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City of Lewiston's Home Repair Program Online Application

2. Pre-Application Instructions
   You must read and acknowledge the information in the link provided.

   You must read and acknowledge the information in the link provided.

3. Required Reading for the Home Repair Program
   Home Repair Program Required Reading

   The required reading explains the general conditions and expectations for property owners participating in the program.

4. Acknowledgment*

   1. Yes

   By checking this box, it indicates you (as well as any other residents) have read and understand the program description.

5. If yes, please continue with the application.

7. 

8. City of Lewiston's Home Repair Program
   This application is for home repairs for low income residents within the City of Lewiston. Please fill out the information below to the best of your abilities and read the policies before completing.

   This application is for home repairs for low income residents within the City of Lewiston. Please fill out the information below to the best of your abilities and read the policies before completing.

10. To Qualify*

    You must be able to check off all the following questions to qualify.

    1. All applicant names are on the house deed.
    2. Mortgage is paid off or current.
    3. Property tax and assessment are current.
    4. You have homeowner's insurance.
    5. You are located in the City of Lewiston.
12. Application Paperwork Checklist

    Once you have obtained the required paperwork copies that are needed for your application, please check them off. Some of these documents will not apply. Note that this paperwork must be submitted for ALL household residents.

    1. Most recent tax return (for all applicants)
    2. If NO IRS Tax forms, Part 5 Income Inclusions
    3. Copy of Driver's license or valid State ID (all applicants)
    4. Copy of 4 most recent paycheck stubs or bank statements with 4 income deposits.
    5. Copy of school or college docs for full time students living in the home over 18
    6. Copy of Social Security benefits (if applicable)
    7. Copy of current mortgage statement or deed
    8. Copy of Home Insurance
    9. Copy of most recent utility bill
    10. Read and signed the acknowledgement for the "Renovate Right" handbook
14. Applicant Information

16. Name*

17. Email Address

18. Phone Number*

20. Address*

22. City*

23. State*

24. Zip Code*

26. Ethnic Statistical Information

    Check only one box.

    1. Asian
    2. Native American/Alaskan Native
    3. Black/African American
    4. Caucasian/White

    1. Native Hawaiian/Pacific Islander
    2. Hispanic/Latino
    3. Other
    4. Prefer not to say
30. Relevant Household Data
    List all persons living in the home along with all persons with ownership interest or rights to the property. All persons included in the title search must be listed and sign the Rehabilitation Agreement and Lien. Their income will be counted in the total household income. Incomes for full time students and persons younger than 18 years of age are not required to sign.

    List all persons living in the home along with all persons with ownership interest or rights to the property. All persons included in the title search must be listed and sign the Rehabilitation Agreement and Lien. Their income will be counted in the total household income. Incomes for full time students and persons younger than 18 years of age are not required to sign.

32. First Name*

33. Last Name*

35. First Name

36. Last Name

38. First Name

39. Last Name

41. Income

    If full time student or younger than 18, do not state income.

42. Income

43. Income

45. Number of people over the age of 18 residing in the home:*

46. Total Household Income:*

    As estimated and recorded on IRS tax forms in the Adjusted Gross Income line.

50. CDBG - HUD 2020 Income Limit "Lewiston, ID - Clarkston, WA MSA"
    Write the total income listed below that matches the total number of persons from the previous section. If total household income is more than the total income limit, STOP HERE. You do not qualify.

    Write the total income listed below that matches the total number of persons from the previous section. If total household income is more than the total income limit, STOP HERE. You do not qualify.

52. 

54. Income Limit:*

    Insert income limit based on chart above.

58. Are you related to an employee / elected official / appointed official of the City of Lewiston?*
    -- Select One --YesNo

59. If yes, state name, relation, and occupation.

63. Description of requested repairs:*

67. Information and Agreements
    You have reached the end of the online submission for the Home Repair Program. To fully complete this application, you must submit all the required documents to the Community Development Specialist at the Community Development Department. The address is 215 D Street, Lewiston ID 83501. Remaining paperwork includes "Renovate Right" acknowledgment, Required Reading, and copies of documents stated above. If you have any questions regarding this application or the remaining paperwork required for eligibility, please call (208)746-1318 x 7265.

    You have reached the end of the online submission for the Home Repair Program. To fully complete this application, you must submit all the required documents to the Community Development Specialist at the Community Development Department. The address is 215 D Street, Lewiston ID 83501. Remaining paperwork includes "Renovate Right" acknowledgment, Required Reading, and copies of documents stated above. If you have any questions regarding this application or the remaining paperwork required for eligibility, please call (208)746-1318 x 7265.

69. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide traditional signature(s) at a later date.

    1. I agree
71. Electronic Signature*

73. Date Applied:
    Date Applied:

    Date Applied:

Leave This Blank:


75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit Submit and Print

* indicates a required field