Quote Tracking Sheet Assessment Form Completion Form Attachment a BÁÁHÁÁLÍ CHAPTER HOUSING MATERIAL ASSISTANCE COVER SHEET Name: Date: TRACKING NUMBER: APPLICATION DOCTOR’S STATEMENT NN VOTER REGISTRATION (If applicable) HOME SITE LEASE FAMILY INFORMATION MATERIAL LIST (CIB FOR ALL HOUSEHOLD MEMBERS) DOCUMENT CHECK BY: ADMINISTRATIVE ASSISTANT DATE BÁÁHÁÁLÍ CHAPTER ADMINISTRATIVE APPROVAL: APPROVED DISAPPROVED: REASON FOR DISAPPROVAL: APPROVED/DISAPPROVED BY: CHAPTER MANAGER DATE CLOSE OUT CHECKLIST Weatherization Repairs Type of Assistance Addition New Construction (1) (2) (3) Quotations PEP Request Yes No Date: Assessment Form Initials: Date: Pictures No of Pictures: Fund Approval Packet Vendor: Date of Check: Receipt of Purchase Date: Match?: Completion Form Date: Initials:
Quote Tracking Sheet Assessment Form Completion Form Attachment a BÁÁHÁÁLÍ CHAPTER HOUSING MATERIAL ASSISTANCE COVER SHEET Name: Date: TRACKING NUMBER: APPLICATION NN VOTER REGISTRATION HOME SITE LEASE MATERIAL LIST DOCTOR’S STATEMENT (If applicable) FAMILY INFORMATION (CIB FOR ALL HOUSEHOLD MEMBERS) DOCUMENT CHECK BY: ADMINISTRATIVE ASSISTANT DATE BÁÁHÁÁLÍ CHAPTER ADMINISTRATIVE APPROVAL: APPROVED DISAPPROVED: REASON FOR DISAPPROVAL: APPROVED/DISAPPROVED BY: CHAPTER MANAGER DATE CLOSE OUT CHECKLIST Type of Assistance Weatherization Repairs Addition New Construction Quotations (1) (2) (3) PEP Request Yes No Assessment Form Date: Initials: Pictures Date: No of Pictures: Fund Approval Packet Vendor: Date of Check: Receipt of Purchase Date: Match?: Completion Form Date: Initials: