We May Be Able To Help You Rehab Your Home

Home Rehab

Application for Home Rehab

We are Here To Help!
Moriah McGill (707) 468-1336 Ext 112 Contact Moriah	Melodee Brusha (707) 468-1336 Ext 114 Contact Melodee

The Northern Circle Indian Housing Authority Board has established the following income limits to be eligible for our income based programs.
The following income limits are effective starting July 9, 2022.

The income limits are based on household annual income and the number of household members.

Household Members	Annual Income Limit
1 Person	$50,400
2 People	$57,600
3 People	$64,800
4 People	$72,000
5 People	$77,800
6 People	$83,600
7 People	$89,300
8 People	$95,100

Who Is Eligible

Homeowners who are an enrolled member of an NCIHA consortium tribe (membership verified).

You must be income-qualified to receive services (income is verified), and you must have a current home owner's insurance policy.
Click the "Income Limits" button to see the current income limits.

How do I apply

You can apply below using our web application or by downloading the application and submitting it to NCIHA manually

Home Owners Assistance Fund

Home owners who have been impacted by the Covid-19 pandemic may also be eligible for the Home Owner's Assistance Fund (HAF). Eligible home owners may get help covering mortgage or utility payments that are past due. They may also be eligible for minor rehab projects which affect their home's livability - HVAC repairs, accessibility concerns, water heater replacement, etc.

To apply for HAF assistance, click this box to be taken to the application page - be sure to check HAF from the list of programs.

NCIHA Rehab Application

1Applicant

2Household Members

3Eligibility Questions

4Current Housing

5Employment Income

6Other Income

7Applicant Certification

8HUD Authorization

9Proof of Ownership

10Application Review

Applicant Information

Applicant Name(Required)

Current Mailing Address(Required)

County(Required)

Please enter the County you currently reside in.

Phone Number

Please enter your best contact number.

Email Address

Tribal Affiliation(Required)

Select your tribal affiliations. You, or a family member in your household, must be a member of one of the NCIHA consortium tribes to be eligible for NCIHA services.

Family member who is a consortium Tribe member

If the applicant is not a member of the selected tribe, please select the household member who is a member.

Tribal Roll Number(Required)

Tribal Verification Signature(Required)

Please sign here to give your tribe authorization to verify your enrollment with Northern Circle.

Applicant's Information

Applicant Birthdate(Required)

Gender(Required)

Applicant Social Security #(Required)

Check all that apply

Veteran

Disabled

Handicapped

Student (12+ units at college or voc ed school)

Elderly (62 or older)

Employment Income

List the employer information for each family member employed.

Family Member Employed

Employer(Required)

Signature(Required)

Sign here to authorize your employer to release income information to NCIHA for the purpose of your application.

Social Security Number(Required)

Contact Person(Required)

Employer Phone Number(Required)

Employer Fax Number

Employer Email

Employer Address(Required)

Family Member Employed

Employer(Required)

Signature(Required)

Sign here to authorize your employer to release income information to NCIHA for the purpose of your application.

Social Security Number(Required)

Contact Person(Required)

Employer Phone Number(Required)

Employer Fax Number

Employer Email

Employer Address(Required)

Family Member Employed

Employer(Required)

Signature(Required)

Sign here to authorize your employer to release income information to NCIHA for the purpose of your application.

Social Security Number(Required)

Contact Person(Required)

Employer Phone Number(Required)

Employer Fax Number

Employer Email

Employer Address(Required)

Other Income

List other income sources which are not from work such as (but not limited to) CalWORKS/TANF, Social Security, Disability, Veteran's Benefits, etc.

Family Member Receiving Benefit

List the name of the person who receives the income, even if it is received for another person. For example, list the parent's name if the parent receives disability benefits for a minor child.

Agency Providing Benefit(Required)

Signature(Required)

Sign here to authorize the agency providing benefits to release income information to NCIHA for the purpose of your application.

Social Security Number(Required)

Contact/Case Worker(Required)

Agency Phone Number(Required)

Agency Fax Number

Agency/Contact Email

Agency Address(Required)

Family Member Receiving Benefit

List the name of the person who receives the income, even if it is received for another person. For example, list the parent's name if the parent receives disability benefits for a minor child.

Agency Providing Benefit(Required)

Signature(Required)

Sign here to authorize the agency providing benefits to release income information to NCIHA for the purpose of your application.

Social Security Number(Required)

Contact/Case Worker(Required)

Agency Phone Number(Required)

Agency Fax Number

Agency/Contact Email

Agency Address(Required)

Family Member Receiving Benefit

List the name of the person who receives the income, even if it is received for another person. For example, list the parent's name if the parent receives disability benefits for a minor child.

First Last

Agency Providing Benefit(Required)

Signature(Required)

Sign here to authorize the agency providing benefits to release income information to NCIHA for the purpose of your application.

Social Security Number(Required)

Contact/Case Worker(Required)

Agency Phone Number(Required)

Agency Fax Number

Agency/Contact Email

Agency Address(Required)

Applicant Certification and Acknowledgement

HOUSING REHAB APPLICANT CERTIFICATION

1. GIVING TRUE AND COMPLETE INFORMATION.

I certify all the information provided on this application is accurate and complete to the best of my knowledge. I have reviewed all applicable NCIHA forms and certify the information shown is correct.

2. REPORTING CHANGES IN INCOME OR HOUSEHOLD COMPOSITION

I understand I am required to report changes in income and any changes in the household size when a person moves in or out of the unit. I understand the rules regarding guests/visitors, and when I must report anyone who is stying with me.

3. REPORTING ON PRIOR HOUSING REHAB ASSISTANCE

I certify I have disclosed where and when I received any previous federal housing assistance and whether or not any money is owed. I certify that for this previous assistance I did not commit any fraud, knowingly misrepresent any information, or vacate the unit in violation of the lease.

4. NO DUPLICATE RESIDENCES OR ASSISTANCE

I certify the house or apartment will be my principle residence, and I will not obtain duplicate federal housing assistance while I am in this current program.

5. NO OWNERSHIP INTEREST IN ANOTHER HOME WHICH I COULD USE AS A RESIDENCE

I certify I do not own any interest in a house, condominium, cooperative, or building which I could use as a residence, and that I am currently in need of decent, safe, and sanitary housing. If I acquire an ownership interest in a residence while I am renting a house or apartment from NCIHA, I agree to notify NCIHA immediately. Further, I understand NCIHA may terminate my lease based on my ownership interest in a residence. I agree to vacate the house or apartment I am renting from NCIHA immediately if NCIHA terminates my lease because I have acquired an interest in a residence.

6. COOPERATION

I know I am required to cooperate in the supplying of all information needed to determine my eligibility, level of benefits, or verify my true circumstances. Cooperation includes attending pre-scheduled meetings and completing and signing needed forms. I understand failure, or refusal to do so, may result in delays, termination of assistance, or eviction.

7. CRIMINAL AND ADMINISTRATIVE ACTION FOR FALSE INFORMATION

I understand that knowingly supplying false, incomplete, or inaccurate information is punishable under federal or state criminal law. I understand that knowingly supplying false, incomplete, or inaccurate information is grounds for termination of housing assistance and/or termination of tenancy.

8. TRIBAL MEMBERSHIP

I certify that I, or a member of my household, is a current member of one of the NCIHA consortium tribes. If applying for on-site housing or Tribe specific assistance, I certify that I, or a member of my household, is a current member of the applicable Tribe.

9. NO OUTSTANDING DEBTS

I certify I do not have any outstanding debts with NCIHA or my Tribe. Any outstanding debts must be resolved before I am eligible for assistance with NCIHA.

CERTIFICATION OF APPLICANT FAMILY MEMBERS

All Adult (18 Years or Older) Members of Household Required to Sign Below

I certify I have read and understand the declarations listed above. I also certify the information I have provided is true to the best of my knowledge, and understand that any misrepresentations of information or false statements shall be grounds for termination of Lease/MHOA.

Applicant Signature(Required)