Fillable 2017 URBAN BEAR MANAGEMENT ASSISTANCE (Seminole County Government)

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2017 URBAN BEAR MANAGEMENT ASSISTANCE (Seminole County Government)

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The 2017 URBAN BEAR MANAGEMENT ASSISTANCE (Seminole County Government) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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PARCELID#:

PROPERTYADDRESS:
Numberofpeoplelivingatthisaddress:
________________
ContactTelephoneNumber:
___________________________
Resident(s) MonthlyIncome
Resident1: $
Resident2: $
Resident3: $

TotalIncomeAllResidents
$
PROOFOFINCOME
CHECK BOX that matches the form you are attaching.
Needatleastonelisteddocumentforeachowner.
MostRecentTaxReturn(2016)
Two(2)mostrecentpaystubs
SocialSecurityAwardLetter
Pensionstatement
Bankstatementshowingdepositofincome
I hereby agree to comply with Urban Bear Management requirements of Chapter 258 of the Seminole County Code of
OrdinancesandattestthatthepropertyaddressiswithintheUrbanBearManagementAreaofSeminoleCounty(currently
westofI‐4).

Sig nature__________________________________Date____________
Please MAIL completed application and proof of income to:
Community Assistance Division
534 West Lake Mary Boulevard
Sanford, FL 32773
Income questions: Call 407-665-2300. General questions: Call 407-665-2260.
Limit one bear-resistant container per residence
Available only while grant funds remain
2017 URBAN BEAR MANAGEMENT ASSISTANCE
APPLICATION For 64-Gallon Bear Resistant Refuse Container
2017FederalPovertyGuidelines(150%)
Numberin
Household
AnnualIncome MonthlyIncome
1 $17,820 $1,485
2 $24,030 $2,003
3 $30,240 $2,520
4 $36,450 $3,038
5 $42,660 $3,555
6 $48,870 $4,073
SWMD USE ONLY:
Approved:___
Logged:___
Receipt:___
CA USE ONLY:
APPROVED _______
DISAPPROVED____
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2017 URBAN BEAR MANAGEMENT ASSISTANCE (Seminole County Government)

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Completed 6 August 2020

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