Existing entities who provide housing designed specifically for older adults and people with disabilities
- Award amount requested (Dollar amount)
- Matching funds committed (Dollar amount)
A one-to-one match is required. Match must be in the form of equity from developer, cash contribution, third party grants or the sale of tax credits, or debt from a third party secured by the property or assets of the developer. No in-kind match is allowed. Applicants are expected to have some personal equity contributions beyond 3rd party contributions.
- Number of units for proposed construction or affected by renovation
- Property name and address
- Property owner and contact information
- Project manager and contact information
- SAM.gov entity registration and UEI number
- Project description and scope
Project Description and Scope
Provide a detailed description of applying organization, type of housing to be provided, any applicable licensure requirements and current status of licensing (attach copy of license). Projects can be renovation, new construction or acquisition with major rehabilitation. In order to qualify as major rehabilitation at least one half of the total development budget must be for rehabilitation and major components must be replaced including but not limited to roofs, siding, doors & windows, bathroom equipment and accessibility improvements. Include the current condition or use of the property, as well as the intended use. Please include demographic information related to employees, residents (describe population to be housed and any requirements for residency), and visitors anticipated to be served by the capital project. Other information can include market studies and senior debt financing commitments.
Project funding need
Provide reasoning as to why the grant is being requested and what other sources and amounts of funding have been pursued for this project. Include any pending funds or funds that are to be applied for in the next 12 months. Also include the impact of the project compared to the need of the community.
Project budget and narrative
Provide a detailed budget with expected expenditures required for the success of the project. You can also include owner equity & other 3rd party equity contributions and total development cost, as well as any local incentives provided.
Proof of matching funds
You must provide written proof that all matching funds are available at the time of application submission. This application cannot leverage these program funds with any BASE or state ARPA funds. Local ARPA funds may be leveraged with this program. These matching funds must also be documented in your Project Budget and Narrative.
Provide details on the timeframe for completion of the project with the funds awarded. All projects must be completed by March 31, 2025.
Project bids and estimates
Attach any bids or estimates you have received for your Project. Please attach any architectural or engineering reports that are relevant for your Project.
Attach any relevant photographs of the proposed project site.
Project five-year expense and proforma
Provide expenses and incomes for the five years of the project following the completion of the use of all granted funds.
Three letters of support
Letters of support should come from local or county governments, community foundations, senior citizen groups or centers, or other interested parties.
IRS Form W-9
Risk assessment questions