Grants Administration Division

HOUSING REHABILITATION ASSISTANCE PROGRAM
SUPPORTING DOCUMENTATION

2240 Civic Center Drive
North Las Vegas, NV 89030
Phone: (702) 633-1532
Fax: (702) 642-1511

Submit the following documentation with your Housing Rehabilitation Program application. Please be as thorough as possible. This is required documentation.

INCOME & ASSET INFORMATION

EMPLOYMENT INCOME (Submit this documentation for each household member who is employed)

• Name, address and telephone number of employer
• Copy of most current tax return
• Current rate of regular pay, overtime pay and number of hours normally worked per week (three current pay stubs)
• Information regarding any changes expected during the next twelve months in pay or number of hours worked
• Other types of income received from employment (EXAMPLE: Tips, commissions, profit-sharing programs, etc.)

NOTE: If a member of your household is over 18 years of age and unemployed, a signed statement to that effect must be included.

BENEFIT & SUPPORT INCOME (Submit this document for each household member who received any of the following types of income. Supply name, address and telephone number of the source of income & information regarding the amount of income received.)

BANK ACCOUNT BALANCES (Include Christmas clubs, CDs, IRAs, etc.)

Copy of most current bank statements reflecting balance.

REAL ESTATE

STOCKS, BONDS, TRUSTS & OTHER INVESTMENTS

• Statements with account numbers on all investments and information regarding income received from investments.

EDUCATIONAL GRANTS & SCHOLARSHIPS (Submit this documentation for each household member who received an educational grant or scholarship.)

• Information regarding type of assistance and purposes for which the assistance can be used.
• Name, address and telephone number of institution providing assistance.

OTHER INCOME

• Name, address and telephone number of source of income and information regarding amount of income.

NOTE: If any assets have been sold or given as gifts within the past two years (such as giving property or money to a family member), provide information regarding these assets.

FAMILY MEMBER INFORMATION

AGE

• Birth certificate or other proof of age if head of household or spouse is 62 years of age or older.

CHILDREN (Submit this documentation for each child who is a member of the household.)

• Birth certificate, custody agreement, adoption papers or other legal proof that the child resides in the household.

FULL-TIME STUDENTS (Submit this documentation for each household member who is 18 years of age or older and still attends school full-time.)

• Name, address and telephone number of learning institution.

DISABILITY (Submit this documentation for each household member who has a disability.)

• Information regarding disability benefits and amount of income.

DISPLACEMENT (Submit this documentation if your household has recently been displaced by government action.)

• Documentation detailing displacement situation.