Rhode Island Home Repair Program Intake Form

Rhode Island Home Repair Program - Intake Application

By submitting this form with basic information about your property, you will reserve a place in the intake queue. From that queue, PRF will contact you to begin income verification, which will determine your property's eligibility for a forgivable home repair loan. This program is funded by the State of Rhode Island through the 2024 Housing Bond. Para español, haga clic en la bandera en la esquina superior derecha.
If you need assistance filling this out or if you do not have an email address, call us at (401)272-2760 and dial 3 in the first menu.

During business hours, we may be available to fill out an application with you. If we are unable to answer at the time you call, leaving a voicemail in the appropriate mailbox will reserve your intake queue spot as if you submitted this form. However, we strongly encourage you to apply online if you are able.
Property Owner Name*

First NameLast Name
Homeowner Email*
For receiving updates, follow-up forms, and a copy of what you submit here.
Homeowner Phone Number*
Please enter a valid phone number at which we can reach you.
Is this a paper application or a phone application?

PaperPhone
Street Address*
Ex. 372 West Fountain St
Street Address 2
Ex. Unit 2, Apartment 3 - use homeowner's unit if applicable.
City / Town / Municipality*
ZIP Code*
If your mailing address typically uses a village name, you may enter it here.
Ex. Greenville, Rumford, Wyoming
In what city is the property?
Full Property Address

Street Address - Ex. 372 West Fountain St

Street Address Line 2

City - Use the municipality name, not a village name. Ex. Smithfield or North Kingstown, not Greenville or Wickford State / Province

Postal / Zip Code
Select the type(s) of repair work that your home needs.*

ChimneyDoorsElectricalEnergy Efficiency ImprovementsExterior - Trim, Porch, Siding, SoffitsExterior PaintingFoundationHeatingInterior SurfacesPlumbingRetaining WallRoof Repairs or ReplacementSmoke or CO DetectorsWindowsOther
(Optional) Give any additional description or contextual information for your property's necessary repairs.
Has your property been cited for a code violation that has not been resolved?

YesNo
Upload Code Violation - Optional

You are able to upload a copy of your code violation here, but this can also be collected later. If your property is eligible for this program, PRF will prioritize home repair work that resolves violations.
Cancelof
Property Type*

Single FamilyMulti Family
Does the owner live at this property?*

YesNo
Total number of residential units*
Including owner's unit, if owner lives on property. If you rent multiple rooms in a single unit, the rooms' occupants are counted as a single household within the unit.
Homeowner Mailing Address - If you do not live on the property in need of repairs

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Unit 1 - Please select the most accurate occupancy description

Owner OccupiedTenant OccupiedFamily Member Occupied - No Rent CollectedVacant
Unit 1 Monthly Rent
As per most recent lease agreement
Unit 2 - Please select the most accurate occupancy description

Owner OccupiedTenant OccupiedFamily Member Occupied - No Rent CollectedVacant
Unit 2 Monthly Rent
As per most recent lease agreement
Unit 3 - Please select the most accurate occupancy description

Owner OccupiedTenant OccupiedFamily Member Occupied - No Rent CollectedVacant
Unit 3 Monthly Rent
As per most recent lease agreement
Unit 4 - Please select the most accurate occupancy description

Owner OccupiedTenant OccupiedFamily Member Occupied - No Rent CollectedVacant
Unit 4 Monthly Rent
As per most recent lease agreement
In what year did you buy the property?
This property does not qualify for this home repair loan program.

This property has more than 4 units, which means it is not eligible for this program. You will not be able to submit this form, but if you are interested in assistance from other sources, you may use our contact form on our website, revolvingfund.org.
Owner's Estimated Annual Household Income
PRF will need documents to verify this income in the next stage of qualification, but an initial estimate can help us determine which program is right for this property.
Household Size*
Total number of people that live on the single-family property or people living in the property owner's unit. This information will be verified during income qualification.
Household income limit is {incomeLimit}

Because this property is in {city}, and its household size is {householdSize}, the annual household income limit to qualify for a forgivable loan is {incomeLimit}.

Household income is calculated using the gross / pre-deduction value of most income sources.
Check this box if your property is a part of a Homeowner Association (HOA), condo association, or managing organization.

An organization manages my property
Select all programs for which you have previously applied or been approved - this will not impact your eligibility, but PRF can coordinate with other agencies if needed.

CAPP Weatherization ProgramCAPP Lead Safe Providence ProgramCAPP Low Income Home Energy Assistance Program (LIHEAP)City of Providence Home Repair ProgramGHHI Healthy Providence ProgramHabitat for Humanity Home Modification Grant ProgramPrevious PRF Forgivable Home Repair Loan ProgramsRhode Island Livable Homes Modification Grant ProgramOther
Do you authorize Providence Revolving Fund to reach out to other agencies to supply income qualification information

YesNo
How did you hear about this program?
Ex. News coverage, social media, word of mouth, town or city hall, housing organization
Please check this box if someone other than the homeowner is filling out this form. They will be able to provide contact information in addition to the homeowner's.

I am not the homeowner
Name of Individual Assisting With Application
Relationship to Homeowner
Please describe how you are related. Ex. "He is my father" or "I am her grandson"
If PRF should contact this individual who is not the homeowner for the next phases of this program, enter their phone number here. (Optional)
Please enter a valid phone number.
If PRF should contact this individual who is not the homeowner for the next phases of this program, enter their email address here. (Optional)
If the homeowner does not have an email address, please put the assisting individual's email address in the "Homeowner Email" field earlier in this form.
Income Limit Calculation for Household and City
Language
Income Limit Area
Full address
What is your preferred communication method?
HOA
Once you submit this form, you will receive an email with a copy of the info you submitted. You will also receive an email from info@revolvingfund.org with details on the next phase of this program. If you don't see the email within 24 hours, make sure to check your spam folder.
Should be Empty:

Rhode Island Home Repair Program - Intake Application

If you need assistance filling this out or if you do not have an email address, call us at (401)272-2760 and dial 3 in the first menu.

This property does not qualify for this home repair loan program.