Lead Hazard Control Program Form

The City of Warren’s Lead Hazard Control Grant allots up to $20,000 in federal grant funds toward identifying, addressing, and abating any lead-based paint hazards in homes that feature, for a significant amount of time, at least one child under 6. Homes with a pregnant woman may also qualify. By completing the following form, you agree to be added to the City of Warren’s waiting list for the Lead Hazard Control Grant, and you will be contacted by the City’s Community Development office for further processing. Please note that applicants and properties are subject to full income and qualification review; completing this form does NOT guarantee personal or property eligibility.

For more information on the Lead Hazard Control Grant, please call Community Development at (586) 574-4686.

Lead Hazard Control Program

Name(Required)

First Last

Phone(Required)

Email(Required)

Address (NOTE: all homes to be rehabilitated must be in Warren)(Required)

Street Address Address Line 2 City ZIP Code

Was your home built prior to 1978?(Required)

Yes

Not sure

Are there any children under 6 living in or spending significant time in your home?(Required)

Yes

Are there any pregnant women living in or spending significant time in your home?(Required)

Yes

Do you own or rent your home?(Required)

Own

Rent

How many people live in your home?(Required)

What is the estimated total household annual income for your household (please include income types for ALL household members over 17)?(Required)

How did you hear about this program?(Required)

CAPTCHA