2022 Griffin Heights Housing Rehab Program Application

2022 Griffin Heights Housing Neighborhood Rehab Program APPLICATION (CDBG Funding)

The City of Tallahassee is now accepting applications for the Griffin Heights Neighborhood Housing Rehab Program. The program is funded by a US Department of Housing and Urban Development (HUD) Community Development Block Grant (CDBG). The application period this program runs from August 22 - September 21, 2022. The Griffin Heights Neighborhood Housing Rehab Program was adopted and funded by the Tallahassee City Commission on September 22, 2021. Approximately $250,000 in CDBG funding is available for this program.
Pre-Screening Questionnaire

Please provide the following information. Please Note: Completion of this Pre-Screening Questionaire does not guarantee eligibility or assistance through the City of Tallahassee Griffin Heights Housing Rehab Program. Further eligibiltiy determination is required.
1. I am listed as an owner of this property. Please Note: All owners will be verified and will have to sign the application. *
2. The property is located within the Griffin Heights neighborhood boundaries. Please note: Griffin Heights boundaries include Tharpe Street to the north, Old Bainbridge Road and Woodward Avenue to the east, West Brevard Street and Tennessee Street to the south, and Colorado, California and Arkansas streets to the west. *
3. The home is owner-occupied. Please Note: Vacant units do not qualify for this program.*
4. The property taxes and any municipal debts associated with the property are paid or they are being paid, per a payment arrangement with the City of Tallahassee and Leon County. Municipal debts include COT utilities, property taxes, code liens, etc. *
5. Do you currently occupy this home as your primary residence?*
6. Is the cumulative income of the household occupying the property 80% or less of the Area Median income for Leon County based on the information below? Please Note: The City of Tallahassee will conduct third party income and asset verification.*
Area Median Income (AMI) Table

Household Size:	1 person	2 people	3 people	4 people
AMI 80%:	$42,750	$48,850	$54,950	$61,050

IF YOU ANSWERED NO TO ANY OF THE ABOVE QUESTIONS, YOU DO NOT QUALIFY FOR THIS PROGRAM. PLEASE CHECK THE BOX BELOW TO CONFIRM YOUR QUALIFICATION.
APPLICANT INQUIRY

Please provide the following information. For the applicant name, enter your official name, as listed on your Driver License or Social Security Card.
Applicant Name (Must be property owner)*

First NameMiddle NameLast Name
Provide the names of all owners listed on the title of the property
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Home)*

Area CodePhone Number
Phone Number (Cell)

Area CodePhone Number
May we send you a text message? *
Co-owner Name
Co-owner Phone Number

Area CodePhone Number
Co-owner Email
example@example.com
May we send you a text message? *
Business Number

Area CodePhone Number
Email Address
Does the property have any code violations? *
If yes, please explain.
PROPERTY REVIEW
List of Repairs Needed

From the list provided below, please select the repairs that you would like to be done to your home. Please understand that not all selections may be funded based on cost and/or the condition of the home.
Funding/Prioritization Criteria

Please provide the following information.
1. Is your home owner-occupied, that is, are you living in the home? *
2. Is your home at least 50 years old and/or has it been designated historic by a local, state, or national entity? *
3. Are any of the homeowners living in the home, ages 65 years or older? *
4. If you answered yes to question number 3, please list the name(s) of each homeowner age 65 years and older, their date of birth and provide a photo copied ID.
Name 1

First NameLast Name
Birth Date

MonthDayYear
Please attach a copy of homeowners photo ID

Browse Files

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Name 2

First NameLast Name
Birth Date

MonthDayYear
Please attach a copy of homeowners photo ID

Browse Files

Cancelof
Previous Housing Assistance

Please provide the following information.
1. Have you received repair or rehab services by the City and/or other agencies in the past 10 years ? *
2. If you answered yes to the previous question, please list the type of repair(s) and year received.
3. Have you recently applied to any other City repair or rehab programs? *

INCOME VERIFICATION

Please provide the annual income before taxes, garnishments, or deductions, from all sources, including wages, Social Security, disability, VA, child support, retirement, pensions, etc., for all persons over age 18 living in the home.
IMPORTANT

Information provided to this application will be used for consideration in the first stage of the review process. If the applicant is selected as a potential recipient of this grant during the first stage, he/she will be required to provide documentation of income and assets at the next stage of the reviewing process.
Household Member 1

First NameLast Name
Age
Income Source
Annual Income
Household Member 2

First NameLast Name
Age
Income Source
Annual Income
Household Member 3

First NameLast Name
Age
Income Source
Annual Income
Household Member 4

First NameLast Name
Age
Income Source
Annual Income
Household Member 5

First NameLast Name
Age
Income Source
Annual Income
REQUIRED DOCUMENTS

Please provide the following information
Primary Applicant Name
Driver License *

Browse Files

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Co-Applicant Name
Driver License

Browse Files

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Property Photo - Street View (optional)
SUBMIT

Once the application is submitted, it can only be re-opened by an Administrator. Note: Submitting an application does not guarantee approval; all program criteria must be met. Incomplete information of lack of required documents may delay processing of the application.
The applicant(s) certifies that all information in this application, and all information furnished in support of this application, is given for the purpose of obtaining funding under the City of Tallahassee's Griffin Heights Housing Rehab ProgramI/we understand that Florida Statute Chapter 817 provides that willful false statements or misrepresentations concerning income, asset, or liability information relating to financial condition is a misdemeanor of the first degree, punishable by fines and imprisonment under sections 775.082 and 775.083, Florida Statutes. I/we further understand that any willful misstatement of information will be grounds for disqualification.I/we certify that the application information provided is true and complete to the best of my/our knowledge.I/we consent to the disclosure of information for purposes of income and home ownership verification related to this application for financial assistance.I/we agree to provide any documentation needed to assist in determining eligibility and are aware that all information and documents provided, except as exempted pursuant to law, are a matter of public record.I/we understand that the repairs are intended to benefit the occupants, and the property will be occupied for the duration of the repair work and after the repairs are complete. By my/our signature below, I/we hereby certify that we own the home to be repaired and affirm that I/we will continue to maintain the home unless otherwise approved by the City.I/we understand that a forgivable lien will be placed on my/our property for the cost of the repairs which will be recorded in the public recordsI/we understand that this grant is a seven year forgivable loan, with one-seventh of the grant being forgiven every year that the property continues to be occupied by the applicant.
PLEASE SIGN

By signing below, I certify all information is true and correct to the best of my knowledge, that I am an owner or co-owner of the property, that I agree to abide by the terms of the grant program and that I agree to the proposed exterior repairs that will be undertaken on the property.
Applicant (Owner) Name
Applicant (Owner) Signature
Date Signed

MonthDayYear
Date
Co-owner Name
Co-Owner 1 Signature
Date Signed

MonthDayYear
Date
Co-owner 2 Name
Co-Owner 2 Signature
Date Signed

MonthDayYear
Date
Co-owner 3 Name
Co-Owner 3 Signature
Date Signed

MonthDayYear
Date
Co-owner 4 Name
Co-Owner 4 Signature
Date Signed

MonthDayYear
Date
Should be Empty:

2022 Griffin Heights Housing Neighborhood Rehab Program APPLICATION (CDBG Funding)

Area Median Income (AMI) Table

PROPERTY REVIEW

INCOME VERIFICATION

IMPORTANT

REQUIRED DOCUMENTS

SUBMIT