CHN Housing Partners Online Delinquent Property Tax Assistance Application

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Page 1

Welcome to CHN Housing Partners' Online Application for Delinquent Property Taxes

How does it work?
This lifeline, funded by the U.S. Department of Treasury's Homeownership Assistance Fund, is for Cuyahoga County homeowners who are facing financial hardships due to COVID-19 and need help paying delinquent property taxes. Financial assistance per household caps at $10,000. 

Income restrictions apply. Funding is targeted at households at or below 100% Area Median Income (with the ability to go up to 150% AMI in select cases). 

Income

Limits 

100% Area 

Median Income 

Household Size

Annual 

Monthly 

1

$68,900

$5,742

2

$78,800

$6,567 

3

$88,600 

$7,383

4

$98,400

$8,200 

5

$106,300

$8,858

6

$114,200

$9,517

7

$122,100

$10,175

8

$129,900

$10,825

CHN is the entry point to access delinquent property tax assistance, a broad array of housing, utility assistance, and referral resources, which you will be screened for. You will be under no obligation to participate in any programs we recommend. 

Fill out the online application in its entirety and gather a few documents:
   1. Photo identification for each household member over 18 years of age - any individual listed as a property owner or on the tax bill must be included in this application (if this is an issue, please call our hotline at 216-774-2336)
   2. Proof of citizenship (birth certificate, Social Security card, naturalization certificate or passport) for all household members
   3. Income documentation (proof of income for most recent 30 days.  If there is no current income, you may provide a 2020 W2, or 1099.    

For your convenience, CHN Housing Partners allows the use of e-signatures with this online form. You will be prompted to enter your name at the end of this form prior to submitting to give consent. If you have questions or need further assistance, please call (216)774-2336.

Who qualifies?
Residents of the City of Cleveland and Cuyahoga County who are having difficulty making property tax payments due to the economic impact of the pandemic and who meet income eligibility requirements. Applicants must owe less than $10,000 in delinquent property taxes. Applicant cannot currently be in mortgage or tax foreclosure. The property must be owner-occupied and be the applicants primary residence. The property must be in the applicant's name and may not be owned by an LLC. 

Priority is given based on criteria such as: income, homestead status, and accurate information and complete documentation. If you qualify, you may be required to attend more in-depth financial counseling, provided by CHN, as a condition for payment of the delinquent property tax balance. 

Online Application Guidelines
To apply for programs with CHN Housing Partners, you must complete an application with us along with providing documents to verify the information submitted. Each participant in this program is required by the U.S. Department of Treasury and Ohio Housing Finance Agency to provide their annual income level to establish eligibility for this federally-funded program, and to verify race/ethnicity for data collection purposes only. We have split this into the following sections:

1. Applicant and co-applicant information: Your contact and demographic information, as well as information for any individual listed on the tax bill or as property owner.
2. Household members: Other members of your household and their demographic information
3. Income sources: All sources of income and public benefits for all household members over 18
4. Assets: All liquid assets for all household members over 18
5. Housing & utility details: Details about your property taxes and utilities for program-specific purposes and to help us assess what program(s) you may need
6. Document upload: We will request scanned copies, legible photos or screenshots of documents as verification for your eligibility for programs. 

You may encounter a slow system or downtime due to a high volume of traffic on the site. Please use the "Save my progress and resume later" feature located at the top of the form OFTEN to avoid losing any information. (This form is powered by FormAssembly.)


Fair Housing Act (42 USC 3600, et seq.)
If you have an impairment, disability, language barrier, or otherwise require an alternative means of completing this form or accessing information about our services, please talk to us about arranging alternative accommodations. We serve all clients regardless of income, race, color, religion/creed, sex, national origin, age, family status, disability, or sexual orientation/gender identity. We administer our programs in conformity with local, state, and federal anti-discrimination laws, including the federal Fair Housing Act (42 USC 3600, et seq.)

Click Next Page to Continue


Please use the page numbers above to navigate to specific areas of the form

Page 2

Please use the page numbers above to navigate to specific areas of the form

Applicant and Co-Applicant Details

In this section, please enter your most up to date contact information and demographic information.

CHN Housing Partners (CHN) is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all personal information shared verbally and/or in writing will be managed within ethical and legal consideration. Additionally, we want you to understand how we use the personal information we collect. Please carefully review this notice as it describes our policy regarding the collection and disclosure of your nonpublic, personal information.
 
CHN's Privacy Policy

The Applicant (and Co-Applicant, if applicable) should be an adult member of your household that will be able to represent, provide information for, and make decisions on behalf of your household. 

All individuals listed on the tax bill and/or as homeowner(s) must be included in the application (either co-applicant or household members).


Please prepare for upload: Photo Identification and Social Security Cards for each Applicant and Co-Applicant.
Applicant Information

















Enter date in MM/DD/YYYY format








Co-Applicant Information










Enter date in MM/DD/YYYY format








Need help? Call our hotline at (216)774-2336.

WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

Page 3

Please use the page numbers above to navigate to specific areas of the form

Household Members

Please enter additional members who reside in your household (i.e. children, dependents, other family members, etc.). Use the "Add Additional Household Member" link to add as many as you need.

All individuals listed on the tax bill and/or as homeowner(s) must be included in the application (either co-applicant or household members).

You do not need to re-enter Applicant or Co-applicant (if applicable) information here.


Please prepare for upload: For each household member, be prepared to provide verification that they are your dependents - such as Social Security Cards and Birth certificates

Household Member


Enter date in MM/DD/YYYY format











Need help? Call our hotline at (216)774-2336.

WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

Page 4

Please use the page numbers above to navigate to specific areas of the form

Current Income Sources and Public Benefits


Please enter all sources of Income and Public Benefits that your household is CURRENTLY receiving, for all household members over the age of 18. 


Use the "Add Additional Income Source" link to add as many as you need


Current Annual Income is the estimated income for the current year including any wages,

benefits, alimony, child support and other forms of financial income or support.


Income includes: Full-time employment, part-time employment, self-employment, spousal support, child support, investment income, Social security, SSI, SSDI, income from assets, pension/annuity, unemployment, adoption subsidy, short term disability, long term disability, veteran's benefits, zero income, family contribution, other

Public benefits include: Food stamps, WIC, ADC, OWF/TANF, rental subsidy, utility allowance, other public benefit

Please prepare for upload: Verification of income for the past 30 days - pay stubs, employment letters, award letters, etc. 


If you answered "No", please upload a copy of your most recent W2, 1099, or most recent wage statement to document the income you earned last year. 
Current Income or Public Benefit Source

Enter the Household Member who this income belongs to


Provide the Job Title for Employment types, if applicable
Please take the total income you received in the last 30 days and multiply by 12 to determine your annual income:

Please estimate to the best of your ability. Our staff will review your documents and provide a full eligibility determination.
           *Unless you indicate you are not interested at this time, CHN will provide a referral to                     Towards Employment at towardsemployment.org




WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

Page 5

Please use the page numbers above to navigate to specific areas of the form

Assets Declaration
Please enter all liquid Assets you have control over for all household members over the age of 18. Liquid assets are cash on hand or assets in any other form that can be converted to cash within 20 days (SSA.gov)

Asset types include: Bank Accounts - Savings and/or Checking, Investment Accounts, Retirement, Certificates of Deposit, Cash on Hand, Pre-paid Debit Cards, Health Savings Accounts, Life Insurance Cash Value

Asset


Please estimate to the best of your ability - enter 0 if unsure
Need help? Call our hotline at (216)774-2336.

WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

Page 6

Please use the page numbers above to navigate to specific areas of the form

Household and Utility details

We will be asking more specific questions about your Housing Details here, including your living situation, mortgage information, and utility details. This information will allow for us to screen eligibility for the wide range of programs we offer. You will be under no obligation to participate in programs we recommend.

Reminder: To qualify for this program, you must owe less than $10,000 in delinquent property taxes.
Housing




To lookup your tax balance, please go to myplace.cuyahogacounty.us and enter your parcel number or address. 

Reminder: To qualify for this program you must owe less than $10,000 in delinquent property taxes. If you owe more than $10,000 in delinquent property taxes, you are ineligible for this program and will be referred to our Foreclosure Prevention team.

Please enter the amount you owe on your current tax bill. Contact the Fiscal Office or visit myplace.cuyahogacounty.us if you need to check your current tax balance.



Mortgage Information











Hardship Statement
We require a statement of Hardship that helps explain why you need assistance. Please select the category that represents the primary hardship reason and any additional detail in the Hardship Statement. 


up to 255 characters

WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

Page 7

Please use the page numbers above to navigate to specific areas of the form

Upload Documents

Please use this page to upload documents that support your application. You can attach electronically downloaded documents, use a scanner, or take pictures or screenshots of your documents with your phone.

You can upload multiple files per section by using the "Add another ..." link. There is a limitation of 20 files per form. 

Gather the required documents:
1. Photo identification for all household members 18 years or older
2. Verification of household members (Social Security card preferred, or birth certificate) for all household members
3. Income (Pay stubs and wage statements from the past 30 days for all household members over the age of 18; if you cannot provide these documents, please call us at 216-774-2336)
4. Utility Bills (Most recent utility bills to help us as we verify owner-occupancy of property)


You must provide documents for everyone listed on the tax bill or listed as a property owner. Failure to provide this documentation may lead to delays in processing your application or cause your application to be denied. If you have any questions, please call our hotline at 216-774-2336.

Complete applications with all required supporting documents will be processed faster - please upload as much as you are able to and ensure you have documents for each section!  


If taking photos with your phone/camera, you can line up your IDs and Social Security cards within one image, instead of one at a time
ID


Utility Bills
Utility bills help us verify owner-occupancy. Please submit your most recent utility bills.







Need help? Call our hotline at (216)774-2336.
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.

Page 8

Please use the page numbers above to navigate to specific areas of the form
Acknowledgement & Submit

I/we certify that all provided information is correct to the best of my knowledge and have received a copy of CHN's Housing Counseling Disclosure and Privacy Policy. I/we authorize CHN Housing Partners to verify all information contained on this online form and to pull my credit report. I/we understand that I may be assisted by federal funds which carry severe penalties, including incarceration.

CHN's Housing Counseling Disclosure and Privacy Policy

By typing my full name below, I hereby authorize CHN to release nonpublic personal information it obtains about me to any third parties necessary to provide me with the services I requested. I acknowledge that I have read and understand the above privacy practices. I understand I will receive a copy of all information submitted at the email address I provided on Page 2, "Applicant E-mail Address".
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.




Save my progress and resume later | Resume a previously saved form