Help for Homes Application

Transcription

1 Help for Homes is the City of Thornton s minor home repair program. Qualified homeowners are eligible to have minor repairs or rehabilitation performed on their home free of charge. The goal of the Help for Homes program is to ensure that low-income Thornton homeowners who are 55 years of age or older or disabled live in healthy and safe homes. Repair costs are limited to $3,500 per household and per property. If you have questions on the program or application, please call the Neighborhood Services Division at Program Qualifications All homeowners must meet the following criteria and provide proof of their eligibility: Criteria 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. Age or Disability Homeownership Status Legal Residency Assets Description Family Size / 1 person / 2 people / 3 people / 4 people / 5 people / 6 people / 7 people / 8 people / Income less than: $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 and be current on mortgage payments. Cannot have outstanding code violations or liens recorded with Adams County or State of Colorado. Must be a legal U.S. resident. Must have less than $10,000 in assets. Home Repair Eligibility This program is funded through the U.S. Department of Housing and Urban Development. Therefore, repairs that directly relate to the health, safety or accessibility of the homeowner are eligible, such as: ELIGIBLE Stabilizing steps, wheelchair ramps, door widening Furnace or water heater repairs Minor electrical or plumbing repairs Minor roofing repairs NOT ELIGIBLE Roof or sewer replacement Work in or to the yard, driveways, fencing New windows Remodeling, additions, purely aesthetic improvements

2 The Process 1. Submit an application and copies of required documents to the City. Once reviewed, you will receive a letter to let you know if your application is approved or denied. 2. If approved, staff from our repair contractor will perform a home inspection to determine what repairs are needed. The City staff will review the inspection report and will verify if the problems are eligible to be repaired through the program. 3. If repairs are approved, contractors will schedule a time to perform the repairs. 4. After the work is completed you will be asked to sign documents which verify that the work was performed. Also, you will receive a survey asking you to rate your experience with the program. Applying for the Program The following items must be submitted to Neighborhood Services in order to apply for the program: Completed application, signed and dated by the homeowner(s), including Immigration Affidavit Copies of income verification for each member of the household that is 18 years or older: o Most current tax returns; or o 1099R or most recent statement for any retirement savings distributions (i.e. IRA, pension), showing total year to date disbursements; or o Two most recent consecutive pay stubs; or o Award letters for any government assistance received (Social Security, Old Age Pension, unemployment) and/or child support or alimony. Copy of driver s license or state issued photo identification of homeowner(s). Copy of verification of physical or mental disability, if under age 55. This can be a recent Social Security Disability Insurance/Supplemental Security Income statement or letter from your doctor. 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. Copies of any asset records for all adults living in the home: o Two most recent checking and/or savings bank statements o Two most recent investment account statements, if you have an investment account(s) o Mortgage statement or title for other property owned other than your primary residence o Name and value of business owned and operated If you have received home repairs through the program previously and you are approved to receive additional repairs, you may be requested to provide a copy of homeowner s insurance or verification of speaking with a HUD-certified housing counselor about financial options to address future repairs. Submit application and all supporting documents to MAILING ADDRESS FAX IF DELIVERING IN PERSON 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 80229

3 The application and supporting documentation is only seen by those that administer the program. Any personal information, such as bank account numbers and social security numbers, will be obscured from the documents. Homeowner Information 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 Age of homeowners: Applicant Co-Applicant Have you previously received assistance through the Help for Homes program? YES NO The following five bulleted questions are optional: What is your race? White/Caucasian Asian African American American Indian/Alaskan Native Hawaiian What is your ethnicity? Hispanic Non-Hispanic Are you, or is anyone living in your home a veteran? YES NO Are you a female head of household? YES NO How did you hear about the Help for Homes program? Home Information 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 in 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?

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, co-applicant, and any other adults or children. Applicant Name Birth Occupation Files IRS Tax Return? Co-Applicant 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:

5 List the total monthly income of all household members. Copies of documentation must be provided to verify all sources of household income listed below. Type of Income Household Member Applicant Co-Applicant Employment 1 $ $ $ Employment 2 $ $ $ Type of Income Household Member Applicant Co-Applicant Social Security Retirement Insurance $ $ $ Social Security Disability Insurance (SSDI) $ $ $ Retirement/Pension $ $ $ 401(k), 403(b), or 457(b) payments withdrawn in the last year $ $ $ Child support/alimony $ $ $ : $ $ $ Statement of Assets Applicants cannot have more than $10,000 in assets, which includes money in savings or checking accounts, equity in a second home, investment property or business and investment funds. It does not include your primary residence, retirement accounts, and/or vehicles. Do you have a checking account? Yes No. Amount in account: $ Do you have a savings account? Yes No. Amount in the account: $ Do you have cash savings not in bank accounts? Yes No. Amount of the cash on hand: $ Do you own rental property or land? Yes No Value of property: $ Amount still owed: $ Do you own stocks, bonds, or other investments (not including retirement accounts)? Yes No Total value of stocks, bonds, or other investments: $ Do you have any other investments or assets? Yes No List any investment/assets and the amounts:

6 Applicant s Certifications The applicant/co-applicant 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/co-applicant also certifies that all information provided in this application is true and correct to the best of the applicant s knowledge and belief. The applicant understands that any discrepancy or omission in the information provided may disqualify him/her from participation in the Help for Homes program. Indemnification I/We hereby agree to indemnify and hold harmless the City of Thornton, its officers, agents, employees, volunteers and contractors for the Help For Homes program or Thornton Paint-A-Thon 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 or Paint-A-Thon programs. Housing Education Agreement The Help for Homes program has a maximum grant amount for each house and homeowner so it is important that homeowners are prepared to handle expensive repairs in the future. The applicant and co-applicant agree that he/she/they will contact a housing counselor within the next 12 months or attend a class to learn about home maintenance and repair costs, lifespans of home components and systems and options to be prepared to handle future home maintenance expenses, unless he/she/they have home insurance. A list of free, qualified counseling agencies will be provided by the City. The applicant and co-applicant understand that if additional home repair program assistance from the City is requested in the future, he/she/they may be asked to provide verification of his/her housing counseling or of home insurance. Applicant Signature Co-Applicant Signature

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