Form Center

2. I own and occupy my home in Cass County.*

   1. Yes
   2. No
3. Proof of household income eligibility for all occupants over 18 years of age*

   1. Yes
   2. No
4. I have read the program guidelines.*

   1. Yes
   2. No
6. Applicant's Name*
8. Co-Applicant's Name
10. Address*
12. City*
13. State*
14. Zip Code
16. Phone Number*
17. Contact Method*

    1. Mobile

    1. Home
19. Email address*
21. Signature of Applicant*
22. Date
    Date
24. Signature of Co-Applicant
25. Date
    Date
29. What kind of work are you hoping to complete on your home?
33. Family Composition

    Please list everyone who live in your home. You will need to supply financial information for everyone who lives with you over the age of 18.

35. Name
36. Relationship
37. Age
39. Sex

    1. Male
    2. Female
40. Birthdate
    Birthdate
41. Legally Disabled/Handicapped

    1. Yes
    2. No
42. Student

    1. Yes
    2. No
46. Name
47. Relationship
48. Age
50. Sex

    1. Male
    2. Female
51. Birthdate
    Birthdate
52. Legally Disabled/Handicapped

    1. Yes
    2. No
53. Student

    1. Yes
    2. No
57. Name
58. Relationship
59. Age
61. Sex

    1. Male
    2. Female
62. Birthdate
    Birthdate
63. Legally Disabled/Handicapped

    1. Yes
    2. No
64. Student

    1. Yes
    2. No
68. Name
69. Relationship
70. Age
72. Sex

    1. Male
    2. Female
73. Birthdate
    Birthdate
74. Relationship
75. Age
79. Name
80. Relationship
81. Age
83. Sex

    1. Male
    2. Female
84. Birthdate
    Birthdate
85. Relationship
86. Age

88. In order to be considered, applicants must submit the following documents:

    • The deed to the home.
    • A paid mortgage statement.
    • A receipt showing taxes are paid.
    • A copy of paid home insurance.
    • Copy of the most recent year’s tax returns or W-2’s, pay stubs, etc.
    • Proof of child support received.
    • Proof of social security, disability or other income.

    These documents may be mailed or dropped off to

    Amanda Sleigh
    City of Dowagiac
    241 S. Front Street
    Dowagiac, MI 49047

    or scanned and emailed to acm@dowagiac.org

Leave This Blank:


90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit Submit and Print

* indicates a required field