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COUNTY OF HAWAI’I <br />OFFICE OF HOUSING AND COMMUNITY DEVELOPMENT <br />RESIDENTIAL REPAIR PROGRAM <br />INSTRUCTIONS FOR COMPLETING THE APPLICATION FORM: <br /> - Type or print information using black ink. <br /> - Sign and date the application. <br /> - Fill in all applicable information. <br /> - Sign and date Authorization for the Release of Information <br />DOCUMENTS TO BE SUBMITTED WITH THE APPLICATION: <br /> - Copy of three (3) months of most recent employment pay stubs for allhousehold <br />members. <br /> - Copy of most recent documentation of any other income for allhousehold members (such <br />as: Social Security, Disability, Pension, Public Assistance, Life Insurance Payments, <br />Living Allowances, etc.) <br /> - Copy of six (6) months of statements for checking accounts, the most recent bank statement <br />for savings accounts and any other assets for allhousehold members (Such as: IRA, <br />Mutual Funds, Annuities, Stocks, Bonds, etc.) <br /> - Copy of Deed. <br /> - Copy of most recent Real Property Tax Assessment. <br /> - Copy of most recent Mortgage Statement <br />- Copy of current homeowners’ insurance policy. <br /> - Copy of most recent Federal Income Tax Return. <br /> - Copy of most recent State Income Tax Return. <br /> - If you did not file a Federal and/or State Income Tax Return, complete the attached <br />Certification of Non-Filing of Federal and/or State Income Tax Return, have it notarized and <br />submit it with the completed application. <br /> - Personal check, cashier’s check or money order for $50.00 payable to “Director of <br /> Finance”. <br />RETURN THE APPLICATION BY MAIL OR IN PERSON TO: <br />County of Hawai`i <br />Office of Housing and Community Development <br />1990 Kino’ole Street, Suite 105 <br />Hilo, Hawai’i 96720-5293 <br />If you need any other information or assistance regarding the application, please feel free to contact <br />our office at (808) 959-4642. <br /> <br />