Helping Hand: Disaster Relief Program
Rio Grande Habitat for Humanity has created the Helping Hand: Disaster Relief program to provide relief and assistance to those families who found themselves affected by the recent flooding’s of June 2019. Rio Grande Habitat for Humanity will partner with local businesses, organizations and the community to provide assistance to those families who meet our guidelines and repairs fall within our scope of work.

How does it work?

“Disaster Relief” applicants must meet the same three fundamental principles as other Habitat for Humanity families: they must demonstrate a need for adequate shelter, fall within our income guidelines and be willing to partner with Habitat for the completion of designated sweat equity hours.

Families must provide the following documents:
• Driver’s license/ID of applicant (if applicant isn’t the homeowner provide theirs as well)
• Income (pay stubs, alimony, child support, benefits, etc.) for anyone/everyone living at home and earning income
• W-2 & 1040’s for 2018 & 2017
• If self-employed, provide the past 2 years of profit-loss statements
• Bank statements (3 months checking accts, 6 months savings acct)
• Evidence mortgage has been paid off (if still paying, evidence of current mortgage balance)
• Pictures of damaged area


Family of income limits 1 2 3 4 5 6 7 8
$31,900 $37,600 $42,300 $46,950 $50,750 $54,500 $58,250 $62,000

*An application without the supportive documents will not be evaluated and will be denied after 30 days of submission*

To submit supporting documentation copies may be submitted at the following:
- In person at 412 W. Ash Avenue-McAllen; 507 N. 1st Street, Harlingen, Texas
- Via email at hansel@habitatrgv.org
- Via fax machine 956-631-3595
- USPS to 412 W. Ash Avenue-McAllen; 507 N. 1st Street, Harlingen, Texas

**Due to the limited amount of funds available for the Helping Hand: Disaster Relief program, we cannot guarantee that all families who qualify will receive assistance**

I acknowledged that I am aware that an application without the supportive documents (mentioned above) will not be reviewed until all documents have been turned in. If documents are not submitted, the application will be denied after 30 days of submission and the family would have to reapply if they would like to continue in the program. *
Name of Applicant *
Your answer
Age *
Your answer
Gender *
Property address (Street number, City, State and zip code) *
Your answer
Household size (number of people living in the house) *
Your answer
Ages everyone living at home *
Your answer
Number of years living at this location? *
Your answer
Estimated annual income (household) *
Your answer
Preferred language *
Primary phone number we can each you at *
Your answer
Secondary phone number *
Your answer
Email address (if available)
Your answer
I (applicant) am the homeowner
Choose options that best represent you
Someone in the household is: *
Race: *
The following are general questions regarding the home (Please complete ALL sections to the best of your knowledge)
Does your home have flood insurance? *
Were you affected by the June 2018 flood? *
Did you apply with FEMA for June 2018 flood assistance? *
If yes, did you receive assistance from FEMA (2018)? *
Did you apply for FEMA this year (2019)? *
Did you get approved for assistance from FEMA this yr (2019)? *
Did you apply with Rio Grande Habitat for Humanity for disaster relief assistance for June 2018 floods? *
If yes, did you receive assistance from Rio Grande Habitat for Humanity for June 2018 floods? *
Try to answer the following questions to the best of your ability and knowledge.
Type of ownership: *
Type of foundation: *
Damage to: *
Required
Please provide a brief explanation of damage: *
Your answer
Please read the following section carefully
Acknowledgements / Disclaimers *
Yes
No
Due to the limited amount of funds available for the Helping Hand: Disaster Relief program, we cannot guarantee that all families who qualify will receive assitance
I/We are aware and willing to complete the assigned sweat equity hours designated to us by Rio Grande Habitat for Humanity (RG HFH).
I/We certify that the information on this application is true and accurate and that I/we live at the property at the address given on this application.
I/We certify that the material received must be used for our own Home Improvements and not be sold, transferred or used in trade
I/We agree to allow RG HFH to share photos of the applicant(s) and their homes and will be utilized for public relations, promotional and/or program developmental purposes.
I/We agree to allow RG HFH to share my application and information with other non-profit organizations, and/or Federal agencies (FEMA) for the purpose of additional assistance opportunities only.
I/We understand that the RG HFH is a nonprofit corporation with limited resources and cannot afford to provide or guarantee assistance for each applicant. Consequently, I/we agree that RG HFH, its staff, whether voluntary compensated, and its board of directors will not be liable in any way or otherwise be held responsible by me/us or anyone acting on my/our behalf in connection with my/our application for RG HFH or any claims of any nature associated herewith in.
Your acceptance into the program is based on the information contained in your application, as defined in Rio Grande Habitat for Humanity’s policy
I/We agree that inappropriate behavior, failure to complete task assigned by the Habitat team (sweat equity hours) and/or uncooperative/inappropriate behavior will be grounds for disqualification from our program.
Rio Grande Habitat for Humanity does not allow staff, volunteers, and/or subcontractors to receive monetary compensation and/or other type of gifts.
By checking the box below, you acknowledge to agree with the ten (10) terms outlined in the “Helping Hand Disaster Relief Program” Guidelines. *
Required
Applicant signature (print name will be considered as signature) *
Your answer
Homeowner's name if not the applicant & phone number
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Rio Grande Habitat for Humanity, Inc..