Critical Home Repair - Homeowner Application

Instructions: Please read all questions carefully and complete the entire application. If you need assistance, please contact the Home Repair Programs Manager at:

repairs@spshabitat.org or call: (360)763-5691x130


This information will not be shared with anyone outside of South Puget Sound Habitat's Critical Home Repair Department.


Program Requirements

  • This is a repayment program; parties will be responsible for a portion of the cost of the repairs on a payment plan structure.
  • You must be the homeowner and this must be your primary place of residence.
  • You must live in Thurston County.
  • Interested parties must be below 80% AMI as defined by HUD. Habitat will calculate this for you, based on the income information provided within this form.
  • There will be an in-home inspection completed as part of the application process.


Applicant Information

Please enter your full legal name

Please enter co-applicant's full legal name

Contact Information

Phone

Repair Information

Please describe the repair(s) needed

Please attach any pictures of your repair needs here (optional):

Drag and drop files here or

Household and Dependent Questions

Please estimate your gross household income per year.

Please enter numbers only, no symbols.

Household Size*

Please click total number of people in household

Children Under 18
Senior (65 & over)

Please select number of residents in your household that are 65 years or older on today's date

Click if you or a member of your household is active military

Click if you or a member of your household is a veteran

Click if you or a member of your household is disabled

Residence Information

Do you have a mortgage?
Is your mortgage payment current?

Please check if you have homeowners insurance

Is your homeowner's insurance current?
Home Type
Do you own or lease the land that your mobile home is located on?*

Willingness to Partner

To be considered for the program, you and your household members must be willing to partner with our organization. Each adult in your household is considered a program participant who is required to complete program requirements. This includes applicants and any person over the age of 18 at the time of the application. This is what is called "sweat equity", each applicant must contribute 8 hours minimum.

Are you willing to partner?*
Is the co-applicant willing to partner?*

Information for Monitoring Purposes

Please read this statement before Completing the following questions: The following information is requested by us to use in our reporting and for tracking purposes. You are not required to furnish this information but are encouraged to do so. The law provides that we do not discriminate on the basis of this information, nor on whether you choose to furnish it or not.

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Please select 1 option or select "Mixed Race" if more than 1 race.

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Please click on the arrow to select an option, or enter one if your option is not listed.

Select or enter value
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Please enter any other repair programs you have applied to

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