MCLTRG CLIENT INTAKE FORM

BEFORE completing the form below, please review the required documention for the application process:

1. Income and Asset Verification (Form 3A), completed during application process

2. Verification of Employment (Form 3B), signed by client after application and mailed by MCLTRG

3. Affidavit of Zero Income (Form 3C), signed during intake

4. Beneficiary Certification (Form 1A), completed during intake process

5. Current Year Benefit Letter (SS Award Letter for Disability)

6. Three Months of Pay Stubs

7. Three Months of Bank Statements

8. Child Support Documentation

9. Declaration of Citizenship (Form 5D), signed during intake

10. Hold Harmless Agreement (Form 1C), signed during application process

11. Deed

12. Homeowner’s Insurance

13. Current Mortgage Statement

14. Current Property Tax Receipt

15. Documentation of Year Home Built (Tax Assessor or GIS)

16. Previous Year’s Tax Return

17. Tax-Assessed Property Value

18. FEMA Declaration Letter (if applicable)

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PLEASE NOTE

• In order to qualify for the SCOR Grant, residents cannot make more than 30% of the Marion County median income.

• At this time, in order to qualify for the South Carolina Housing Finance grant, residents must need repairs that equal at least $30,000.