ SSI benefits, or a disability verification form completed by doctor or other qualified individual.* Latest mortgage statement that shows payments are current. If the home is paid off, copy of title or release of deed of trust. Proof of home insurance. Legal Residency Must be a legal U.S. resident. Applicant must sign and date the affidavit attached to the application. Assets Must have less than $10,000 in assets. Full copies of the 2 most recent consecutive months of checking and savings bank statements and investment statements for all people living in the home. Property and business information, as applicable. * This form can be obtained from City of Thornton staff. No information should be provided to the city that describes either the nature or extent of the disability. Applicants who do not meet the qualification criteria listed above will be referred to other agencies or programs which may be able to address the applicant needs.

2 What is the process? 1. Submit an application and required documents to the City. A letter will be sent to you letting you know if your application is approved or denied. 2. If approved, BRI staff will contact you to setup an appointment to inspect the home. The inspection will determine what types of repairs are needed and eligible. For example: ELIGIBLE Accessibility: wheelchair ramps, door widening or installation of grab bars Safety improvements: outdoor lighting, smoke detectors Minor electrical or plumbing repairs Minor roofing repairs NOT ELIGIBLE Major home repairs: roof replacement or sewer line repairs Yard work, landscaping, driveways, fencing New windows Remodeling, additions, purely aesthetic improvements 3. Brothers Redevelopment, Inc. submits a cost estimate to the City of Thornton for the proposed work. City of Thornton staff approves eligible work that does not exceed the maximum budget. 4. If approved, Brothers Redevelopment, Inc. and/or sub-contractors will contact you to schedule a time to perform the repairs. 5. After the work is completed you will be sent a survey to gather feedback on your experience with the program. Ready to submit? Please include the following items: Completed application, signed and dated by the homeowner(s). Signed and dated Immigration Affidavit (attached to this application) Income verification for each member of the household that is 18 years or older. This includes but is not limited to (if applicable): o Most current tax returns o 1099R or most recent statement for any retirement savings distributions (i.e. IRA, pension), showing total year to date disbursements. o Two (2) most recent consecutive pay stubs o Award letters for any government assistance received and/or child support or alimony. Copy of driver s license or state issued photo identification of homeowner(s). Proof of disability *(if applicable). Copy of mortgage statement indicating payments are current. If the home is paid off, provide a copy of the property title or release of deed of trust. Proof of home insurance. Proof of assets, which includes but is not limited to (if applicable): o Two (2) most recent checking and/or savings bank statements o Two (2) most recent investment account statements o Other property description / mortgage statement or title o Name and value of business owned and operated Applications can be: MAILED TO: FAXED TO: DELIVERED IN PERSON TO: City of Thornton Attn: Help for Homes Program 9500 Civic Center Drive Thornton, CO City of Thornton, City Development (Planning front counter, one-story building behind City Hall) 9500 Civic Center Drive Thornton, CO Questions? Please call the Neighborhood Services Division at Please Keep This Page for Your Records

3 HOMEOWNER APPLICATION FOR ASSISTANCE The following information is required in order to determine whether you qualify for the Help for Homes and Thornton Paint-A-Thon programs. The application and supporting documentation will be viewed by those that administer these programs. Any personal information such as bank account numbers or social security numbers will be obscured from the document prior to review. Homeowner Information Date: Name of applicant(s): Property address: Home phone #: Alternative phone #: address: Is anyone in the home currently employed? YES NO Is anyone in the home disabled? YES NO Note: No information should be provided that describes either the nature or extent of the disability. Age of homeowners: Applicant Co-Applicant What is your ethnicity? (optional) Hispanic Non-Hispanic What is your race? (optional) White/Caucasian Asian African American American Indian/Alaskan Native Hawaiian Other Are you, or is anyone living in your home a veteran? (optional) YES NO Are you a female head of household? (optional) YES NO How did you hear about the Help for Homes program? Home Information Have you previously received assistance through the Help for Homes program? YES NO Do you live in a Home Owners Association (HOA) Community? YES NO Do you intend to sell your home or transfer the title of your home within the next five years? YES NO Are you aware of any mechanical, HOA, tax or other liens on your property? YES NO If yes, please explain: Do you have homeowner s insurance? YES NO Have you contacted your insurance company to see if any of the repairs could be covered through your insurance? YES NO If yes, what was the result? FOR INTERNAL USE ONLY Date application received: Date application completed: Household Size: Annual Household Income: Total amount spent previously through Help for Homes: $

4 What health, safety or accessibility repairs does your home need (in order of priority)? Financial and Asset Information Total Annual Income Limits per Household Size 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons $44,750 $51,150 $57,550 $63,900 $69,050 $74,150 $79,250 $84,350 List all occupants living at this address, including you (the applicant), co-applicant, and any other adults or children. Name Birth Date Occupation Files IRS Tax Return? Applicant Yes No Co-Applicant Yes No Other Occupant Yes No Other Occupant Yes No Other Occupant Yes No Is there anyone on the title to the property who does not live there? YES NO If yes, provide the name of person(s) on title and an explanation: List the total monthly income of all household members. Please note that documentation must be provided for all sources of household income listed below. Type of Income Household Member Applicant Co-Applicant Other Employment 1 $ $ $ Employment 2 $ $ $ Unemployment $ $ $ Social Security Retirement Insurance $ $ $ Social Security Disability Insurance (SSDI) $ $ $ Other Retirement/Pension $ $ $ 401(k), 403(b), or 457(b) payments withdrawn in the last year $ $ $ Child support/alimony $ $ $ Other: $ $ $

5 Statement of Assets To qualify for the Help for Homes program, applicants cannot have more than $10,000 in assets, which includes but is not limited to cash, money in savings accounts, money in checking accounts, equity in a second home or investment property and investment funds. This does not include your current primary residence, retirement accounts, and/or vehicles. Please answer the following questions: Do you have a checking account? Yes No. If YES, amount in account: $ Do you have a savings account? Yes No. If YES, what is the amount in the account: $ Do you have other cash savings (not including cash in a bank account)? Yes No. If YES, what is the amount of the cash on hand: $ Do you own rental property or land? Yes No If YES, value of property: $ Amount still owed: $ Do you own stocks, bonds, or other investments (not including retirement accounts)? Yes No If YES, value of stocks, bonds, or other investments: $ Do you have any other investments or assets? Yes No If YES, list the investment/assets and the amounts:

6 Indemnification I (We) herby agree to indemnify and hold harmless the City of Thornton, its officers, agents, employees and sub-grantees for the Help For Homes program against all liabilities, judgments, costs, and expenses arising out of, or in consequence of, housing rehabilitation or repairs provided as part of the City of Thornton s Help for Homes program. Applicant s Certifications The applicant(s) hereby certifies that he/she is the owner-occupant of the property to be repaired and that the property is his/her principal residence. The applicant also certifies that all information provided in this application, including the income information, is true and correct to the best of the applicant s knowledge and belief. I (we) understand that any discrepancy or omission in the information provided may disqualify me (us) from participation in the Help for Homes program. Applicant Signature Date Co-Applicant Signature Date

7 AFFIDAVIT I,, swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): I am a United States citizen, or I am a Permanent Resident of the United States, or I am lawfully present in the United States pursuant to Federal Law. I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute and it shall constitute a separate criminal offense each time a public benefit is fraudulently received. Signature Date

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