Fillable Hom e Repair Program Eligibility Criteria NEED assistance. (Habitat for Humanity of Montgomery County, TX)

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Hom e Repair Program Eligibility Criteria NEED assistance. (Habitat for Humanity of Montgomery County, TX)

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Hom
e Repair Program
Eligibility Criteria
NEED
• You must own the home in need of repairs: residences located in Montgomery County are eligible for
assistance.
• You must occupy the home as your primary residence, and you must be the property title holder.
• Homeowner(s) must either be a U.S Citizen or a legal permanent resident of the U.S.
• Applicants who own multiple real estate properties are not eligible.
• You (or a member of your household) must have a need that makes the requested repairs necessary.
Supporting documents must be provided.
• Combined household income must be less than 60% of the Area Median Income of Montgomery County.
Refer to the chart below.
• Eligible properties are Single Family Residences (SFR) and manufactured homes.
o Multi-Family dwellings (apartment buildings, duplexes, tri-plexes, etc.), homes used as rental units,
boats and recreational vehicles (RV’s) are not eligible.
• Homeowner must be current with the following:
o Mortgage loan payment (if homeowner is still making payments)
o Homeowner’s insurance coverage
o Property taxes
o HOA dues (if applicable)
A
B
I
LITY TO PAY
• Homeowners will be responsible to pay all or a portion of
the material cost for the repair. The amount of
pa
yment is based on the homeowner’s monthly income.
WILLINGNESS TO PARTNER WITH HABITAT
• The homeowner must provide the required information by given deadlines.
• Homeowner must be agreed to partner with HFH Montgomery County to complete sweat equity hour
requirement as listed below:
o At least one person from the household needs to be on site by appointment to work on the project
along with the volunteers. The homeowner, or an appointed family member or friend, will contribute
to sweat equity hours. If there is any physical challenge to helping repairs, homeowner will work with
Habitat to determine an alternate way to perform sweat equity.
o For safety reasons, children under the age of 16 are not allowed on the construction site while
construction is in progress. Children between the ages of 16 and 18 must be accompanied by a
parent or a guardian.
o Homeowners are strongly encouraged to attend education classes provided by Habitat for Humanity
when available.
Household Size
Monthly
Maximum Annual:
1
$0- $2,670
$0- $32,046
2
$0- $3,050
$0- $36,624
3
$0- $3,430
$0- $41,202
4
$0- $3,815
$0- $45,780
5
$0- $4,120
$0- $49,442
6
$0- $4,425
$0- $53,105
7
$0- $4,730
$0- $56,767
8
$0- $5,040
$0- $60,430
Home Repair Program
Eligible Repairs
EXTERIOR
INTERIOR
• Siding and trim repair and replacement;
replacing wood members
• Exterior scraping, caulking and painting
• Handrails at property entrances
• Replace wood damaged by termites
and dry rot, including sill, frames, etc.
• Window repair (new screen, glass,
glazing) or replacement
• Gutter replacement/repair
• Porch, deck or wheelchair ramp
construction
• Repair or replacement of porch, stairs
or ramp
• Minor drainage issues
• Door repairs or replacements for house
• Weather-stripping at doors
• Caulking and foaming cracks and gaps
at the doors and windows
• Adding or replacing door seals
• Supporting existing structural members
• Installation or repairs of mechanical,
plumbing, or electrical components and/or
services
• Floor and wall repair/replacement
• Bathroom grab bars; installation of accessible
bathroom components (bathtub, toilet, vanity,
sinks, etc.)
• Supporting existing structural members
• Ceiling repairs
• Venting issues for kitchen and bathroom
• Weather-stripping at doors
• Caulking and foaming cracks and gaps at the
doors and windows
• Insulating openings, attics, crawlspaces, etc.
to eliminate heat loss
• Insulating pipes and duct work; wrapping
water heaters
• Where applicable, applying insulation in walls
Repair Exclusions:
• Foundation repairs
• Cosmetic or decorative repairs and modifications
• Construction or demolition of rooms and additions
• Remodeling improvements not related to health, safety or accessibility needs
• Repairs on properties that are uninhabitable
• Repairs on properties with open permits
• Repairs on properties with unpermitted or illegal additions
• Repairs on properties undergoing current construction, renovation or remodeling
• Repairs on properties in a state of incomplete construction, renovation or remodeling
• Repairs on properties which Habitat deems unsafe for staff, volunteers or contracted
professionals
• Homes that are “red tagged”, condemned, uninhabitable and/or with extensive damages over the
program limit are not eligible.
• Property cannot currently be under construction, renovation or remodel OR in a state of
incomplete construction, renovation or remodeling activity.
• The budget for total material cost on the entire project will be based on need.
You will need to provide proof of total household income by providing copies of the supporting
documents listed below. Your application will be considered incomplete if copies of supporting
documents are not provided with the application.
If you need assistance in completing the application, call the Main Office at 936-441-4663 to
schedule an application appointment during business hours: Tue-Sat 8:30am to 4:30pm
Provide the following documents when you return your application:
• Copies of Driver’s License and/or Texas I.D. for all adult family members (18 years and older)
• Divorce Decree (if applicable)
• Proof of Income (as applicable)
o Copies of current Award Letters or most recent stubs for:
▪ Social Security
▪ SSI
▪ Pension or Retirement
▪ Disability (SSDI)
▪ Child Support, TANF (SNAP is not a source of income)
o Copies of Pay Stubs for the most recent two months
o Copies of bank account statements (6 mos.)
To Order a Social Security Statement, please call 1-866-964-6304.
Requested Repairs:
Please note the types of repairs or modifications you are requesting for your home, noting the most important (1)
to least (8).
Ramp access to primary entrance
Hand Rail to primary entrance
Grab bars in bathroom
Roof repair
Floor repair
Plumbing
Electrical
Other
Home Repair Program Application
P.
O Box 2624
,
Conroe,
TX
773
0
5
Tel:(936) 441-4663
Fax: (936) 756-4667
We are pledged to the
letter and spirit of U.S.
policy for the
achievement of equal
Housing opportunity throughout
the
nation. We encourage and
support an affirmative advertising
and
marketing program in which
there
are no barriers to obtaining
housing
because of race, color,
religion,
sex,
handicap, familial
status, or national origin.
List the names, ages, and relationship to applicant of all people living in
the home: (Attached a list if more space is needed)
Name
_________________________
_________________________
_________________________
_________________________
_________________________
Relationship to applicant
__________________________
__________________________
__________________________
__________________________
__________________________
Age
__________
__________
__________
__________
__________
Do you own your home: YES NO
FOR OFFICE USE ONLY- DO NOT WRITE IN THIS SPACE
o Accepted
Date Application Received ___/___/____
Date of Family Visit ___/___/____
Date of Property Assessment ___/___/____
o Denied
Co-Applicant
Name
Address
Social Security Number
Date of Birth
/
/
Marital Status:
legally married
separated
unmarried
(Incl.
single, legally divorced, widowed)
Phone
Number (home)
(cell)
Applicant
Name
Address
Social Security Number
Date of Birth
/
/
Marital Status:
legally married
separated
unmarried
(Incl. single, legally divorced, widowed)
Phone Number (home)
(cell)
Personal Statement
Please write a brief explanation of why you are in need of Home Repair services.
NO
Did you or anyone in your household serve or is currently in the
military?
YES NO
Combined Monthly Bills* Amount per month ($)
Applicant Employment Information*
Employer’s Name
Employer’s Address
Employer’s Phone
Type of Business
Years
at this Job
Monthly
Wages (gross) $
Co-Applicant Employment Information*
Employer’s Name
Employer’s Address
Employer’s Phone
Type of Business
Years
at this Job
Monthly
Wages (gross) $
Applicant Assets *
Name of Bank/Savings and Loan/Credit Union:
Address:
Balance: $
Co-Applicant Assets*
Name of Bank/Savings and Loan/Credit Union:
Address:
Balance: $
SSI $
Applicant Monthly Income*
Wages $
Food Stamps $
Social
Security $_
Disability $
Alimony
$
Child Support $
Other $
Total
$
Co-Applicant Monthly Income*
Wages $
Food Stamps $
Social
Security $_
SSI $
Disability $
Alimony
$
Child Support $
Other $
Total
$
I understand that by filing this application, I am authorizing Habitat for Humanity to evaluate my actual need for the
Habitat home repair program, my ability to repay the no-interest loan and other expenses for the repair product and my
willingness to partner with Habitat. I understand that the evaluation will include personal visits, a credit check, and
employment verification. I have answered all the questions on this application truthfully. I understand that if I have not
answered the questions truthfully, my application may be denied. The original or a copy of this application will be
retained by Habitat for Humanity of Montgomery County, TX even if the application is not approved.
Date
Applicant Signature
Co-Applicant
Signature
Date
*Attach extra sheet if there is income from other adult household member besides the applicant/Co-applicant.
Mortgage
Utilities (gas, electric, water)
Phone/Internet/TV
Car Payment
Car Insurance
Child Care
Food
Student Loans
Medical Expenses and Medical Insurance
Alimony/Child Support
Average Credit Card Payment
TOTAL
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Permission to Refer
If your needs can be met more appropriately by another program, may we share your application with them?
(circle one)
YES
NO
Unless you give us permission to share your information with other organizations, your application will be kept
confidential.
Photo / Video Release
I, the homeowner, hereby grant and convey in perpetuity to Habitat for Humanity all right, title, and interest
in any and all
photographic images, use of homeowner’s name, printed interviews or statements, and
video or audio recordings made by
Habitat and/or its agents, contractors, directors, employees, officers,
volunteers, and other representatives in the course of
performing the Work (described in the pre-work
agreement form, to be signed before beginning any work), including, but
not limited to, any royalties,
proceeds or other benefits derived from such photographs, printed materials or recordings.
Homeowner’s Name (Printed) Homeowner’s Signature
Date
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signature
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Home Repair Applicant Agreement
I hereby authorize and instruct Habitat for Humanity of Montgomery County. (hereafter Habitat MCTX) to
obtain and review my credit report. My credit report will be obtained from a credit-reporting agency chosen by
Habitat MCTX. I understand and agree that Habitat MCTX intends to use the credit report for the purpose of
evaluating my financial readiness for the Home Repair Program.
I understand that by filing this application, I am authorizing Habitat MCTX to evaluate my need for critical
home repairs, my ability to repay a no-interest loan, and my willingness to be a partner family. I understand
that the evaluation will include a home assessment and income verification. I have answered all the questions
on this application truthfully. I understand that if I have not answered the questions truthfully, my application
may be denied, and that even if I have already been selected to be eligible to receive Critical Home Repair
services, I may be disqualified from the program. I further understand that Habitat for Humanity will notify me
of repairs that can complete, if any. The original or a copy of this application will be retained by Fort Bend
Habitat for Humanity even if the application is not approved.
____________________________
Applicant Name (Print)
____________________________
Co-Applicant Name (Print)
Date: _____________________
Send completed application along with supporting documentation to:
Habitat for Humanity of Montgomery County, TX
Attention: Family Services
PO. Box 2624
Conroe, TX 77305 United States
(936) 441-4663 OFFICE
Complete the following if you are not the Applicant but are assisting the Applicant in completing the
application:
Name Date Contact Number Organization
____________________________
Applicant Signature
____________________________
Co-Applicant Signature
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signature
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signature
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Home Repair Program
Application Checklist
Complete application form with signature of applicant and co-applicant
Copies of Driver's License and/or Texas I.D. for all adult family members (18 years and older)
Divorce Decree (if applicable)
Copy of most recent property tax bill or proof of payment plan from the Montgomery County Tax Office
Copy of the deed on the home or other proof of ownership, such as a property tax receipt. All documents
submitted must show the name and address of the applicant.
Mortgage Statement (if applicable)
Proof of homeowner insurance(if applicable)
Documentation of all salary/income for applicant and co-applicant
o Copy of income tax return for last two years
o Copy of last pay stubs or other proof of income for the last 2 months
o Copy of most recent bank statements for the last 6 months
o Copy of benefit letters for social security, disability, retirement, and proof of child support, if any
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Hom e Repair Program Eligibility Criteria NEED assistance. (Habitat for Humanity of Montgomery County, TX)

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Completed 24 December 2020

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