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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 all household <br /> members. <br /> - Copy of most recent documentation of any other income for all household 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 all household 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 />