Homeowners Application

Preliminary Application for Home Improvement Program (HIP)

2. Please provide the following information about your household:












Income includes, but is not limited to: Gross wages, salaries, tips, commissions, overtime, alimony, child support, pensions, and social security, unemployment and disability benefits.







Signature
I certify that the information provided herein is true and complete and that any misrepresentation of income or household size reported herein may be cause for program disqualification. I also understand that this information is to be used only for determining my preliminary eligibility and does not obligate me in any way.


You will receive notification that your Preliminary Application was successfully submitted.   If you do not receive this notification, please resubmit your Preliminary Application.
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