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CDBG - Neighborhood Rehab Application

  1. Please select the type of CDBG Neighborhood Rehab funding you are applying for.*

  2. Applicant Information

  3. Female Head of Household*

  4. Do you own any additional Properties?*

  5. Rehab Property Information

  6. Are you the property owner?*

  7. Does the owner live on the property?*

  8. Are there additional owners on the deed or mortgage?*

  9. Is this inquiry related to an outstanding building code violation?*

  10. Are there any outstanding liens (other than mortgage(s)) or judgements affecting this property?*

  11. Are any property tax or mortgage payments in arrears?*

  12. Primary Applicant: Income Information

  13. Do you currently rent room(s) in your home or unit?*

  14. Income Data

    Please complete the following income data questions for the rehab property ONLY - all submitted documentation must support information provided below. Complete for Single Family Home Rehab projects only.

  15. Asset Information

    Please complete the following asset information for other properties and business assets. Complete for Single Family Home Rehab projects only.

  16. Certification

    I/We, certify that I/we have examined all the information contained above and certify that it is true and correct. I/we, agree to maintain the current status of affordable housing unit for a period of three years. I/We as property owner(s) agree that the City’s obligation to provide payment is contingent upon the property owner(s);

  17. A. Using payment solely in connection with the work; B. Not amending the contracts without the prior written approval of the City; C. Paying all cost in connection with the work and paying all cost in connection with any additional work (“Additional Work”) which may be performed; D. Permitting the City and its Agents and Designees to enter the Property to make periodic inspections of the work; and E. Complying with all the procedures established by the City and for the said Neighborhood Rehabilitation Program

  18. The Property Owner hereby agrees to indemnify and hold the City and the City’s officers, employees and agents: harmless against any and all claims, liabilities and expenses in connection with the contract(s), the work and any additional work.

  19. WARNING: ANY PERSON WHO KNOWINGLY AND WILLINGLY MAKES FALSE OR FRAUDULENT STATEMENTS MAY BE DETERMINED INELIGIBLE FOR ALL COMMUNITY BLOCK GRANT PROGRAM ASSISTANCE AND HELD LEGALLY RESPONSIBLE.

  20. Leave This Blank:

  21. This field is not part of the form submission.