C.J. Francis, III Foundation
Community Housing Impact Grant - Applicant Questionnaire
Grant Eligibility Checklist
Rows
Yes
No
N/A
This is will be the applicant's primary resident
First-Time Homebuyer
Primary residence located within city of Dayton
Applicant must have completed or be willing to complete a HUD- approved homebuyer education course.
Applicant contribute a minimum of $500 of their own funds toward the home purchase.
Professional Inspection
Median Income at or below the 100% AMI for Dayton, Ohio
Are you willing to write a impact statement after grant approval.
Consent to Contact
Are you a Realtist
Rows
Yes
No
N/A
Realtor
Title Company
Lender
Name of Applicant
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Subject Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Estimated Closing Date
-
Month
-
Day
Year
Date
Real Estate Agent
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Lender
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Title Company
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: