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2. Paint Voucher Program Application
4. Property Owner's Name
6. Property Address
8. Mailing Address
10. Phone Number
11. Cell Phone Number
12. Email Address
14. Supporting Data Checklist must be included with the application.
    The application will not be reviewed without all supporting data.
16. Square Footage of Home
17. Estimate of Cost for Paint
19. Type of Paint
20. Color(s) of Paint
22. Body Color Sample
23. Trim Color Sample
24. Accent Color Sample
26. Work Will Be Done By:

    If a professional is completing the work a written estimate is required with the cost of paint itemized from other costs.

    1. I will be doing the work.
    2. I will have a professional completing the work.
27. Written Estimate
29. An Owner may only apply for one Paint Voucher
31. Signature & Agreement
    I hereby submit the grant application, color samples and estimate for the proposed project and understand the Zephyrhills Community Redevelopment Agency (CRA) Board must grant approval. No work shall begin and funding is not guaranteed until the CRA Board approves completed application and written approval is received. I agree to place a CRA Grant sign for the duration of the project and agree to return the sign. I further understand that the project must be completed within 6 months from date written approval is received and the reimbursement will not be paid until the project is completed. I agree to leave the completed project in its approved colors for a period of 2 years from the date of completion. I also understand a W-9 is required for tax purposes.
33. Electronic Signature
34. Date
    Date
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field