Fillable 2020-Housing-Rehabilitation-Application English Housing Rehabilitation Program Application

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2020-Housing-Rehabilitation-Application English Housing Rehabilitation Program Application

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HOUSING REHABILITATION PROGRAM
OCTOBER 1, 2019- SEPTEMBER 30, 2020
The City of Frisco's Housing Rehabilitation Program is funded by the Community Development
Block Grant (CDBG). These funds are awarded to the City of Frisco by the U.S. Department of
Housing and Urban Development (HUD). Our goal is to preserve existing low and moderate
income housing, to assist very low, low and moderate income owners/occupants in bringing their
dwellings up to an acceptable standard, and to enhance and revitalize neighborhoods within the
City.
Housing rehabilitation funds shall be used for those repairs necessary to bring the structure up to
the International Residential Code. In addition to necessary structural repairs, most projects will
include provisions for correction of all health/safety code violations, installation of smoke
detectors and exterior painting. Items needing repair will be prioritized, with corrections on items
necessary to comply with HUD and City minimum property standards receiving priority for
funding.
Projects are designated as minor projects or major rehabilitation projects depending on the urgency
of the repair in regards to health and safety of the occupants and the neighborhood occupants.
Residency is defined as the property must be located within the city limits. Income eligibility is
determined by the IRS Form 1040 Adjusted Gross Income Requirements. The home must be a
single-family dwelling and owner-occupied by a family that meets income guidelines.
TOTAL FAMILY INCOME MAY NOT EXCEED THE FOLLOWING 2020 INCOME AMOUNTS:
MAXIMUM INCOME CHART
Household
Size
1
2
3
4
5
6
7
8
Low Income
(80% of Area Median)
$48,300
$55,200
$62,100
$68,950
$74,500
$80,000
$85,500
$91,050
Very Low Income
(50% of Area Median)
$30,200
$34,500
$38,800
$43,100
$46,550
$50,000
$53,450
$56,900
Extremely Low
(30% of Area Median)
$18,100
$20,700
$23,300
$26,200
$30,680
$35,160
$39,640
$44,120
Source: U.S. Department of Housing & Urban Development. These income figures are
subject to change annually. (Effective April 1, 2020)
The Community Development Block Grant staff will review applications for the Community
Assistance Housing Repair Project in order to determine level of housing needs and how these
needs affect the health and/or safety of people living in the house.
For more additional information please contact Sarah Carroll at (972) 292-5114 or email
scarroll@friscotexas.gov.
APPLICATION CHECKLIST
Applications will not be processed until all of the listed documents have been submitted.
CHECK OFF EACH BOX FOR INFORMATION INCLUDED:
□ Signed application for all persons on title including, but not limited to, the following
attachments:
1. Applicant Certification
2. Consent to Release Information
3. Eligibility Release form
4. Verification of Employment
5. IRS – Request for Transcript of Tax Return
□ Copy of Warranty Deed for single family homes, condominium, or town homes.
□ Copy of current (within 1 month) mortgage statement.
□ Copy of signed complete set of last two Federal Income Tax Returns, including all schedules
and attachments for all persons in the household and on title.
□ Copies of paycheck stubs for the last 30 days for all wage earners in household or verification
of wages from current employer.
□ Other income documentation
Social Security/SSI (supply a copy of the award letter):
Retirement
Disability
AFDC
Interest on Savings/Income Earning Accounts
Child Support – Divorce decree, court documents, State Attorney General
Other
□ Three (3) most recent bank statements (checking and savings);
□ Proof of property tax payment;
□ Copy of Social Security Card;
□ Copy of valid current identification (e.g. driver’s license or State of Texas ID);
□ Signed Lead Based Paint Notification Form (required for properties built before 1978)
□ Copy of Homeowner’s Insurance.
□ Signed Residency Verification Forms for all adult household members.
Your prompt reply providing the required information will be appreciated.
APPLICATION
The Housing Rehabilitation Application consists of two sections. Part 1 - Household Data, establishes
the members of the household. Part 2 – Source of Income is used to determine income eligibility.
Information regarding age, race, ethnicity, national origin, disabilities or familial status is used for
statistical purposes and has no bearing on the approval of the application.
Date: ______________
PART 1: HOUSEHOLD DATA
Name:
Address:
Social Security Number:
Phone Number: Email Address:
Marital Status: ______________________ Female Head of Household?
How long have you lived at this address?
Do you own any other real estate property? ___Yes ___No
If “Yes” please list address:
Race/Ethnicity:
Do you consider yourself to be Hispanic? ___Yes ___No
Please check one of the following which applies to you:
__ American Indian/Alaskan Native __ American Indian/Alaskan Native & Black
__ American Indian/Alaskan Native & White __ Asian
__ Asian & White __ Black/African American
__ Black/African American & White __ Native Hawaiian/Pacific Islander
__ Other __ White
LIST ALL PERSONS LIVING IN HOUSEHOLD:
First Name
Last Name
Relationship
Age
Social Security
#
1
Self
2
3
4
5
PART 2: SOURCE OF INCOME: WHAT ARE THE SOURCES OF YOUR INCOME?
Family
Member
Employer or
Income Source
Address of
Employer
Telephone
Number
Monthly
Income
Additional Income
& Source
Self
Please describe the repairs needed:
Please describe how the need for these repairs affects health and/or safety:
CONSENT TO RELEASE INFORMATION
Signing below authorizes the release of information from your records to the City of Frisco Community
Development Block Grant Program. This authorization is made in connection with an application that
has been made in order to obtain CDBG funds for home repair.
This release is specific to all organizations including FEMA.
Initials
APPLICANT CERTIFICATION
The applicant (whether one or more) certifies that all information in the application and all information
furnished in support of this application, is given for the purpose of obtaining a Housing Rehabilitation
grant from the City of Frisco' Community Development Block Grant Program, and is true and complete
to the best of the applicant's knowledge and belief. The applicant additionally certifies that the applicant
is the OWNER AND OCCUPANT of the property to be repaired. The applicant consents to the
verification of any of the information contained in this application.
I understand that the release of information does not guarantee that assistance will be provided, but
without the information, assistance may not be available.
Initials
Signature of Applicant(s)
Applicant's Signature:
Date:
Applicant's Signature:
Date:
PENALTY FOR FALSE OR FRADULENT STATEMENT: U.S.C. Title 18, Section 1001,
provides: “Whoever, in any matter within the jurisdiction of any department or agency of
the United States, knowingly and willfully falsifies or makes any false writing or document
knowing the same to contain any false, fictitious, or fraudulent statement or entry shall be
fined not more than $10,000 or imprisoned not more than five years, or both.”
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2020-Housing-Rehabilitation-Application English Housing Rehabilitation Program Application

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Completed 12 July 2020

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