APPLICATION FOR HOUSING REHABILITATION ASSISTANCE

Size: px
Start display at page:

Download "APPLICATION FOR HOUSING REHABILITATION ASSISTANCE"

Transcription

1 City of St. Petersburg HOUSING & COMMUNITY DEVELOPMENT DEPARTMENT (727) One Fourth Street North, Ninth Floor Municipal Services Building St. Petersburg, Florida COMPLETION OF THIS APPLICATION DOES NOT OBLIGATE THE APPLICANT Assistance Requested: Housing Rehabilitation Emergency Repair * Barrier Free Rental or * Barrier Free Home-Owner *Provides a grant and/or loan used to render a home accessible for persons with disabilities. A. General Information: Applicant Co-Applicant Full Legal Name Social Security Number Date of Birth & Age Property Street Address Post Office Box, if applicable Telephone Home: Work: Cell: Work: Cell: Check all that apply: Married (includes Separated) Unmarried ( Single Widowed Divorced) B. Other Household Members (including roommates): Name(s) Social Security Number Date of Birth & Age Relationship 1. Is Applicant, Co-Applicant or any household member, age 18 or older, a full-time student? No Yes If yes, please provide their name(s) and attach proof of fulltime student status: Home Repair Application 2015 Page 1

2 C. Employment Information: EMPLOYMENT INFORMATION Applicant Co-Applicant Employer/Company Name Employer Street Address City/State/Zip Supervisor Name Employer Telephone Number Position Employee Identification # Length of Employment Frequency of Pay Hourly Weekly Monthly Annually Hourly Weekly Monthly Annually Rate of Pay $ $ D. Employment Information for Other Household Members 18 of Age Years or Older: EMPLOYMENT INFORMATION Household Member #1 Household Member #2 Employer/Company Name Employer Street Address City/State/Zip Supervisor Name Employer Telephone Number Employee Identification # Position Length of Employment Frequency of Pay Hourly Weekly Monthly Annually Hourly Weekly Monthly Annually Rate of Pay $ $ EMPLOYMENT INFORMATION Household Member #3 Household Member #4 Employer/Company Name Employer Street Address City/State/Zip Supervisor Name Employer Telephone Number Employee Identification # Position Length of Employment Frequency of Pay Hourly Weekly Monthly Annually Hourly Weekly Monthly Annually Rate of Pay $ $ Home Repair Application 2015 Page 2

3 E. All Other Sources of Income: NOTE: Income for ALL Household Members from all sources must be listed: Business or Rental Income, Child Support, Alimony, Social Security Benefits, Pensions, Disability, Supplemental, Unemployment or Workers Compensation, AFDC/TANF Payments, Disability, Adoption and/or any other sources of income. (Use separate sheet to list additional sources) Household Member Source of Income Gross Annual/Monthly Income Received Total: $ F. Asset and Asset Income: NOTE: All Household Member, including minors, must list and provide copies: Checking and Savings Accounts, IRA s, CD s, Bonds, Stocks, Equity in Real Estate Owned, Annuities, etc. (Use separate sheet to list additional items) Type of Asset Asset Value Name of Bank Account Number Name on Account G. Liabilities: Total: $ Type of Credit or Loan Name of Creditor Balance Owed Monthly Payment Total: $ Total: $ H. Property Information: (please provide the names and addresses of any non-resident owners on a separate sheet): 1. Is there a first mortgage on your property? Yes No. 2. Is there a second Mortgage on your property? Yes No If yes, is the first or second mortgage a Fixed Rate Mortgage Yes No If your first or second mortgage loan is an Adjustable Rate (ARM), a Reverse Mortgage, an interest only payment loan, a negative amortizing balance loan, is past due or threatening foreclosure or you have 2 or more existing mortgage loans secured by your home you may not be qualified for assistance. STOP & call (727) for further information. Home Repair Application 2015 Page 3

4 First Mortgage Loan Information: Lender s Name City, State and Zip Code Account Number # Mortgage Balance $ Monthly Mortgage Payment Including PITI $ Second Mortgage or Home Equity Loan or Credit Line Information: Lender s Name City, State and Zip Code Account Number # Mortgage Balance $ Monthly Mortgage Payment Amount $ 3. Do you currently own real estate other than your primary residence? Yes No a) Provide address, city, state and value information of the property and a copy of any lease/rental agreements (if applicable): 1. Value: $ Use separate sheet to list additional properties 4. Is your primary residence insured? Yes No? If yes, please provide the following information Home Owners Insurance Flood Insurance Insurance Company Insurance Company Insurance Agent Insurance Agent Street or P. O. Address Street or P. O. Address City, State & Zip Code City, State & Zip Code Policy Number Policy Number 5. Are you a tenant applying for a Barrier Free Loan or Grant? Yes No If, yes, please provide your landlord s name, address and telephone number. Name Address City, State, Zip Telephone Number I. Disposition of Assets 1. Have you given away, transferred ownership of or sold an asset in an amount in excess of $1,000 within the past two years? Yes No Asset Asset Value Date Sold Use separate sheet to list additional items Home Repair Application 2015 Page 4

5 2. Prior Assistance 1. Has this property or have you previously received financial assistance for repairs or down payment from the City of St. Petersburg or another agency (i.e. St. Petersburg Housing Authority or St. Petersburg Neighborhood Home Solutions, Inc. f/k/a St. Petersburg Neighborhood Housing Services)? Yes No If yes, please provide the following information: To Whom was Assistance Provided Date of Assistance Purpose of Assistance Assistance Provided by what Agency 3. Child Support and Alimony 1. Child support and/or alimony is received by the applicant, co-applicant or other household member. Yes No If yes, check the appropriate box(es) below and provide the requested information: a. Court ordered child support and/or alimony is received not received b. Court ordered child support and/or alimony is being pursued yes No c. The absent parent is court ordered to pay $ weekly monthly annually d. The absent parent is approximately $ in arrears. e. The last payment of child support and/or alimony was on (date). 2. Child support and/or alimony court ordered paid by the applicant or co-applicant. Yes No. If yes, the amount is $ paid weekly monthly annually. 4. Ethnicity and Special Needs* This information is requested for reporting purposes only. Please check all that apply for the Head of Household Only. White Black Hispanic/Haitian Asian/Pacific Islander Native American Farm Worker Disabled Elderly Other Other Home Repair Application 2015 Page 5

6 5. Loan Repairs Requested Note: The city will inspect your property to determine that repairs requested are those necessary to meet the city s Code of Ordinance or to provide for a safe and healthy environment for its occupants. The Housing Rehabilitation Program is not designed to address deficiencies caused by neglect of general maintenance requirements, which are the responsibility of the home-owner or to provide home improvement upgrades such as stainless steel appliances, granite counter tops, etc. Please provide a brief description of the repairs needed in your home in the space provided or check the appropriate boxes listed below: Description of work requested: Check appropriate box: Roof, Gutters, Soffit & Fascia Electrical Window & Doors Plumbing & Sanitation Ceilings, Walls & Floors Weatherization Foundation Stairs, Rails & Porches Paint & Lead Based Paint Appliances Bathroom Tub, Shower, Lavatory Kitchen Security Other 6. Acknowledgements I/we understand that Florida Statute 817 provides that willful false statements or misrepresentation concerning income; asset or liability information relating to financial condition is a misdemeanor of the first degree, punishable by fines and imprisonment provided under Statutes and I/we further understand that any willful misstatement of information will be grounds for disqualification. I/we certify that the application information provided is true and complete to the best of my/our knowledge. I/we consent to the disclosure of information for the purpose of income verification related to making a determination of my/our eligibility for program assistance. I/we agree to provide any documentation needed to assist in determining eligibility and are aware that all information and documents provided may be a matter of public record. Applicant Signature Co-Applicant Signature Date Date Home Repair Application 2015 Page 6

7 SOCIAL SECURITY NUMBER COLLECTION POLICY DISCLOSURE & AUTHORIZATION TO RELEASE INFORMATION CONSENT FORM Applicant & Co-Applicant We/I hereby consent that the City of St. Petersburg ( City ) or any credit reporting agency or bureau designated by the City, may collect and retain any and all information concerning our/my employment, bank accounts, credit card accounts, installment obligations and any other matter, which may be required in processing our/my application for a mortgage loan. We/I also authorize release of related information by our/my employer(s), designated credit reporting agency or bureau, financial institution(s), government agency and any other creditors as listed in my/our application for assistance from the City. The City collects Social Security numbers from prospective mortgage loan and grant recipients during the application process to determine credit worthiness of the applicant, data collection, benefit processing and tax reporting. This Consent Form may be photocopied and all copies shall be as effective as those containing my/our original signature(s) dated this day of,. Social Security Number Date of Birth Property Street Address Post Office Box, if applicable Applicant Co-Applicant Applicant Signature Co-Applicant Signature Print Name Print Name Home Repair Application 2015 Page 7

8 SOCIAL SECURITY NUMBER COLLECTION POLICY DISCLOSURE & AUTHORIZATION TO RELEASE INFORMATION CONSENT FORM Other Household Member We/I hereby consent that the City of St. Petersburg ( City ) or any credit reporting agency or bureau designated by the City, may collect and retain any and all information concerning our/my employment, bank accounts, credit card accounts, installment obligations and any other matter, which may be required in processing our/my application for a mortgage loan. We/I also authorize release of related information by our/my employer(s), designated credit reporting agency or bureau, financial institution(s), government agency and any other creditors as listed in my/our application for assistance from the City. The City collects Social Security numbers from prospective mortgage loan and grant recipients during the application process to determine credit worthiness of the applicant, data collection, benefit processing and tax reporting. This Consent Form may be photocopied and all copies shall be as effective as those containing my/our original signature(s) dated this day of,. Social Security Number Date of Birth & Age Property Street Address Post Office Box, if applicable Household Member 18 or older Household Member Signature Print Name Home Repair Application 2015 Page 8

9 SOCIAL SECURITY NUMBER COLLECTION POLICY DISCLOSURE & AUTHORIZATION TO RELEASE INFORMATION CONSENT FORM Other Household Member We/I hereby consent that the City of St. Petersburg ( City ) or any credit reporting agency or bureau designated by the City, may collect and retain any and all information concerning our/my employment, bank accounts, credit card accounts, installment obligations and any other matter, which may be required in processing our/my application for a mortgage loan. We/I also authorize release of related information by our/my employer(s), designated credit reporting agency or bureau, financial institution(s), government agency and any other creditors as listed in my/our application for assistance from the City. The City collects Social Security numbers from prospective mortgage loan and grant recipients during the application process to determine credit worthiness of the applicant, data collection, benefit processing and tax reporting. This Consent Form may be photocopied and all copies shall be as effective as those containing my/our original signature(s) dated this day of,. Social Security Number Date of Birth & Age Property Street Address Post Office Box, if applicable Household Member 18 or older Household Member Signature Print Name Home Repair Application 2015 Page 9

Dear Resident, Sincerely, Neighborhood Services Staff. Rehabilitation Program. Purchase/Workforce Program. Completed Application Form

Dear Resident, Sincerely, Neighborhood Services Staff. Rehabilitation Program. Purchase/Workforce Program. Completed Application Form City of Delray Beach Neighborhood Services Division Dear Resident, Thank you for your interest in the City of Delray Beach Neighborhood Services Programs. We are required to document your eligibility for

More information

Homeowner Rehabilitation Program Application

Homeowner Rehabilitation Program Application This program is designed to remove potentially dangerous health and/or safety hazards from homes owned by very low income persons as their primary residence. The repairs could also include adding accessibility

More information

HOUSING ASSISTANCE PROGRAMS

HOUSING ASSISTANCE PROGRAMS Marion County Board of County Commissioners Community Services 2631 SE Third St. Ocala, FL 34471 Phone: 352-671-8770 Fax: 352-671-8769 HOUSING ASSISTANCE PROGRAMS LOAN APPLICATION State Housing Initiatives

More information

RESIDENTIAL REHABILITATION PROGRAM

RESIDENTIAL REHABILITATION PROGRAM City of North Lauderdale COMMUNITY DEVELOPMENT DEPARTMENT 701 S.W. 71 st Avenue North Lauderdale, Florida 33068 Telephone: (954) 724-7065 Fax: (954) 720-2064 RESIDENTIAL REHABILITATION PROGRAM If you are

More information

If eligible, I understand this is a direct assistance loan which is a 0% loan to be paid upon sale or transfer of title.

If eligible, I understand this is a direct assistance loan which is a 0% loan to be paid upon sale or transfer of title. APPLICATION - PART I Hunterdon County Housing Rehabilitation Program reserves the right to verify all information provided in this application ******The County will NOT conduct an eligibility interview

More information

Residential Rehabilitation Program Application

Residential Rehabilitation Program Application Thank you for your interest in the City of West Palm Beach s Residential Rehabilitation Program. The Residential Rehabilitation Program is administered by the Department of Housing and Community Development

More information

HOMEOWNER REHABILITATION LOAN

HOMEOWNER REHABILITATION LOAN City of Mobile COMMUNITY & HOUSING DEVELOPMENT DEPARTMENT DEADLINE: Friday, February 27, 2015 at 4:00 p.m. CITYWIDE IV HOMEOWNER REHABILITATION LOAN APPLICATION Please Return the Completed Application

More information

First-Time Homebuyers Training Assistance Program Application

First-Time Homebuyers Training Assistance Program Application Dear Prospective First Time Home Buyer: Thank you for your recent inquiry regarding the City of Kenner Department of Community Development s First Time Home Buyers Training Assistance Program. The purpose

More information

Verification that property taxes and HOA fees are current Verification that the mortgage is current or mortgage satisfaction letter from lender

Verification that property taxes and HOA fees are current Verification that the mortgage is current or mortgage satisfaction letter from lender You must submit a completed City of Lauderhill Application. You are required to submit COPIES of the following documents for your program of interest, along with the General Requirements to participate

More information

Eligibility Checklist

Eligibility Checklist Eligibility Checklist Application o Completed and signed application o Signed Authorization of Release of Information form for all adult household members (each member must sign a separate form) Household

More information

CalHome Homeowner Rehabilitation Loan Program Information

CalHome Homeowner Rehabilitation Loan Program Information CalHome Homeowner Rehabilitation Loan Program Information 333 W Ocean Blvd., 3rd Floor Long Beach CA 90802-4430 (562) 570-6949 Fax (562) 570-6215 lbcic.org Thank you for your interest in the Cal-Home Homeowner

More information

Alix Desulme District 4 Council Representative 2015 Single Family Home Beautification Program

Alix Desulme District 4 Council Representative 2015 Single Family Home Beautification Program Councilman Alix Desulme District 4 Council Representative 2015 Single Family Home Beautification Program The City of North Miami 2015 Single Family Home Beautification Program is a repair and rehabilitation

More information

These amounts are set for this area by HUD and are revised periodically.*

These amounts are set for this area by HUD and are revised periodically.* RIVERSIDE HOUSING DEVELOPMENT CORPORATION HOUSING REHABILITATION PROGRAMS The Housing Rehabilitation Programs are intended to serve City of Riverside residents who own their homes, live in their own homes,

More information

DENVER URBAN RENEWAL AUTHORITY HOUSING PROGRAMS SINGLE FAMILY REHABILITATION PROGRAM

DENVER URBAN RENEWAL AUTHORITY HOUSING PROGRAMS SINGLE FAMILY REHABILITATION PROGRAM DENVER URBAN RENEWAL AUTHORITY HOUSING PROGRAMS SPONSORED BY THE CITY AND COUNTY OF DENVER S DEPARTMENT OF HOUSING & NEIGHBORHOOD DEVELOPMENT SERVICES PROGRAM SINGLE FAMILY REHABILITATION PROGRAM The Single

More information

APPLICATION NUMBER MSC-20 PART I: The following information is optional and is used for statistical purposes only

APPLICATION NUMBER MSC-20 PART I: The following information is optional and is used for statistical purposes only APPLICATION FOR HOME IMPROVEMENT LOAN LEELANAU COUNTY HOUSING REHABILITATION PROGRAM EQUAL HOUSING OPPORTUNITY: BUSINESS CONDUCTED IN ACCORDANCE WITH THE FEDERAL FAIR HOUSING ACT OF 1988 FOR OFFICE USE

More information

H O M E FOR HOMEOWNERS IN DISTRICT 3

H O M E FOR HOMEOWNERS IN DISTRICT 3 H O M E R E H A B L O A N P R O G R A M FOR HOMEOWNERS IN DISTRICT 3 Are You Having Problems with Your Plumbing? Do You Need a New Roof? Are Your Windows Old and Seeping Air? How About Other Over Looked

More information

We will help you get bids from contractors after we have processed your application.

We will help you get bids from contractors after we have processed your application. Dear Homeowner: Thank you for your interest in the Home Exterior Loan Program (HELP). We look forward to assisting you with your home repairs. The HELP guidelines and application are included with this

More information

Town of Plymouth 2016 HOUSING REHAB LOAN APPLICATION

Town of Plymouth 2016 HOUSING REHAB LOAN APPLICATION Town of Plymouth 2016 HOUSING REHAB LOAN APPLICATION Hours: Monday thru Friday 7:30 a.m. - 4:00 p.m. Please return to Office of Community Development 11 Lincoln Street, Plymouth, MA 02360 Hiring Contractors

More information

40 TH YEAR CDBG RESIDENTIAL REHABILITATION PROGRAM

40 TH YEAR CDBG RESIDENTIAL REHABILITATION PROGRAM City of North Lauderdale Community Development Department 701 S.W. 71 st Avenue North Lauderdale, Florida 33068 Telephone: (954) 722-0900 40 TH YEAR CDBG RESIDENTIAL REHABILITATION PROGRAM If you are interested

More information

DOWN PAYMENT/CLOSING COST LOAN PROGRAM PRELIMINARY APPLICATION

DOWN PAYMENT/CLOSING COST LOAN PROGRAM PRELIMINARY APPLICATION Eau Claire County Government Center 721 Oxford Avenue, Room 3344 Eau Claire, Wisconsin 54703 715-839-2889 Georgia.Crownhart@co.eau-claire.wi.us DATE: TIME: FOR OFFICE USE ONLY DOWN PAYMENT/CLOSING COST

More information

RENTAL HOUSING APPLICATION

RENTAL HOUSING APPLICATION OFFICE USE ONLY: Property: Date/Time: 901 30th Street Paso Robles, CA 93446 Phone: (805) 238-4015 Fax (805) 238-4036 Bdrm size: Waitlist No: Hhld Size: AMI: % Applicant RENTAL HOUSING APPLICATION M / F

More information

Rural Housing Service Pre-Qualification Worksheet County You Wish To Live In:

Rural Housing Service Pre-Qualification Worksheet County You Wish To Live In: USDA United States Department of Agriculture Rural Housing Service Pre-Qualification Worksheet County You Wish To Live In: APPLICANT INFORMATION CO-APPLICANT INFORMATION Name: Name: Address: Address: City,

More information

Federal Jumpstart Housing Assistance Program Application

Federal Jumpstart Housing Assistance Program Application Federal Jumpstart Housing Assistance Program Application INSTRUCTIONS: Complete all information requested on this application to the best of your ability. Please use ink, and print legibly. Contact your

More information

CITY OF KINGSTON COMMUNITY DEVELOPMENT BLOCK GRANT RESIDENTIAL REHABILITATION PROGRAM City Hall 420 Broadway Kingston, NY 12401 (845) 334-3928

CITY OF KINGSTON COMMUNITY DEVELOPMENT BLOCK GRANT RESIDENTIAL REHABILITATION PROGRAM City Hall 420 Broadway Kingston, NY 12401 (845) 334-3928 CITY OF KINGSTON COMMUNITY DEVELOPMENT BLOCK GRANT RESIDENTIAL REHABILITATION PROGRAM City Hall 420 Broadway Kingston, NY 12401 (845) 334-3928 Dear Applicant: Thank you for your interest in the City of

More information

CITY OF COLORADO SPRINGS HOUSING DEVELOPMENT EMERGENCY REPAIR PROGRAM APPLYING FOR EMERGENCY REPAIR SERVICES:

CITY OF COLORADO SPRINGS HOUSING DEVELOPMENT EMERGENCY REPAIR PROGRAM APPLYING FOR EMERGENCY REPAIR SERVICES: CITY OF COLORADO SPRINGS HOUSING DEVELOPMENT EMERGENCY REPAIR PROGRAM APPLYING FOR EMERGENCY REPAIR SERVICES: Energy Resource Center weatherizes homes for low-income & medium income households. We also

More information

Rio Homes Permanently Affordable Homes Application Process

Rio Homes Permanently Affordable Homes Application Process Rio Homes Permanently Affordable Homes Application Process Thank you for your interest in the third phase of the Rio Homes. This partnership between AZNORTH Development, Inc. and the City of Flagstaff

More information

CITY OF VICTORVILLE. APPLICATION Administered by Neighborhood Partnership Housing Services, Inc.

CITY OF VICTORVILLE. APPLICATION Administered by Neighborhood Partnership Housing Services, Inc. CITY OF VICTORVILLE OWNER OCCUPIED HOME REPAIR LOAN APPLICATION Administered by Neighborhood Partnership Housing Services, Inc. Submit completed application and all requested information to: NPHS, Inc.

More information

Tooele County HOMEOWNER HOUSING REHAB LOAN APPLICATION

Tooele County HOMEOWNER HOUSING REHAB LOAN APPLICATION ELIGIBILITY Income Eligibility: This program is available to households with a maximum of 80 percent of the median family income for Tooele County. If your household income is greater than the limits,

More information

Thornton Home Repair Loan Program

Thornton Home Repair Loan Program OVERVIEW Homeowners who live in Thornton may be eligible for a 0% interest rate loan to pay for larger repairs needed on their home. This loan program, offered through the City of Thornton and Brothers

More information

LIVE NEWARK DEPARTMENT OF ECOMONIC AND HOUSING DEVELOPMENT DIVISION OF HOUSING AND REAL ESTATE HOME FACADE PROGRAM (HFP) APPLICATION

LIVE NEWARK DEPARTMENT OF ECOMONIC AND HOUSING DEVELOPMENT DIVISION OF HOUSING AND REAL ESTATE HOME FACADE PROGRAM (HFP) APPLICATION LIVE NEWARK DEPARTMENT OF ECOMONIC AND HOUSING DEVELOPMENT DIVISION OF HOUSING AND REAL ESTATE HOME FACADE PROGRAM (HFP) APPLICATION Please PRINT and complete ALL pages of this application in its entirety

More information

CITY OF SAN MARCOS DOWNPAYMENT ASSISTANCE PROGRAM (Homebuyer completes this form.) Self Qualification Form

CITY OF SAN MARCOS DOWNPAYMENT ASSISTANCE PROGRAM (Homebuyer completes this form.) Self Qualification Form CITY OF SAN MARCOS DOWNPAYMENT ASSISTANCE PROGRAM (Homebuyer completes this form.) Self Qualification Form Name: Before you submit your application, and pay your $350 non-refundable Downpayment Assistance

More information

Criminal background and eviction will be check within the past 5 years.

Criminal background and eviction will be check within the past 5 years. Housing Authority of the City of Fort Lauderdale (HACFL) Telephone: (954)556-4100 Submit your application to: HACFL- Affordable Housing Division 500 West Sunrise Boulevard Fort Lauderdale, FL 33311 The

More information

Key Real Estate Advisors, Inc.

Key Real Estate Advisors, Inc. 10231 Metro Pkwy, Suite 2 Fort Myers, Florida 33966 Office (239) 454-3749 Fax: (239) 425-0701 www.keyrealestateadvisors.com AGENT - APPLICATION CHECK LIST LEASING AGENT: Name: Phone: Email: Property Address:

More information

Gloversville Community Development Agency. CDBG Housing Rehabilitation Program

Gloversville Community Development Agency. CDBG Housing Rehabilitation Program Version 10/29/14 Gloversville Community Development Agency CDBG Housing Rehabilitation Program THE PROGRAM ELIGIBLE IMPROVEMENTS The Gloversville Community Development Agency is operating a housing rehabilitation

More information

If this is a HAFA short sale: Please note that contributions are not be allowed in a HAFA short sale from the buyer; seller or agents.

If this is a HAFA short sale: Please note that contributions are not be allowed in a HAFA short sale from the buyer; seller or agents. All short sales are processed on Equator.com. Agents must be registered for short sales to be assigned to them. Required Document Checklist must be complete (all documents uploaded into Equator and labeled

More information

HOMEBASE AFFORDABLE HOMES PROGRAM

HOMEBASE AFFORDABLE HOMES PROGRAM HOMEBASE AFFORDABLE HOMES PROGRAM INCOME ELIGIBILITY APPLICATION Revised April 2013 Please provide ALL applicable information on this form. It will be used to determine your eligibility; HomeBase Income

More information

Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program

Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program Program Overview Under the First Time Homebuyer Program, the Hallandale Beach CRA will provide up to $50,000 in assistance

More information

HOUSING REPAIR PROGRAM APPLICATION

HOUSING REPAIR PROGRAM APPLICATION HOUSING REPAIR PROGRAM APPLICATION City of Deerfield Beach Planning and Growth Management Community Development Division 533 South Dixie Highway, Suite 101 Deerfield Beach, Florida 33441 (954) 480-6420

More information

PRINCE GEORGE S COUNTY My HOME LOAN PROGRAM APPLICATION

PRINCE GEORGE S COUNTY My HOME LOAN PROGRAM APPLICATION 9200 Basil Court Suite 504 Largo, Maryland 20774 301.883.5456 301.883.5291 fax PRINCE GEORGE S COUNTY My HOME LOAN PROGRAM APPLICATION My HOME LN#: APPLICANT NAME(S): Projected Settlement Date: DTI: (max

More information

You must submit copies of the following items with your application: (a) Full copy of your 2014 federal income tax statement, if applicable;

You must submit copies of the following items with your application: (a) Full copy of your 2014 federal income tax statement, if applicable; 2015 Dear Applicant: Enclosed are the program guidelines, application, and lead based paint notice for the County s Senior Citizen Owner-Occupied Property Rehabilitation Program. Keep the guidelines and

More information

IMPORTANT! PLEASE READ THIS ENTIRE NOTICE

IMPORTANT! PLEASE READ THIS ENTIRE NOTICE IMPORTANT! PLEASE READ THIS ENTIRE NOTICE Completed Applications May Be Returned by email to: apply@ccmanagers.com by Fax to 212-348-3670 or by Mail. Do NOT return page 1 & 2 with your application YOU

More information

Invitation for Purchase 159 Settlers Landing Road Hampton, Virginia 23669 By Hampton Redevelopment & Housing Authority

Invitation for Purchase 159 Settlers Landing Road Hampton, Virginia 23669 By Hampton Redevelopment & Housing Authority Invitation for Purchase 159 Settlers Landing Road Hampton, Virginia 23669 By Hampton Redevelopment & Housing Authority Sales Price - $72,135 The Hampton Redevelopment and Housing Authority (HRHA) is soliciting

More information

2015 Senior Emergency Safety Grant

2015 Senior Emergency Safety Grant 2015 Senior Emergency Safety Grant The program is designed to address immediate health and safety deficiencies at your home. Final determination of necessary improvements will be made by the Housing Programs

More information

One Affordable Homeownership Unit - Adaptable Unit with Accessible Features

One Affordable Homeownership Unit - Adaptable Unit with Accessible Features One Affordable Homeownership Unit - Adaptable Unit with Accessible Features Located at 100 Pacific Street near Central Square, this unit will be available, through the City s Inclusionary Housing Program,

More information

NEIGHBORHOOD STABILIZATION PROGRAM (NSP) APPLICATION FOR NSP LOAN. Program Guidelines

NEIGHBORHOOD STABILIZATION PROGRAM (NSP) APPLICATION FOR NSP LOAN. Program Guidelines APPLICATION FOR NSP LOAN Income limits per household Program Guidelines Maximum Income 1 48,150 2 55,000 3 61,900 4 68,750 5 74,250 6 79,750 7 85,250 8 90,750 Homebuyer Requirements Home Education Minimum

More information

TAX DEFERRAL INFORMATION AND INSTRUCTION SHEET

TAX DEFERRAL INFORMATION AND INSTRUCTION SHEET CECIL COUNTY, MARYLAND OFFICE OF FINANCE 200 CHESAPEAKE BLVD, STE. 1100 ELKTON, MARYLAND 21921 TAX DEFERRAL INFORMATION AND INSTRUCTION SHEET The Annotated Code of Maryland, Tax-Property Article 10-204

More information

MANUFACTURED HOME REPAIR LOAN PROGRAM

MANUFACTURED HOME REPAIR LOAN PROGRAM MANUFACTURED HOME REPAIR LOAN PROGRAM The Habitat for Humanity of Greater Los Angeles (Habitat LA) Manufactured Home Repair Loan Program helps low-income manufactured homeowners make needed home repairs.

More information

City of Odessa Community Development Home of Your Own/Homeownership Assistance Programs

City of Odessa Community Development Home of Your Own/Homeownership Assistance Programs City of Odessa Community Development Home of Your Own/Homeownership Assistance Programs The following items must be submitted with your application before we can proceed with processing. All portions of

More information

2015 Housing Resource Group, LLC 1

2015 Housing Resource Group, LLC 1 Your application must include: Copies of the last five most recent current consecutive pay stubs for all household members age 18 or older Verification of self-employment income received during the preceding

More information

Application for Housing

Application for Housing Application for Housing HELP Philadelphia IV consists of sixty 1-BEDROOM units. Applicant Information Last Name First Name MI Street Address Apt. # City State Zip Code Social Security# Home Phone: Date

More information

Dear Homeowner, Enclosed are Guidelines and Application for the Middletown Township Home Improvement Program.

Dear Homeowner, Enclosed are Guidelines and Application for the Middletown Township Home Improvement Program. Organized December 14, 1667 Pride in Middletown TOWNSHIP OF MIDDLETOWN Department of Planning and Community Development 3 Penelope Lane Middletown, NJ 07748-2504 Tel: (732) 615-2098 (732) 615-2280 Fax:

More information

PLEASE USE BLUE INK APPLICATION FOR HOUSING

PLEASE USE BLUE INK APPLICATION FOR HOUSING PLEASE USE BLUE INK APPLICATION FOR HOUSING DEVELOPMENT NAME Renaissance II, Smith Hill Vision, Smith Hill Vision II DEVELOPMENT NUMBER 525 / 514 DEVELOPMENT ADDRESS 47 Goddard Street 1 st Flr. Providence,

More information

CITY OF WESTMINSTER MOBILE HOME GRANT PROGRAM

CITY OF WESTMINSTER MOBILE HOME GRANT PROGRAM CITY OF WESTMINSTER MOBILE HOME GRANT PROGRAM ELIGIBILITY REQUIREMENTS Thank you for your interest in Westminster s Mobile Home Grant Rehabilitation Program. The Mayor and City Council have approved this

More information

Dear Homeowner: Enclosed is an application packet for our home repair program. The maximum grant under this program is $6,000.

Dear Homeowner: Enclosed is an application packet for our home repair program. The maximum grant under this program is $6,000. Dear Homeowner: Enclosed is an application packet for our home repair program. The maximum grant under this program is $6,000. Please complete the first three pages of the application, attach required

More information

Cotuit Meadows Cotuit, MA 3-Bedroom, 2-Bath Single Family Homes $189,000

Cotuit Meadows Cotuit, MA 3-Bedroom, 2-Bath Single Family Homes $189,000 Cotuit Meadows Cotuit, MA 3-Bedroom, 2-Bath Single Family Homes $189,000 Cotuit Meadows is a 124-home development built on 50 acres of land located off Falmouth Road (Route 28) at the Barnstable-Mashpee

More information

Grant money available for minor home repairs

Grant money available for minor home repairs FOR IMMEDIATE RELEASE Oct. 1, 2014 Contact: Sandy Lila, Neighborhood Improvement Coordinator slila@nlauderdale.org or 954-597-4745 Grant money available for minor home repairs We all got em. Pesky home

More information

Section 1: Applicant & Co-Applicant Information If your current marital status is married, co-applicant information is required. If the parents are

Section 1: Applicant & Co-Applicant Information If your current marital status is married, co-applicant information is required. If the parents are WORKSHEET! DO Instructions NOT MAIL! for completing the application. Section 1: Applicant & Co-Applicant Information If your current marital status is married, co-applicant information is required. If

More information

Lottery Information The Willows Ayer, MA

Lottery Information The Willows Ayer, MA Lottery Information The Willows Ayer, MA Located at Longview Circle in Ayer, The Willows is starting a new phase of construction which will offer 13 new homes for eligible first time homebuyers (certain

More information

Program Year 2016 Mobile Home Renovation Program Loan Application

Program Year 2016 Mobile Home Renovation Program Loan Application Program Year 2016 Mobile Home Renovation Program Loan Application Thank you for your interest in the Town of Hamburg s Mobile Home Renovation Loan Program. I am pleased to send along the attached program

More information

COMPLETE AND MAIL BACK TO: SEAGO ATTN: Julie Packer 1403 W. Highway 92 Bisbee, AZ 85603

COMPLETE AND MAIL BACK TO: SEAGO ATTN: Julie Packer 1403 W. Highway 92 Bisbee, AZ 85603 COMPLETE AND MAIL BACK TO: SEAGO ATTN: Julie Packer 1403 W. Highway 92 Bisbee, AZ 85603 Name: APPLICATION/INTAKE FORM (updated 3/11) Name: Please fill out the Application/Intake form completely # in Household:

More information

Be SMART Home Application

Be SMART Home Application U.S. DEPARTMENT OF ENERGY Be SMART Home Loan The Be SMART Home Loan Program offers innovative financing to improve home energy efficiency through replacement and upgrading of appliances, systems, and whole

More information

Date Received: Time Received: Application taken by:

Date Received: Time Received: Application taken by: Received: Time Received: Application taken by: APPLICATION FOR HOUSING Low-Income Housing Tax Credit Property This is an application for housing at: Whitney Young Manor, LP 358 Nepperhan Avenue, Management

More information

Thank you for considering a grant from Homes Are Possible, Inc. (HAPI)!

Thank you for considering a grant from Homes Are Possible, Inc. (HAPI)! Thank you for considering a grant from Homes Are Possible, Inc. (HAPI)! Home rehabilitation work may include but is not limited to: Roof repairs/shingles Siding Windows/Door Plumbing Electrical Foundation

More information

COLLIER COUNTY SHIP DOWN PAYMENT / CLOSING COST ASSISTANCE PROGRAM

COLLIER COUNTY SHIP DOWN PAYMENT / CLOSING COST ASSISTANCE PROGRAM COLLIER COUNTY SHIP DOWN PAYMENT / CLOSING COST ASSISTANCE PROGRAM Collier County Housing and Human Services 3301 East Tamiami Trail Building H, Room 211 Naples, Florida 34112 Phone (239) 252 4663 Fax:

More information

RICE COUNTY ENVIRONMENTAL SERVICES RICE COUNTY SUBSURFACE SEWAGE TREATMENT SYSTEM LOW INCOME FIXUP GRANT PROGRAM

RICE COUNTY ENVIRONMENTAL SERVICES RICE COUNTY SUBSURFACE SEWAGE TREATMENT SYSTEM LOW INCOME FIXUP GRANT PROGRAM (507) 332-6113 RICE COUNTY ENVIRONMENTAL SERVICES 320 Northwest Third Street Suite 9 Faribault, Minnesota 55021-6145 Toll free from Northfield (507) 645-9576 Toll free from Lonsdale (507) 744-5185 TDD

More information

GUIDELINES FOR ACCEPTANCE IN THE HABITAT FOR HUMANITY OF PULASKI COUNTY PROGRAM

GUIDELINES FOR ACCEPTANCE IN THE HABITAT FOR HUMANITY OF PULASKI COUNTY PROGRAM GUIDELINES FOR ACCEPTANCE IN THE HABITAT FOR HUMANITY OF PULASKI COUNTY PROGRAM 6700 S. University Ave. Little Rock, AR 72209 501.376.4434 Apply for a Home 1. You will be considered for a Habitat home

More information

1. APPLICANT INFORMATION. Applicant's Name Age & Birth date Applicant's Name Age & Birth date

1. APPLICANT INFORMATION. Applicant's Name Age & Birth date Applicant's Name Age & Birth date 1755 13 th Street Courtenay, BC V9N 7B6 Application for a Habitat Home If you have questions about how to fill out this form, please call the Habitat office at (250) 334-3777 Ext. 310 and leave a message

More information

NATIVE VILLAGE OF KOTZEBUE HOUSING DEPARTMENT EMERGENCY REPAIR PROGRAM

NATIVE VILLAGE OF KOTZEBUE HOUSING DEPARTMENT EMERGENCY REPAIR PROGRAM NATIVE VILLAGE OF KOTZEBUE HOUSING DEPARTMENT EMERGENCY REPAIR PROGRAM The Native Village of Kotzebue offers assistance for emergency repairs under the Native American Housing Assistance Self-Determination

More information

Help for Homes Application

Help for Homes Application 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

More information

Commercial Loan Application-Personal Financial Statements Fields with Asterisk (*) must be completed

Commercial Loan Application-Personal Financial Statements Fields with Asterisk (*) must be completed Commercial Loan Application-Personal Financial Statements Fields with Asterisk (*) must be completed Applicant s Information Last Name: Social Security #: Home Address: Employment Information Employer

More information

Thank you for requesting an application for an apartment. Enclosed, please find an application package.

Thank you for requesting an application for an apartment. Enclosed, please find an application package. Dear Applicant, Thank you for requesting an application for an apartment. Enclosed, please find an application package. Please read the application carefully, complete every section, and date where indicated.

More information

Housing Rehabilitation Program Preliminary Application City of Arlington 501 W. Sanford Street, Suite 20 Arlington, Texas 76011

Housing Rehabilitation Program Preliminary Application City of Arlington 501 W. Sanford Street, Suite 20 Arlington, Texas 76011 Date of Application (Office Stamp Only) Housing Rehabilitation Program Preliminary Application City of Arlington 501 W. Sanford Street, Suite 20 Arlington, Texas 76011 The information collected below will

More information

Residential Loan Application for Reverse Mortgages

Residential Loan Application for Reverse Mortgages Residential Loan Application for Reverse Mortgages This application is designed to be completed by the applicant(s) with the lender s assistance. Applicants should complete this form as Borrower or Co-Borrower,

More information

Home Repair Program. Section 1: Homeowner Information. Section 2: Special Needs. 2015 Homeowner Application

Home Repair Program. Section 1: Homeowner Information. Section 2: Special Needs. 2015 Homeowner Application Home Repair Program 2015 Homeowner Application **Applications are considered year round.** Rebuilding Together Muscatine County is a non-profit, volunteer organization that helps low-income homeowners

More information

Enclosed is an application packet for our home repair programs. The maximum grant under this program is $6,000.

Enclosed is an application packet for our home repair programs. The maximum grant under this program is $6,000. Dear Homeowner: Enclosed is an application packet for our home repair programs. The maximum grant under this program is $6,000. Please complete the first three pages of the application, attach required

More information

FREDERICK COUNTY HOMEBUYER ASSISTANCE PROGRAM Application for Closing Cost Assistance

FREDERICK COUNTY HOMEBUYER ASSISTANCE PROGRAM Application for Closing Cost Assistance Frederick County Department of Housing and Community Development (DHCD) 5340 Spectrum Drive, Suite A Frederick, MD 21703 www.frederickcountymd.gov/housing FREDERICK COUNTY HOMEBUYER ASSISTANCE PROGRAM

More information

Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS

Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS Frederick County Department of Housing and Community Development Neighborhood Conservation Initiative (NCI) Program LENDER CHECKLIST for NCI/AG APPLICATION PACKAGE Homebuyer(s) Property Address 8-30-13

More information

EMERGENCY AND FURNACE LOAN APPLICATION

EMERGENCY AND FURNACE LOAN APPLICATION Revised 1/2013 EMERGENCY AND FURNACE LOAN APPLICATION 1. Return Loan application to office of Development Services at 1 Riverfront Plaza, Suite 110, or mail to P.O. Box 708, Lawrence, Kansas, 66044. Telephone:

More information

phone fax

phone fax 480-898-0228 phone 480-898-9007 fax www.affordablerental.org Save the Family's Transitional Program was designed to promote self-sufficiency and stabilize family lifestyles with the community through intensive

More information

WAITING LIST REQUESTS

WAITING LIST REQUESTS Please complete this form and the attachments and forward to the Leasing Department at the address provided. WAITING LIST REQUESTS NAME: If I qualify, I wish to be placed on the following waiting lists:

More information

Menorah Plaza, Menorah West, and Harry & Jeanette Weinberg Apartments

Menorah Plaza, Menorah West, and Harry & Jeanette Weinberg Apartments Menorah Plaza, Menorah West, and Harry & Jeanette Weinberg Apartments Date Time Method Initials APPLICATION Menorah Plaza, Menorah West, and Weinberg Apartments do not discriminate against applicants based

More information

City of Wausau Homeowner Rehabilitation Program APPLICATION FOR DEFERRED PAYMENT LOAN

City of Wausau Homeowner Rehabilitation Program APPLICATION FOR DEFERRED PAYMENT LOAN Date Time City of Wausau Homeowner Rehabilitation Program APPLICATION FOR DEFERRED PAYMENT LOAN To the applicant: The information on this form will be used to determine your eligibility for a Homeowner

More information

PLEASE SUBMIT ONLY ONE (1) APPLICATION PER HOUSEHOLD EVEN IF YOU ARE INTERESTED IN MORE THAN ONE (1) PROPERTY. THANK YOU.

PLEASE SUBMIT ONLY ONE (1) APPLICATION PER HOUSEHOLD EVEN IF YOU ARE INTERESTED IN MORE THAN ONE (1) PROPERTY. THANK YOU. Dear Applicant: Thank you for your recent inquiry of occupancy at a Carabetta Management Company apartment community. Due to the nature of Federal Assistance provided for these properties, we are required

More information

Personal Loan Guidelines

Personal Loan Guidelines Personal Loan Guidelines Loan applicants must live in Northeast Ohio and have an income, the ability to repay the loan and the inability to obtain the money from a conventional lender. The maximum loan

More information

Program Year 2015 Housing Renovation Grant/Loan Program Application

Program Year 2015 Housing Renovation Grant/Loan Program Application Program Year 2015 Housing Renovation Grant/Loan Program Application Thank you for your interest in the Town of Hamburg s Housing Renovation Program. I am pleased to send along this program application

More information

Home Equity Loan Application

Home Equity Loan Application LCMS Rostered Church Worker Home Equity Loan Application INSTRUCTIONS: This is an interactive form that allows you to enter information in each field by using the tab key to move through the form. The

More information

It is our mission to provide excellence in quality and service

It is our mission to provide excellence in quality and service It is our mission to provide excellence in quality and service Date: Patient Name: MRN: For your convenience, enclosed is a Financial Assistance Application. The application is for bills acquired for services

More information

CITY OF MOBILE COMMUNITY PLANNING & DEVELOPMENT DEPARTMENT

CITY OF MOBILE COMMUNITY PLANNING & DEVELOPMENT DEPARTMENT CITY OF MOBILE COMMUNITY PLANNING & DEVELOPMENT DEPARTMENT HOMEOWNER REHAB LOAN PROGRAM FOR ELIGIBLE RESIDENTS CITY WIDE Are You Having Problems with Your Plumbing? Do You Need a New Roof? Are Your Windows

More information

Uniform Residential Loan Application

Uniform Residential Loan Application Uniform Residential Loan Application This application is designed to be completed by the applicant(s) with the lender's assistance. Applicants should complete this form as "Borrower" or "Co- Borrower",

More information

CITY OF QUINCY MASSACHUSETTS OFFICE OF HOUSING REHABILITATION

CITY OF QUINCY MASSACHUSETTS OFFICE OF HOUSING REHABILITATION CITY OF QUINCY MASSACHUSETTS OFFICE OF HOUSING REHABILITATION 2013 This Program is funded by the Community Development Block Grant (CDBG) and HOME Programs administered by The US Department of Housing

More information

BANKWEST MORTGAGE MANUFACTURED HOUSING CREDIT APPLICATION

BANKWEST MORTGAGE MANUFACTURED HOUSING CREDIT APPLICATION BANKWEST MORTGAGE MANUFACTURED HOUSING CREDIT APPLICATION DATE OF APPLICATION: SALES PRICE: DOWN PAYMENT (10% Minimum)*: PURPOSE OF LOAN: PURCHASE CONSTRUCTION REFINANCE LOAN AMOUNT: HOME WILL BE: PRIMARY

More information

Uniform Residential Loan Application Washington Federal Savings

Uniform Residential Loan Application Washington Federal Savings Uniform Residential Loan Application Washington Federal Savings This application is designed to be completed by the Applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower"

More information

Uniform Residential Loan Application

Uniform Residential Loan Application Uniform Residential Loan Application This application is designed to be completed by the applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower",

More information

Healthy Homes Department Housing Rehabilitation Program County of Alameda Community Development Agency (CDA)

Healthy Homes Department Housing Rehabilitation Program County of Alameda Community Development Agency (CDA) For CDA use only: application first received: Project ID#: Dear Homeowner: With funding and Programs available, NOW is a great time to have those needed home repairs done! Thank you for your interest in

More information

Neighborhood Housing Services of Green Bay, Inc. d/b/a NeighborWorks Green Bay Program Intake Form

Neighborhood Housing Services of Green Bay, Inc. d/b/a NeighborWorks Green Bay Program Intake Form Neighborhood Housing Services of Green Bay, Inc. d/b/a NeighborWorks Green Bay Program Intake Form Return Completed Form to: NeighborWorks Green Bay Today s : 437 S. Jackson St. www.nwgreenbay.org Green

More information

APPLICATION FOR RENTAL REHABILITATION ASSISTANCE

APPLICATION FOR RENTAL REHABILITATION ASSISTANCE City of St. Petersburg HOUSING & COMMUNITY DEVELOPMENT DEPARTMENT (727) 893-7247 One Fourth Street North, Ninth Floor Municipal Services Building St. Petersburg, Florida 33701 A. /applicant information:

More information

Residential Loan Application for Reverse Mortgages

Residential Loan Application for Reverse Mortgages Residential Loan Application for Reverse Mortgages This application is designed to be completed by the applicant(s) with the lender s assistance. Applicants should complete this form as Borrower or Co-Borrower,

More information

SOMERSET DISASTER RECOVERY APPLICATION FOR HOMEOWNER ASSISTANCE

SOMERSET DISASTER RECOVERY APPLICATION FOR HOMEOWNER ASSISTANCE SOMERSET DISASTER RECOVERY APPLICATION FOR HOMEOWNER ASSISTANCE Application # Applicant Name: Co-Applicant Name: Property Address: City: Zip Code: Home Phone: Work Phone: Cell Phone: Section 1 - Property

More information

Help for Homes Program

Help for Homes Program 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

More information

HOME IN PEEL AFFORDABLE OWNERSHIP PROGRAM 2014 Application Form

HOME IN PEEL AFFORDABLE OWNERSHIP PROGRAM 2014 Application Form HOME IN PEEL AFFORDABLE OWNERSHIP PROGRAM 2014 Application Form The Home in Peel Affordable Ownership Program is designed to provide low to moderate income residents who are currently renting in the Region

More information