Neighborhood Improvement Project ApplicationStep 1 of 714%Total Annual Household Income(Required)How many people are in the household?(Required)1 person ($46,500)2 people ($53,160)3 people ($59,820)4 people ($66,420)5 people ($71,760)6 people ($77,100)7 people ($82,380)8 people ($87,720)(60% income limits noted)Applicant - Housing Rehabilitation overview:(Required) I agree to the statement below.I understand that the Neighborhood Improvement Project is limited to correcting code violations for income eligible households who own and occupy the property cited. If the cost of the necessary repairs exceeds the cost cap limitation, I understand that I may not qualify for any assistance. The materials and the work performed to correct the repair items by the Neighborhood Improvement Project is a forgivable loan if I own and live in the property for the applicable period of Affordability/Occupancy, a 5 year minimum, following signing of the Covenant Document. If I own a duplex, there will be a Period of Affordability for the tenant unit based on the amount of funding spent per unit. I hereby certify that all of the above information is true and correct to the best of my knowledge and I agree to have the Neighborhood Improvement Project undertake only the work as described in the NIP Inspector's approved scope. I also understand that participation in this program is a ONE-TIME ONLY SERVICE.Applicant InformationName(Required) First Last Marital Status(Required)SingleMarriedDivorcedSeparatedWidowedAddress(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Phone(Required)Work PhoneDo you have a Co-Applicant? I have a Co-ApplicantCo-Applicant InformationCo-Applicant Name(Required) First Last Is the Co-Applicant's address the same as yours? Co-Applicant's address is the same as mineCo-Applicant Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Co-Applicant's Email Co-Applicant's Phone(Required)Co-Applicant's Work PhoneProperty InfoAre you the property owner?(Required) Yes NoHow many years have you owned and occupied this property consecutively?(Required)Do you own other properties?(Required) Yes NoList all addresses for the other properties you own(Required) Add RemoveHave you or any Co-Applicant been involved in Chapter 7 and/or Chapter 13 Bankruptcy within the past 5 years? Yes NoDo you have any judgments owing to any City/State or Federal government agency? Yes NoThe applicant will not be approved if government judgments have not been satisfied.Income InformationList all wages, W2, Social Security, general assistance, pensions, rents, interest, dividends, grants, etc. (Total anticipated income for the upcoming 12 months from the date of application must be used when considering eligibility.) *Per HUD Technical Guide - 3rd edition 2005 (Census Long Form)Please be aware that additional income information will be needed for consideration of the application this will include: Household Member Income Information (Household Member Name, Source of Income, Employer/Address, and Gross Monthly Amount).NOTE: Income verification is required from ALL household members. Failure to report TOTAL household income /or to provide false information is grounds for permanent cancellation. An increase in household members and/or income must be reported immediately throughout the duration of the program.Total Monthly Household Income(Required)Property InformationNo property space can be used for business or commercial useType of Dwelling(Required) Single Family Duplex (No Rent - used by family member(s)) Duplex (Rent to Tenants) OtherYear Purchased(Required)Year Built(Required)Total Number of all Rooms on 1st Floor(Required)Total Number of Bedrooms on 1st Floor(Required)Total Number of all Rooms on 2nd Floor(Required)Total Number of Bedrooms on 2nd Floor(Required)Energy Utility Monthly Costs:(Required)(Electric, Gas, Oil)Estimated Utility Quarterly Cost of Water:(Required)Mortgage InformationMonthly Mortgage Payment AmountAre your Property Taxes included in your Monthly Mortgage Payment? Yes NoLender's NameLender's AddressType of Mortgage Conventional VA FHA OtherHomeowners Insurance InformationCompany NameAgent NameCompany Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Company PhonePolicy NumberExpiration Date MM slash DD slash YYYY Repairs NeededList the repairs needed on your houseSubscribe to our newsletters I would like to sign up for newsletters from MCC
