-
-
-
-
-
-
Format: (000) 000-0000.
-
-
-
- Do you live within the City of Uniontown?*
- Home Status*
-
- Do you have reason to believe your home is located in a flood plain?*
- Was your home built before 1978?*
- Do you have lead issues in your home?*
- Do you have nay of the below Health or Safety Hazards in your home?*
- Have you received a code violation/sweep violation notice?*
- Is the head of household or other member over the age of 62?*
- Is the head of household or other member disabled?*
- Is the head of household or other member a veteran?*
- Racial Characteristics of Family:*
- Are mortgages recorded against your property?*
- How many mortgages have you had?
-
- Are there children under the age of 18 in your home?*
- Are there children age 6 or younger in the home?*
-
-
- Do you have delinquent student loans?*
- Have you filed for bankruptcy?*
- Has it been discharged for at least 3 years?
- Have you ever received USDA 504 Funds?*
- Have you ever received Weatherization Funds?*
- Do you receive SNAP?*
- Do you receive LIHEAP?*
- Do you need modifications to your home due to medical/accessibility issues?*
- Do you have insurance that would cover the costs of these modifications?*
- Do you or someone in your household have a friend, relative, child, significant other, spouse, etc. that work for the City of Uniontown or the Redevelopment Authority for the City of Uniontown,?*
-
-
-
-
-
- Should be Empty: