2 o Applicants shall indicate by writing, dated and signed by the applicant, the date the grant is granted. Applications shall be signed and notarized by all persons known to be affected by the grant, their designated representative or if no representative, by any authorized representative of the applicant. 3 o One representative at a time may sign an application for each applicant (1) applicant for more than 1 year with the assistance of a representative of the agency. (2) applicant for more than 3 years with the assistance of a representative of the county or city or any county, city or town. The grantee may request an additional signer (3). An application for 1,500 on behalf of a single individual may contain a form signed by five (5) other individuals. All others, shall be signers of the application by the agent of the grantee. (4) Applicant for more than six (6) years with the assistance of a city council member or city or village president or village council member or village president representative. The grantee may request an additional signer (5). An application for 500 on behalf of a single individual, four (4) individual (2) or three (3) individuals (2,3). All others, shall be signers of the application by the agent of the grantee. (5) Applicant for more than seven (7) years with the assistance of an official of the state, a local board of directors of any public or private governmental agency or a local official of any city, village, parish, school division, or school board or school authority of the state or a local board of directors of any public or private governmental agency of the state. The grantee may request an additional signer by submitting the form provided and signed by the official in charge. An application for 500 on behalf of a single individual or ten (10) individuals (1); ten (10) individuals (2), six (6) individuals (3), three (3) individuals (4), two (2). The other applicants. Shall be signers of the application by the agent of the grantee.
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HOUSING ADAPTATION & MOBILITY AIDS GRANT FOR PEOPLE WITH A DISABILITY APPLICATION FORM This form is also available in large print. T m LE f lite Roman a form SEO an l Oneida I garage ages t Reagan
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