Seal of Dane County County of Dane
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Dane County Community Development Block Grant

Sub-Recipient Forms

When using these forms, please verify from your program specialist that you are using the most current version of each form.

Mortgage Reduction

Dane County Loan Eligibility Screening
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Homebuyer File Checklist
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2014 Dane County CDBG & HOME Assistance Eligibility
Dane County CDBG – HOME Borrower Affidavit
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Homebuyer Program Lead Compliance Document Checklist
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IDIS homebuyer setup and completion form
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Income and Asset Interview
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Lead Paint Screening Sheet
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Voluntary Acquisition
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Statement of Voluntary Sale
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Inspection Request Dane County CDBG
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Major Home Rehabilitation

Initial Request form
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Final Request form
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Dane County Prime Contractor and Subcontractors
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2014 Dane County HOME&CDBG Assistance- Loan Eligibility Screening
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Homeowner Rehab Setup and Completion form
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Lead Flowchart
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Income and Asset Interview
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Lead Paint Screening Sheet
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Notice of Presumption (sample)
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Lead Paint Rehab Screening Addendum
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Notice of Lead Hazard Reduction (sample)
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Notice of Lead Evaluation (sample)
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Post Construction Safe Work Practices Certification
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Minor Home Repair

Minor Home Repair Document Checklist
Lead Paint Screening Sheet
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Notice of Lead Evaluation (sample)
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Notice of Presumption (sample)
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Notice of Lead Hazard Reduction (sample)
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Lead Paint Rehabilitation Screening Addendum
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Rental

HOME Rental Project Compliance Report
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Public Services

Beneficiary Data Report
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Beneficiary Report- Head of Household
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CDBG Expense Report
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Public Facilities

Beneficiary Data Report
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Beneficiary Report- Head of Household
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CDBG Expense Report
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Employment & Contract Summary Report
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Checklist for CDBG-Funded Construction Projects over $2,000
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Microbusiness Assistance

Income Certification Form
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Beneficiary Data Reporting Form
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CDBG Expense Report
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