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- 1 Person Household: Does your household income exceed $44,600 (80% AMI)?*
- 1 Person Household: Does your household income exceed $33,480 (60% AMI)?*
- 2 Persons Household: Does your household income exceed $51,000 (80% AMI)?*
- 2 Persons Household: Does your household income exceed $38,220 (60% AMI)?*
- 3 Persons Household: Does your household income exceed $57,350 (80% AMI)?*
- 3 Persons Household: Does your household income exceed $43,020 (60% AMI)?*
- 4 Persons Household: Does your household income exceed $63,700 (80% AMI)?*
- 4 Persons Household: Does your household income exceed $47,760 (60% AMI)?*
- 5 Persons Household: Does your household income exceed $68,800 (80% AMI)?*
- 5 Persons Household: Does your household income exceed $51,600 (60% AMI)?*
- 6 Persons Household: Does your household income exceed $73,900 (80% AMI)?*
- 6 Persons Household: Does your household income exceed $55,440 (60% AMI)?*
- 7 Persons Household: Does your household income exceed $79,000 (80% AMI)?*
- 7 Persons Household: Does your household income exceed $59,280 (60% AMI)?*
- 8 or More Persons Household: Does your household income exceed $84,100 (80% AMI)?*
- 8 Persons Household: Does your household income exceed $63,060 (60% AMI)?*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Do you live in this home year-round?*
- Are your property taxes paid in full?*
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- Do you have a mortgage on your home?*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Do you have a recorded copy of the Warranty Deed to your property?*
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- Is anyone listed on the title or deed to your property who does not live in the household?*
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- Are there any unrecorded lien(s) on property to be rehabilitated?*
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- Is your home a mobile/manufactured home? (Please note, Mobile Homes in parks are not eligible for this program)*
- Is your home insured? (Please note: Homes must be insured to participate in this program.*
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- Have you previously applied for Rehabilitation Assistance?*
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- Have you at any time participated in a housing rehabilitation project at this address?
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- This information is for understanding your need. An inspection will be completed to identify scope of work that will be completed under the program guidelines.*
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- Marital Status:*
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- Person 1: Date of Birth*
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- Person 2: Date of Birth*
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- Person 3: Date of Birth*
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- Person 4: Date of Birth*
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- Person 5: Date of Birth*
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- Person 6: Date of Birth*
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- Person 7: Date of Birth*
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- Person 8: Date of Birth*
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- Date of Testing*
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- Date of Testing*
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- Date of Testing*
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- Date of Testing*
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- Date of Testing*
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- Date of Testing*
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- Date of Testing*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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