Follow the steps to successfully fill out your application form.

1. Click 'Get Form' button to obtain the application form and access it within your preferred online document editor.
2. Begin by filling out your personal information in the designated fields. This includes your first name, middle initial, and last name. Make sure to provide your mailing address, city, state, and zip code accurately.
3. Provide the name of the property owner as recorded with the county and include your daytime phone number, email address, and the county in which your property is located.
4. List all individuals residing in the household, starting with yourself as the applicant. For each person, include their relationship to you, date of birth, and whether they receive income by answering 'Yes' or 'No' accordingly.
5. If there are additional household members, list their information on a separate sheet of paper and ensure it is attached along with this form.
6. Upload proof of income for all individuals earning income in the household. Acceptable documentation includes a 2017 tax return, pay stubs covering four consecutive weeks, statements from agencies for support benefits, or bank statements showing interest earned.
7. Address the section regarding your septic system by succinctly stating why you believe it is failing. Answer questions pertaining to the age of the system, occurrences of ponding sewage on your property, and any safety issues.
8. Provide permission for access to your property for all parties involved in the potential repair or replacement of your sewage system by selecting 'I agree' where stated.
9. Acknowledge your understanding of the terms regarding funding and the agreement to authorizations by selecting 'I understand' for each statement presented.
10. Sign and date the form to certify that the information provided is accurate and complete. Ensure your signature is clearly readable.
11. Once completed, save changes to your document. Choose to download, print, or share the application form as per your requirements.

Submit your application form online today to ensure timely processing!