Pike County Landlord Incentive Program
Pike County can assist landlords with the cost of essential repairs in exchange for creating or maintaining affordable housing for five (5) years. This program is funded through the Pennsylvania Department of Community and Economic Development, Community Development Block Grant.
Landlord Name
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First Name
Last Name
Business Name (if applicable)
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Landlord Business/Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Describe the applicant's experience as a landlord in Pike County. Include rental properties owned, length of time owned, and any violations (i.e. codes, fair housing).
Are the landlord and business current with all taxes?
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Yes
No
If no, provide an explanation.
Is the business debarred or suspended?
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Yes
No
Not sure
Upload a completed and signed W-9 Form
*
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Property Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the property in a flood zone?
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Yes
No
I'm not sure
Do you have flood insurance on the property?
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Yes
No
What type of property are you applying for?
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Single, detached unit
Single, attached unit
Multi-unit, 2 to 4 units
Multi-unit, 5 or more units
Mobile home
Other
In what year was the property built?
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Is there lead-based paint in the property?
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Yes
No
I'm not sure
If yes, please explain.
Provide information for all units at the address.
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Unit #
Bedrooms
Improvements Needed?
Occupied?
Monthly Rent
Low- Moderate-Income Tenant?
Unit 1
Unit 2
Unit 3
Unit 4
Unit 5
Unit 6
Unit 7
Unit 8
Will you create a new unit of affordable housing through this project?
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Yes
No
Will you create a new unit of affordable housing for people with disabilities through this project?
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Yes
No
Will the current tenant be displaced through this project?
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Yes
No
I'm not sure
Describe the repairs that are needed.
*
Upload documentation of property insurance
*
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Upload documentation of flood insurance (If applicable)
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Upload a copy of the property deed
*
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Additional information (if applicable)
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I hereby certify that all information contained in this application is true and accurate. My signature confirms my interest in applying for a forgivable loan through Pike County's Community Development Block Grant program. I authorize Pike County to obtain any information needed to assess my eligibility for this program. I have reviewed the Program Guidelines for the Pike County Renter-Occupied Housing Rehabilitation Program. I agree to follow the program guidelines. I agree to obtain legitimate bids from approved contractors in accordance with program guidelines and regulations after Pike County's housing inspector has prepared specifications and a cost estimate. I understand that the housing inspector and contractors will have to inspect my property to prepare their bids and agree to provide them with access. I agree to have Pike County act as escrowee to disburse Community Development Block Grant funds, if this project is funded.
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Print Name
*
First Name
Last Name
Today's Date
*
-
Month
-
Day
Year
Date
Submit
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