General Instructions
  • Completing this survey is the first step in the application process.
  • Please provide as much information as possible.
  • Once you have submitted your survey, a case manager will review your responses and call you to discuss your next steps.
  • For help, please call us at 912-280-1999.
Thank you for your interest in the HRRP Program. We are currently awaiting clearance from the State before continuing to process new HRRP applicants.  Please enter your information in order to be notified if the Georgia Department of Community Affairs clears us for processing of additional HRRP applications. If you choose to submit your information, you will be notified if the HRRP program re-opens the application intake. This does not constitute a waiting list or any sort of prioritization, but all individuals who submit their information will be similarly notified of future opportunities.

Question Title

* TO BE COMPLETED BY APPLICANT: 

Last Name, First Name, and  Middle

Question Title

* Enter Current Address (Not Damaged Property Address)

Question Title

* Date of Birth (MM/DD/YYYY)

Question Title

* Gender

Question Title

* CO-APPLICANT Information: (If Applicable)

Relationship to Applicant

Question Title

* Last Name, First Name, and Middle

Question Title

* Date of Birth (MM/DD/YYYY)

Question Title

* Gender

Question Title

* ALTERNATE CONTACTS INFORMATION: 
This information is being collected to assist us in locating you if you move or are living temporarily in another location. You may also list a contact who is helping you through this process.

Question Title

* RACE & ETHNICITY FOR THE APPLICANT (Check one): 
This information is being collected to ensure compliance with the Federal Fair Housing and Equal Opportunity regulations.

Question Title

* ELIGIBILITY INFORMATION: 

Was your home damaged by Hurricane Irma?

Question Title

* At the time of the disaster, were you the owner of this residence?

Question Title

* Are you the current owner of the residence?

Question Title

* Program Eligibility Priorities:

What is your yearly Income?

Question Title

* Are you or a member of your household 62 years of age or older?

Question Title

* Do you or any member of your household have a disability?

Question Title

* Are there any children in the household under the age of 18?

Question Title

* PROPERTY INFORMATION:
Provide basic information concerning the damaged property (i.e. physical address of the damaged property, etc.)

Question Title

* Do you currently have homeowner’s insurance on the Damaged Property?

Question Title

Document Check List

<strong>Document Check List</strong>

Question Title

* How did you find out about this program? 
Please mark all that apply

T