Residential Paint Grant Program Application


Paint Voucher Program 

 Property Owner’s Name _________________________________________________________________________________

Property Address _______________________________________________________________________________________


Mailing Address ________________________________________________________________________________________


Phone Number ________________________       Cell Number ________________________

E-mail Address __________________________________________________

Supporting Data Checklist must be included with application. Application will not be reviewed without all supporting data. 

Square footage of home __________________________________________

Estimate of Cost for Paint _________________________________________

Type of Paint __________________________       Colors of Paint ________________________________________________

Check one

_____  I will be doing the work.

_____  I will have a professional completing the work. (A written estimate is
            required with the cost of paint itemized from other costs).

Owner may only apply for one Paint Voucher

I hereby submit the grant application, color samples and estimate for the proposed project and understand the Zephyrhills 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.

Print Name

_________________________________________________     __________________________
Owner Signature                                                                             Date


Paint Voucher Program Supporting Data Checklist

Checklist must be submitted with application


_____   Provide samples of the three colors chosen: Body – Trim – Accent 

_____   Note on sample which is body color, trim color, and accent color. 

_____   Submit W-9 for tax purposes.

_____   Submit written estimate from painter of your choice, excluding labor and materials or written estimate of paint cost.

Attach Color Sample