HANDS OF CENTRAL FLORIDA - HOUSING COUNSELING ORLANDO

Pre-Screening Eligibility Survey

Please complete the following and if eligible, you will be provided the link to the application:

Is your home in Polk County?:

Yes No

Is your home in the city of Lakeland?

Yes No

(due to City of Lakeland CDBG funding contact: homes@cflhands.org for this program)

Is your name on the mortgage?

Yes No

Is this home your principal place of residence?

Yes No

Are you currently past due on your mortgage?

Yes No

Your Total Household income (for all persons over the age of 18) does not exceed 80% of median income. (Income will be verified)

Yes No

Click here for more details

Total Household income

Income includes: employment, unemployment, social security, disability and retirement income, rental income, child support and alimony, etc. Using the chart below. Read down to find the number of persons in your household, then across for the Max income your household could be earning to be eligible for this program. (Example: If my family was of 4, my total household income could not exceed $67,500 per the chart below.)

Local Housing Assistance Income Schedule 2022

Percent of Median Income	Low Income 80%
1	$47,300
2	$54,000
3	$60,800
4	$67,500
5	$72,900
6	$78,300
7	$83,700
8	$89,100

You have documentable information to evidence loss of income, reduction in hours or unemployment as a DIRECT RESULT of the COVID-19 pandemic

Yes No

You have a valid Florida Photo ID or Florida Driver’s License and can provide evidence

Yes No

You have a Social Security number and can provide evidence of

Yes No

You can provide your mortgage statement

Yes No

You can provide a recent utility bill in your name (water, electric)

Yes No

What was the date of your last missed mortgage payment?

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Polk County Mortgage Assistance Program

Pre-Screening Eligibility Survey

Please complete the following and if eligible, you will be provided the link to the application: