Bradford City Water Authority |
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Survey Information THIS INFORMATION IS STRICTLY CONFIDENTIAL AND WILL BE USED ONLY TO DETERMINE IF YOUR COMMUNITY IS ELIGIBLE FOR GRANT MONEY |
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2016 COMMUNITY
DEVELOPMENT BLOCK GRANT FEDERAL INCOME LIMITS: _____ Up to 12,100 _____ Up to 49,700 _____ Up to 32,200 _____ Up to 53,400 _____ Up to 36,800
_____ Up to 57,050 _____ Up to 41,400 _____ Up to 60,750 _____ Up to 46,000 _____ Over 60,750
SOURCE OF INCOME - PLEASE CHECK BELOW
MARITAL STATUS: _____Married _____Single _____Widowed _____Single
Parent FAMILY MINORITY STATUS: ______White _____Black _____American Indian _____Alaskan
Native _____Asian _____Hispanic Is Head of Household Female? _____YES _____ NO Is Head of Household Permanently Disabled? _____ YES _____ NO Do you own your Home? _____YES _____ NO If NO, Name of Owner/Landlord:____________________________________
ANNUAL
INCOME INCLUDES: 1. Gross wages before deductions of all adult
members of the households. 2. The
Net income from operation of a business or profession or from rental of real or personal
property. 3.
Interest and dividends. 4. Social
Security and pensions. 5.
Unemployment Compensation, Disability Compensation, Workmen's Compensation. 6. Public
Assistance. 7.
Alimony and child support. 1. Income from
dependent minors under age 18. Heads of
households and spouses may never be considered minors. 2. Income of full-time
students age 18 or older, who are not heads
of households or spouses. 3. One-time additions to family assets such as
inheritances, capital gains, settlement for personal or
property losses. |